System Enhancement for Health Action in Transition (SEHAT) Public Nutrition Department Nutrition Cluster February 5,

Outline 1. Background 2. Project Design 3. Objectives and scope 4. Components and coverage 5. Implementation modalities 6. Financing Resources 2

Context/background  SEHAT builds on ten years of successful health sector development experience in Afghanistan  Emergency health project (~$120M IDA)  SHARP (~$156M IDA/ARTF)  Remarkable output/outcome level achievements 3

Project Design Process  Project design team within the MOPH led by DM Policy and Plan and participation of GDs  NPP and MOPH Strategic Plan formed the basis of program design  Lessons learned from previous projects incorporated in the design 4

SEHAT development objective to expand the scope, quality and coverage of health services provided to the population, particularly to the poor, in the project areas, and to enhance the stewardship functions of the Ministry of Public Health

SEHAT components  Component 1: Sustaining and improving BPHS and EPHS services (US$307 million)  Component 2: Building the stewardship capacity of MOPH and system development ( US$90 million)  Component 3: Strengthening program management (US$10 million) 6

Component 1: BPHS and EPHS  Contracting Out (PPA) and contracting In (SM) to increase coverage and improve quality of BPHS and EPHS  Training of community midwife and community nurse  Others (HIV, Nomad, prisoners, RBF) 7

Component 2: system development  Strengthening sub- national government for health  Strengthening Healthcare Financing  Developing Regulatory Systems and Capacities for Ensuring Quality Pharmaceuticals  Working with the Private Sector  Enhancing Capacity for Improved Hospital Performance  8

Component 2: system development  Strengthening Human Resources for Health  Strengthening Health Promotion and Behavioral Change  Strengthening Health Information System and Use of Information Technology  Improving Fiduciary Systems 9

Component 3: Strengthening program management  finance incremental operating costs of MOPH at the central and provincial level  support and finance short term technical assistance in specific areas  Coordinate with CBR 10

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Implementation modalities  Contracting out and contracting in  All MOPH department involved  Systems developments  Sub-national (Provincial budgeting)  Analytical work on National Hospitals  Measurement of results through internal/external evaluation system 12

SEHAT Financing Sources IDA -> $100 million ARTF -> $270 million GOIRA -> $ 30 million HRITF -> $ 7 million 13

Thank you! 14