R4D Afghanistan

FHS Inception Phase Report

Fri, 11 May 2012 08:31 GMT

Document Type: Report

Production Year: 2011

Citation: Anon. FHS Inception Phase Report. (2011) 16 pp.

Summary: The Inception Phase for the second phase of the Future Health Systems Research Program Consortium lasted from January-August 2011. This report summarizes the progress made during that time and lays out a plan of action for the next five years of work. In particular, the report summarizes progress made on research (including different analytical frameworks, themes and methodologies), management, capacity development, policy influence and research uptake and monitoring and evaluation of the program.

Association between health workforce capacity and quality of care for children under five in Afghanistan

Fri, 11 May 2012 06:53 GMT

Document Type: Conference Paper
Creator: Edward, A.; Kumar, B.; Niayash, H.; Peters, D.H.; Burnham, G.

Production Year: 2011

Citation: Edward, A.; Kumar, B.; Niayash, H.; Peters, D.H.; Burnham, G. Association between health workforce capacity and quality of care for children under five in Afghanistan. Presented at 28th ISQua Conference, Hong Kong. (2011) 5 pp.

Summary: Objective: To determine the association between health workforce capacity and quality of care in primary care facilities providing a basic package of health services (BPHS) in Afghanistan.

Methods: Since 2004, annual performance assessments were conducted nationally in >600 health facilities including district hospitals, on a sample of >2300 patients under five years, and >1300 health providers selected by stratified random sampling. The assessments included health system capacity measures for provider adequacy, knowledge and training, infrastructure, essential medicines, equipment and availability of clinical guidelines. Quality of care was defined as adherence to the WHO Integrated Management of Childhood Illness (IMCI) clinical guidelines. The findings presented in this study include data from 2005 to 2008.

Results: There was a progressive increase in workforce capacity over the study period, as more health facilities adhered to the BPHS standards for provider staffing Basic Health Centres 75.9% to 85.4% (p<0.001), Comprehensive Health Centres 27.4% to 37.6% (p< 0.03) and District Hospitals (33.3% to 38.1%). Quality of patient assessment and counselling improved significantly for all IMCI index indicators between 2005 and 2008, except for assessment of diarrhoeal symptoms. Health facilities with adequate staffing capacity had significantly higher adherence to IMCI clinical standards of care for years 2006, 2007, and 2008. Other variables significantly associated with quality of care were provider cadre, provider gender, age of child, caretaker gender, consultation time, provider knowledge and satisfaction, and availability of clinical guidelines. High patient volume was also significantly associated with better quality of care in 2005 and 2008.

Conclusions: Investments for enhancing the capacity and quality for health service delivery in Afghanistan have illustrated improved health system performance trends measured by the balanced score card since the inception of the basic package of health services. However, severe deficits in professional workforce, particularly in remote and unsecure areas, and the acceleration of internal and external migration, pose enormous challenges to sustaining the gains achieved in service quality and coverage. Aside from ensuring adequacy of the workforce, appropriate investments are required to improve opportunities for professional development and capacity-building, to ensure the competency and satisfaction of health providers delivering care in insecure and complex healthcare environments.

The media of Afghanistan: The challenges of transition. Policy Briefing No. 5.

Tue, 10 Apr 2012 07:33 GMT

Document Type: Briefing
Creator: Page, D.; Siddiqi, S.

Production Year: 2012

Citation: Page, D.; Siddiqi, S. The media of Afghanistan: The challenges of transition. Policy Briefing No. 5. BBC Media Action, London, UK (2012) 28 pp.

Summary: The media of Afghanistan, like all other sections of Afghanistan society, is undergoing transition. This briefing examines what transition might mean for a sector that has the potential to shape Afghan opinion and hold government to account but now faces considerable uncertainty. It comprises 6 parts:
Part 1 provides a brief overview of how Afghanistan’s media landscape has been transformed over the past decade.
Part 2 examines the effects of this transformation on Afghanistan’s culture and politics as media reflect the struggle between tradition and modernity.
Part 3 looks at the status and pressures facing journalism in the country.
Part 4 examines the role of donors in support to the Afghan media and the implications of a reduction in such support.
Part 5 examines the shortage of independent national media and the challenges faced by Radio Television Afghanistan (RTA).
Part 6 looks to the future and provides some conclusions drawn from the analysis.

Social accountability in situations of conflict and fragility

Tue, 20 Mar 2012 05:42 GMT

Document Type: Briefing
Creator: Schouten, C.

Production Year: 2011

Citation: Schouten, C. Social accountability in situations of conflict and fragility. U4 Anti-Corruption Resource Centre, CMI, Bergen, Norway (2011) 4 pp. [U4 Brief, December 2011, No 19]

Summary: Donor support to social accountability in fragile and conflict-affected states is a relatively new phenomenon. It has emerged with the lessons that top-down anti-corruption approaches have often failed and different approaches are needed to improve state accountability to its people. With increasing support to fragile and conflict-affected states, donors should focus their efforts to: identify and support local accountability measures; strengthen partnerships across sectors, as well as demographic and geographic divides; and support collaborative governance and capacity building to strengthen the social contract between state and society in the wake of crisis.

Afghan values or women’s rights? Gendered narratives about continuity and change in urban Afghanistan

Fri, 02 Mar 2012 10:21 GMT

Document Type: Working Paper
Creator: Kabeer, N.; Khan, A.; Adlparvar, N.

Production Year: 2011

Citation: Kabeer, N.; Khan, A.; Adlparvar, N. Afghan values or women’s rights? Gendered narratives about continuity and change in urban Afghanistan. IDS Working Paper No. 387. Institute of Development Studies, Brighton, UK (2011)

Summary: There is considerable debate about the extent to which gender equality and womens’ rights are universal values. This debate has been particularly heated in Afghanistan where the violation of women’s rights by the Taliban regime was one justification used by the US and its allies for their invasion of the country. There is, however, very little research on how ordinary Afghan women view their lives and their place within a highly patriarchal society and how their views might fit into these debates. This paper explores these issues using in-depth qualitative interviews with 12 Hazara women and their husbands in Kabul. These women are all associates of microfinance organisations and the paper also explores the extent to which access to microfinance has contributed to changes in their attitudes and relationships with others in their families and communities. The paper finds that microfinance is only one of the many changes that these women and their families have experienced in the course of their lives. While many of these changes have been extremely traumatic, they have also expanded women’s horizons, opening up the possibility of new ways of organising gender relations within the family and community. The paper concludes that while the Afghan women in the study may not espouse the idea of individual rights, they would like to see a fairer gender distribution of rights and responsibilities.

Governance, Security and Justice in Fragile Conflict Affected Situations (JRSP)

Tue, 31 Jan 2012 09:26 GMT

Project Status: Current

Project Objectives:

During its inception year, the consortium will produce a number of evidence papers to provide a basis for a defined programme of future research. A series of stakeholder consultations will also take place during 2011 with the objective of establishing a baseline of data that identifies critical gaps in the literature and assesses how stakeholders prioritise research needs. The JSRP aims to think creatively about the interface of research, policy and stakeholders and will approach its research from the perspective of those who live in conflict-affected situations and who are the supposed end-users of good governance policies. The way in which these end-users seek to provide justice and security is often achieved by methods that are outside - but not disconnected from - state level government and these have been termed hybrid governance structures.

The JSRP seeks to provide a better understanding of the relationship between 'official' and 'hybrid' structures and to address such questions as:

How do hybrid governance structures manifest themselves, change and develop in what are generally considered to be 'fragile' states?
What policy responses will support hybrid governance structures that are developmental and oriented towards poverty reduction?
What policies have been shown to have an adverse impact on the end-user?

Research during the operational phase of the programme aims to use a wide range of methodology including:

local-level ethnographic research of 'vernacular' poltiics
quantitative analysis of conflict and hybrid politics and the creation of new datasets
the use of new approaches such as crowd-sourcing and web-crawling
video documentation, cartoon commentaries and artistic storytelling

The consortium will undertake research in several regions, including in the following countries : Sudan, DRCongo, Uganda, Somalia, Ethiopia, CAR, former Yugoslavia, and Afghanistan and its neighbours.

Secure Livelihoods Research Consortium. Researching livelihoods and services affected by conflict.

Wed, 25 Jan 2012 06:52 GMT

Document Type: Document

Production Year: 2011

Citation: Anon. Secure Livelihoods Research Consortium. Researching livelihoods and services affected by conflict. ODI, London, UK (2011) 4 pp.

Summary: This leaflet provides background information about the Secure Livelihoods Research Consortium (SLRC). The SLRC aims to provide a stronger evidence base about how people make a living, educate their children, deal with illness and access other basic services in conflict affected situations (CAS). Providing better access to basic services, social protection and support to livelihoods matters for the human welfare of people affected by conflict, the achievement of development targets, such as the MDGs, and international efforts at peace and state building.

Secure Livelihoods Research Consortium (SLRC)

Wed, 25 Jan 2012 05:47 GMT

Project Status: Current
Project Background:

This programme builds on previous DFID research and bridge the gaps in knowledge about:

When it is appropriate to try and build secure livelihoods in conflict-affected situations (CAS) in addition to meeting immediate acute needs;
What building blocks (e.g. humanitarian assistance, social protection, agriculture and basic services – including water, health, education and support to market institutions and infrastructure) are required in different contexts;
Who can best deliver building blocks to secure livelihoods in different contexts; and
How key investments can be better and more predictably supported by effective financing mechanisms.

The research will focus on three interlinked thematic areas and one crosscutting area:
Theme I: People’s and community responses
Theme II: Governance of state institutions, policies and interventions
Theme III: Aid – roles of aid agencies and non-state actors
Theme IV: Cross-cutting – Building blocks for livelihoods, basic services and social protection

Project Objectives: The Secure Livelihoods Research Consortium (SLRC) aims to provide a stronger evidence base about how people make a living, educate their children, deal with illness and access other basic services in conflict affected situations (CAS). Providing better access to basic services, social protection and support to livelihoods matters for the human welfare of people affected by conflict, the achievement of development targets, such as the MDGs, and international efforts at peace and state building.

Pathways Synthesis Report. Empowerment: a journey not a destination

Fri, 13 Jan 2012 09:43 GMT

Document Type: Report

Production Year: 2011

Citation: Anon. Pathways Synthesis Report. Empowerment: a journey not a destination. Pathways of Women's Empowerment, Brighton, UK (2011) 56 pp.

Summary: This Pathways synthesis report presents the findings and key messages from research from 59 projects in 15 countries carried out over 5 years. The key findings were:
1. What is empowering to one woman is not necessarily empowering to another. 2. Women’s ability to exercise voice and strategic forms of control over their lives is linked to being able to generate regular and independent sources of income. 3. Relationships lie at the heart of women’s empowerment. 4. Sexuality is a vital but neglected dimension of women’s empowerment. 5. Understanding women’s empowerment calls for rigorous and imaginative combinations of research methodologies and methods. 6. Efforts to promote women’s empowerment need to do more than give individual women economic or political opportunities. 7. Policies and laws that affirm women’s rights and open up pathways for women’s empowerment are critically important. 8. Women’s organising is vital for sustainable change. 9. There is no one-size-fits-all approach to women’s empowerment. 10. Fostering public engagement and debate is essential to making policies that work for women’s empowerment and gender equality. 11. Recognising and supporting those within the state who are responsible for the implementation of women’s empowerment interventions is crucial. 12. Changing attitudes and values is as important to bringing about women’s empowerment.

FHS Podcast 2: A visit to Kabul

Fri, 13 Jan 2012 04:40 GMT

Document Type: Web Content
Creator: Agarwal, A.; Knezovich, J.; Osei-Bosnu, K.; Roach, M.

Production Year: 2011

Citation: Agarwal, A.; Knezovich, J.; Osei-Bosnu, K.; Roach, M. FHS Podcast 2: A visit to Kabul, Play time 20:23 (2011)

Summary: In the second podcast from Future Health Systems, Jeff Knezovich visits the FHS Afghanistan team in Kabul to find out what sort of research they're currently undertaking, what challenges they face in attempting research in an insecure environment, and what it's like living and working in difficult security situations. He interviews Kojo, Melissa Roach and Anubhav Agarwal, who tell him about the community scorecard that FHS is in the process of piloting in several provinces in Afghanistan.