As the Covid-19 spreads across Afghanistan, Integrity Watch’s provincial office in Balkh expanded its Community Based Monitoring (CBM) work from 10 health facilities to 25 facilities.
Early monitoring data shows that 13 out of 25 health centers in the province are running short of medicines, and some of the drugs distributed by the health department are expiring in about two months.
Poor management has been identified as another major problem. The lack of a regular queuing system for patients and not enforcing social distancing in at least six health centers has increased the risk for the clients to contract the virus.
In addition, 11 health centers are short of basic safety equipment such as masks, gloves, and disinfectants. These materials, some of which have been distributed in some centers, are not provided in sufficient numbers and therefore most of the health personnel have to buy them from their own money or remain at high risk.
In some health centers, mistreatment of the clients has been reported. In addition, some health centers have been reported to collect illegal payments from the clients such as in Dehdadi District’s 50-bed hospital where the hospital charges more than 50 Afghanis for vaccinating new born babies.
Local volunteers working closely with Health Shuras (councils) shared the identified issues with the management of the health centers. They have reported some improvement in health workers’ behavior, establishment of a queuing system, and improved hygiene and cleanliness of the health facilities. Integrity Watch is assisting the representatives to report the findings of the monitoring to the Department of Public Health in the province for further improvement. However, the department has not been very responsive as there are no formal mechanisms in place to make the department accountable to the local communities. Integrity Watch plans to take this issue to the national level for a policy change.
CBM-Health is the first initiative of its kind in the province that allows local representatives to monitor health services, enter a dialogue with local health officials, and feed data into the national level advocacy of Integrity Watch to improve delivery and management of health services across the county.