The Balanced Scorecard Report - Royal Tropical …

The Balanced

Scorecard Report

Basic Package of Health Services 2018

November 2018

CONTENTS

CONTENTS ....................................................................................................................................i

ABBREVIATIONS ........................................................................................................................ v

DEFINITION OF COMMON TERMS USED IN BSC .........................................................vi

HOW TO READ THE BSC EXPLAINED IN LAY LANGUAGE ...................................... viii

EXECUTIVE SUMMARY ............................................................................................................ix

BACKGROUND ............................................................................................................................ 1

METHODOLOGY .......................................................................................................................... 5

Sampling Frame ..................................................................................................................... 5

Data Collection and Quality Assurance ......................................................................... 6

Revisions to BPHS Balanced Scorecard Over Time .................................................. 7

Description of domains, instruments, scoring ........................................................... 7

Ethical approval ................................................................................................................... 10

NATIONAL RESULTS ............................................................................................................... 11

Afghanistan Health Sector BPHS Balanced Scorecard 2018 - National

Medians ................................................................................................................................... 11

Afghanistan Health Sector BPHS Balanced Score Card 2018 by Province ... 17

NATIONAL LEVEL FINDINGS ............................................................................................... 20

Domain A: Client and Community ................................................................................ 20

Indicator 1: Overall Client Satisfaction and Perceived Quality of Care Index ................ 21

Indicator 2: Community Involvement and Decision Making Index .............................. 23

Indicator 3: Health Post Status Index..................................................................... 24

Domain B: Human Resources ........................................................................................ 25

Indicator 4: Revised Health Worker Satisfaction Index ............................................. 26

Indicator 5: Health Worker Motivation Index ........................................................... 27

Indicator 6: Salary Payment Current ...................................................................... 28

Indicator 7: Revised Staffing Index ........................................................................ 29

Indicator 8: Provider Knowledge Score ................................................................... 30

Indicator 9: Revised Staff Training Score ................................................................ 31

Domain C: Physical capacity ........................................................................................... 32

Indicator 10: Equipment Functionality Index ........................................................... 33

Indicator 11: Pharmaceutical and Vaccines Availability Index .................................... 34

Indicator 12: Laboratory Functionality Index ........................................................... 35

Indicator 13: Clinical Guidelines Index ................................................................... 36

i

Indicator 14: Infrastructure Index ......................................................................... 37

Domain D: Quality of service provision ...................................................................... 38

Indicator 15: Client Background and Physical Assessment ........................................ 39

Indicator 16: Client Counselling Index .................................................................... 40

Indicator 17: Universal Precautions........................................................................ 41

Indicator 18: Time Spent with Clients .................................................................... 42

Domain E: Management systems ................................................................................. 43

Indicator 19: Revised HMIS Use Index ................................................................... 44

Indicator 20: Financial System Index ..................................................................... 45

Indicator 21: Health Facility Management Functionality Index ................................... 46

Indicator 22: New Outpatient Visit Concentration Index ........................................... 48

Indicator 23: Client Satisfaction Concentration Index ............................................... 49

Recommendations at the National Level ................................................................... 50

Sensitivity analysis ............................................................................................................. 51

PROVINCIAL LEVEL FINDINGS ........................................................................................... 54

BADAKSHAN PROVINCE FINDINGS.............................................................................. 56

BADGHIS PROVINCE FINDINGS .................................................................................... 58

BAGHLAN PROVINCE FINDINGS.................................................................................... 60

BALKH PROVINCE FINDINGS.......................................................................................... 62

BAMYAN PROVINCE FINDINGS ...................................................................................... 64

DAYKUNDI PROVINCE FINDINGS ................................................................................. 66

FARAH PROVINCE FINDINGS.......................................................................................... 68

FARYAB PROVINCE FINDINGS ....................................................................................... 70

GHAZNI PROVINCE FINDINGS ....................................................................................... 72

GHOR PROVINCE FINDINGS ........................................................................................... 74

HELMAND PROVINCE FINDINGS ................................................................................... 76

HERAT PROVINCE FINDINGS.......................................................................................... 79

JAWZJAN PROVINCE FINDINGS .................................................................................... 81

KABUL PROVINCE FINDINGS.......................................................................................... 83

KANDAHAR PROVINCE FINDINGS ................................................................................ 85

KAPISA PROVINCE FINDINGS ........................................................................................ 87

KHOST PROVINCE FINDINGS ......................................................................................... 89

KUNAR PROVINCE FINDINGS ......................................................................................... 91

KUNDUZ PROVINCE FINDINGS...................................................................................... 93

ii

LAGHMAN PROVINCE FINDINGS ................................................................................... 95

LOGAR PROVINCE FINDINGS ......................................................................................... 97

NANGARHAR PROVINCE FINDINGS ............................................................................. 99

NIMROZ PROVINCE FINDINGS .................................................................................... 101

NURISTAN PROVINCE FINDINGS ................................................................................ 103

PAKTIKA PROVINCE FINDINGS.................................................................................... 105

PAKTIYA PROVINCE FINDINGS .................................................................................... 108

PANJSHIR PROVINCE FINDINGS ................................................................................. 110

PARWAN PROVINCE FINDINGS ................................................................................... 112

SAMANGAN PROVINCE FINDINGS .............................................................................. 114

SARIPUL PROVINCE FINDINGS.................................................................................... 116

TAKHAR PROVINCE FINDINGS..................................................................................... 118

URUZGAN PROVINCE FINDINGS ................................................................................. 120

WARDAK PROVINCE FINDINGS ................................................................................... 122

ZABUL PROVINCE FINDINGS ........................................................................................ 124

APPENDIX I: NATIONAL HEALTH SERVICES PERFORMANCE ASSESSMENT

SAMPLING FRAME, 2004 ¨C 2018 ..................................................................................... 125

APPENDIX II: NUMBER OF CHWS INTERVIEWED, 2004 ¨C 2018 ........................ 127

APPENDIX III: BASIC PACKAGE OF HEALTH SERVICES SAMPLE, 2018.......... 128

APPENDIX IV: COMPARISON OF BPHS BALANCED SCORECARD INDICATORS

USED IN 2004 TO 2013 WITH INDICATORS USED SINCE 2011/12 ................. 130

APPENDIX V: LIST OF ITEMS INCLUDED IN EACH INDICATOR FOR THE 2018

BPHS BALANCED SCORECARD ......................................................................................... 132

APPENDIX VI: CHANGE IN RANK ORDER OF PROVINCES BETWEEN 2017 AND

2018, ON THE BASIS OF OVERALL MEAN SCORE .................................................... 140

APPENDIX VII: NUTRITION COUNSELLING, NUTRITION KNOWLEDGE, HIV

KNOWLEDGE, HIV ATTITUDE AND HEALTHCARE WASTE MANAGEMENT

WEIGHTED SCORES ............................................................................................................. 141

APPENDIX VIII: CLUSTERWISE BPHS BSC TABLES FOR PROVINCES DIVIDED

INTO CLUSTERS..................................................................................................................... 143

APPENDIX IX CONFIDENCE INTERVALS....................................................................... 148

APPENDIX X RESULTS PER PROVINCE BEFORE 2011/2012 ................................ 169

APPENDIX XI NATIONAL RESULTS BEFORE 2011/2012 ........................................ 204

APPENDIX XII SENSITIVITY ANALYSIS: NATIONAL MEDIANS EXCLUDING

PANJSHIR, PARWAN AND KAPISA PROVINCES ......................................................... 206

APPENDIX XIII SENSITIVITY ANALYSIS: PROVINCIAL RESULTS EXCLUDING

REPLACEMENT FACILITIES ................................................................................................ 208

iii

APPENDIX XIV REPLACEMENT OF HEALTH FACILITIES BY PROVINCE ............ 211

APPENDIX XV PHARMACEUTICALS AND VACCINES AVAILABILITY INDEX ......... 212

APPENDIX XIV BPHS INDICATORS MAPS.......................................................................... 213

REFERENCES: ......................................................................................................................... 214

iv

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download