• South Asia

South Asia

The Ministry of Public Health in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health care settings, this represents the first time that the BSC has been employed in a developing country. This paper from The World Health Organization describes how the BSC for health services in Afghanistan was created, how it is used and the first results of the BSC in 2004.

Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarise the multidimensional nature of health services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

[adapted from the authors]

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