On December 23, 2020, the National Advocacy Committee for Public Policy (NAC-PP), released the findings of the fourth cycle of “Monitoring Government Response to COVID-19 in Nangarhar, Laghman and Kunar”. The monitoring was undertaken by Afghanistan Public Policy Research Organization (APPRO) and funded by UNDP and Danish Embassy in Kabul.
The purpose of this monitoring round is to examine the improvements and/or changes made to ensure transparency and accountability in the use of government funds in COVID-19 health centers in the three target provinces.
Findings from this round of monitoring indicate that preparations for a potential second wave of COVID-19 are taken in Nangarhar and Laghman provinces. This includes a 50-bed hospital in Nangarhar with 50 additional beds on standby and equipment such as ventilators, oxygen cylinders, beds, and personal protective equipment in Laghman province. However, officials in Kunar report of shortage of oxygen supply and oxygen generators in this province.
It is said that initiatives aimed at engaging local elders and local communities in the process of allocating COVID-19 relief funds is missing in the target provinces. Similarly, there are no plans to engage various segments of the community to participate in decisions taken regarding COVID-19. All the decisions are said to be centralized in PGO, with purchases being made by the implementing partners and without meetings being held by the Purchasing and Monitoring Committees.
Civil society organizations have largely remained marginalized from monitoring and oversight of COVID-19 relief services. For instance, the logistics and handover of equipment to the health centers is done in the presence of representatives mostly from government, with civil society predominantly being absent from the process.
The reports of the Monitoring Committees are said to be shared with media outlets in the target provinces; however, these reports are still not publicly available which limits the beneficiaries and civil society organizations’ access to information according to established laws.
With respect to community perception, social stigma attached to the use of COVID-19 services provided by the COVID-19 health centers is a major factor hindering people’s peoples interest in seeking COVID-19 health services. For instance, there are reports of people being subjected to discrimination by relatives and community members in rural areas because they have contracted COVID-19.
The number of COVID-19 health centers is far from sufficient in all the three target provinces. Some community members have had to travel by foot approximately 50-60 kilometers to reach the nearest COVID-19 health center in Nangarhar. Women and girls have had the least access to COVID-19 treatment due mostly to social conservative norms, inaccessibility of COVID-19 health centers and insufficient female health practitioners.
The key informants were asked to state the most urgent outstanding needs of community and the ways by which COVID-19 health service delivery could be improved in the target provinces. The following recommendations are developed based on the primary data from key informant interviews:
National Government Authorities (Particularly MoPH)
- Establish Polymerase Chain Reaction (PCR) testing laboratories in Laghman and Kunar provinces, staffed with doctors, nurses and laboratory technicians.
- Ensure health personnel are adequately trained and laboratories are well-equipped to produce timely COVID-19 test results. Specifically, DoPH shall initiate training programs to health personnel in the target provinces on installing, assembling and using ventilators and conducting CPAP and Bi-PAP on severe COVID-19 patients.
- Strengthen public awareness of COVID-19, its risks and symptoms and the effectiveness of personal hygiene, personal protection such as wearing masks and social distancing in reducing the spread of the virus.
- Establish COVID-19 health centers in populated districts, and recruit additional mobile health teams in less populated districts. Increase the number of qualified doctors, health personnel in the districts of the target provinces.
- Strengthen or introduce local level coordination among local government institutions, grassroots civil society representatives, local communities and private sector entities aimed at better COVID-19 response by government and international community in the target provinces.
- Earmark a specific location for the Coronavirus Center in Kunar province rather than using a building belonging to Directorate of Education.
COVID-19 Health Centers
- Procure oxygen generators and increase medication supply for the COVID-19 Health Center in Laghman. Private sector entities assigned to this task have thus far failed to meet the full demand for oxygen for the critical patients.
For the full report, please visit: http://appro.org.af/publications/monitoring-government-response-to-covid-19-in-nangarhar-laghman-and-kunar-cycle-4/
The National Advocacy Committee for Public Policy (NAC-PP) was established in March 2015 to serve as a policy advocacy and information-sharing platform for good governance. NAC-PP works closely with Provincial Advocacy Committees (PACs) and District Advocacy Committees (DACs) to coordinate advocacy and information sharing from district to national levels.
For more information on NAC-PP, please visit www.nac-pp.net or contact the NAC-PP Secretariat through Mr. Atiq Rahimi at firstname.lastname@example.org.
For more information on the Anti-Corruption Sub-Committee of NAC-PP, see: http://www.nac-pp.net/about-anti-corruption-sub-comittee/. On the Citizen’s Forum Against Corruption (CFAC), see http://www.nac-pp.net/about-cfac/