JezK

Edit File: 1650126978.M587798P75910.mocha3025.mochahost.com,S=48644,W=49643:2,S

Envelope-to: dr.tokhi@jack.ngo,
 ahmad@jack.ngo,
 asady@jack.ngo,
 dr.sadat@jack.ngo,
 dr.shinwari@jack.ngo,
 dr.tabesh@jack.ngo,
 Faiq.sediqi@jack.ngo,
 haseeb.shirzada@jack.ngo,
 Obaid.shahzad@jack.ngo,
 syusofzai@jack.ngo,
 Takal@jack.ngo
Delivery-date: Sat, 16 Apr 2022 12:36:18 -0400
From: "amini@jack.ngo" <Amini@jack.ngo>
To: <asady@jack.ngo>,
	"'dr sayed Ismail Sadat'" <drsadat.57@gmail.com>,
	<dr.sadat@jack.ngo>,
	<dr.shinwari@jack.ngo>
Cc: <dr.tabesh@jack.ngo>,
	"'Shuaib Shahram'" <shuaibshahram@gmail.com>,
	<ahmad@jack.ngo>,
	<Takal@jack.ngo>,
	<Faiq.sediqi@jack.ngo>,
	<Obaid.shahzad@jack.ngo>,
	<haseeb.shirzada@jack.ngo>,
	<dr.tokhi@jack.ngo>,
	<syusofzai@jack.ngo>,
	<marouf.amini@gmail.com>
References: <009d01d85164$c8975510$59c5ff30$@jack.ngo>
In-Reply-To: <009d01d85164$c8975510$59c5ff30$@jack.ngo>
Subject: RE: TPM-WHO findings on Kabul and Parwan Sehatmandi projects (BPHS/EPHS)
Date: Sat, 16 Apr 2022 21:06:08 +0430
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Dear Dr Sahab Asady=20

Greetings from Parwan Team

Unfortunately, I think the existence of the following problems has =
already caused these weaknesses in Parwan province

=20

1. In Parwan province, BPHS and EPHS were not properly implemented =
before due to the weakness of the government system.

2. Because the project given to Jack was emergency in Parwan province, =
there was not enough time to prepare the situation for the survey in all =
health centers because the priority of the emergency project was to have =
active health centers, which in most cases were semi-active.

3. The non-payment of six months' salary to health center staff had =
caused employees to lose their sense of responsibility, and Jack did not =
have enough time to make up for the problem until the survey began.

4. A large number of community health workers had left their areas due =
to the poor security situation

5. Some regional and political problems caused the process of handing =
over the health centers in Parwan province to be delayed at first, and =
this problem caused that there was not enough time to solve the =
mentioned problems in the health centers.

Best regards

Dr Amini

From: asady@jack.ngo [mailto:asady@jack.ngo]=20
Sent: Saturday, April 16, 2022 12:07 PM
To: 'dr sayed Ismail Sadat'; dr.sadat@jack.ngo; dr.shinwari@jack.ngo
Cc: dr.tabesh@jack.ngo; 'amini@jack.ngo'; 'Shuaib Shahram'; =
ahmad@jack.ngo; Takal@jack.ngo; Faiq.sediqi@jack.ngo; =
Obaid.shahzad@jack.ngo; haseeb.shirzada@jack.ngo; dr.tokhi@jack.ngo; =
syusofzai@jack.ngo
Subject: TPM-WHO findings on Kabul and Parwan Sehatmandi projects =
(BPHS/EPHS)

=20

Dear colleagues in Kabul and Parwan

=20

Greetings=20

=20

We received the TPM report of the assessments conducted on 17 provinces =
from Aqrab to end of Jaddi 1400. The Kabul and Parwan projects were =
included in the assessments. The assessment components were HMIS =
verification, health facility functionality, and drug quality. Though we =
had good performances in many areas, we received a number of undesirable =
observations listed below. Could you please go through carefully and =
provide your comments/justifications for each of them in the attached =
format so that we can argue against and rebut the findings where =
possible.=20

=20

1.     TPM findings on Kabul Sehatmandi:=20

a.     BPHS MSS (Minimum Standard of Services) for staff availability, =
as per SOP/BPHS guidelines: None of the provinces met the minimum =
standards of facilities with SOP staff availability score (present =
during visit+ verified 3 months) as defined in revised SOP/BPHS =
guidelines;

b.    BPHS MSS for availability of medicines: None of the 17 provinces =
met the minimum standard of facilities with a drugs availability score =
>90%, as defined in revised SOP/BPHS guidelines. This indicator is =
persistently problematic and has remained low since the first round of =
the TPM verification;

c.     BPHS MSS for availability of equipment: None of the 17 provinces =
met the minimum standards of facilities with an equipment availability =
score >95%, as defined in revised SOP/BPHS guidelines. This indicator =
has also remained problematic since the first round of TPM verification;

d.    BPHS MSS for availability of at least one female community health =
worker (CHW) per health post: Out of the 17 provinces, 10 provinces met =
the minimum standards. The six provinces not meeting the MSS were: =
Wardak, Takhar, Parwan, Nangarhar, Logar, Kabul, and Faryab.

2.     TPM findings on Parwan Sehatmandi:=20

e.     BPHS MSS for all key staff present at least 70% of staff time =
during the verified three months: out of the17 provinces, 12 provinces =
met the MSS, while five provinces (Bamyan, Faryab, Parwan, Nooristan, =
and Saripul) did not reach the MSS for availability of key staff;

f.     EPHS MSS for Medicines availability: Seven provinces (including =
Parwan) did not achieve the minimum standards;

g.    For EPHS services, out of the 8 provinces with EPHS facilities, =
six provinces achieved the optimal threshold of a HMIS score greater =
than 95%, as defined in the SOP 2020. Just two provinces, Parwan and =
Wardak scored lower than the optimal threshold, with a HMIS score of =
94.9% (Parwan) and 92% respectively.

The deadline for submission of our comments/justifications is tomorrow =
morning, thus, I would most appreciate if you can send the responses by =
tonight.

I most appreciate your continuous hard work and resilience.

=20

=E2=80=98Together we can achieve more=E2=80=99

=20

Best Regards,

=20

Abdullah =E2=80=9CAsady=E2=80=9D MD, MMDSc (Malaysia)

Head of Monitoring, Evaluation and Research=20

Just for Afghan Capacity and Knowledge       =D8=A8=D9=84=D9=86=D8=AF =
=D8=A8=D8=B1=D8=AF=D9=86 =D8=B3=D8=B7=D8=AD =D8=AF=D8=A7=D9=86=D8=B4 =
=D9=88 =D8=AA=D9=88=D8=A7=D9=86=D9=85=D9=86=D8=AF=DB=8C =
=D8=A7=D9=81=D8=BA=D8=A7=D9=86=D9=87=D8=A7 (=D8=AC=DA=A9) =20

Address: First Street of Karta-e-Chahar, Kabul Afghanistan=20

Behind AWCC Main Office, House # 08

Ph: +93(0)731 087928=20

Email: <mailto:asady@jack.ngo> asady@jack.ngo =20

Website:www.jack.ngo=20

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<html xmlns:v=3D"urn:schemas-microsoft-com:vml" =
xmlns:o=3D"urn:schemas-microsoft-com:office:office" =
xmlns:w=3D"urn:schemas-microsoft-com:office:word" =
xmlns:m=3D"http://schemas.microsoft.com/office/2004/12/omml" =
xmlns=3D"http://www.w3.org/TR/REC-html40"><head><meta =
http-equiv=3DContent-Type content=3D"text/html; charset=3Dutf-8"><meta =
name=3DGenerator content=3D"Microsoft Word 15 (filtered medium)"><style></style></head><body lang=3DEN-US =
link=3D"#0563C1" vlink=3D"#954F72"><div class=3DWordSection1>Dear Dr Sahab Asady <o:p></o:p>Greetings from Parwan =
Team<o:p></o:p>Unfortunately, I think the existence of the =
following problems has already caused these weaknesses in Parwan =
province<o:p></o:p><o:p>&nbsp;</o:p>1. In Parwan province, BPHS and EPHS were not =
properly implemented before due to the weakness of the government =
system.<o:p></o:p>2. Because the project given to Jack was =
emergency in Parwan province, there was not enough time to prepare the =
situation for the survey in all health centers because the priority of =
the emergency project was to have active health centers, which in most =
cases were semi-active.<o:p></o:p>3. The non-payment of six months' salary to =
health center staff had caused employees to lose their sense of =
responsibility, and Jack did not have enough time to make up for the =
problem until the survey began.<o:p></o:p>4. A large number of community health workers =
had left their areas due to the poor security =
situation<o:p></o:p>5. Some regional and political problems caused =
the process of handing over the health centers in Parwan province to be =
delayed at first, and this problem caused that there was not enough time =
to solve the mentioned problems in the health =
centers.<o:p></o:p>Best regards<o:p></o:p>Dr Amini<o:p></o:p><div><div =
style=3D'border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in =
0in 0in'>From: =
asady@jack.ngo [mailto:asady@jack.ngo] Sent: Saturday, April =
16, 2022 12:07 PM To: 'dr sayed Ismail Sadat'; =
dr.sadat@jack.ngo; dr.shinwari@jack.ngo Cc: =
dr.tabesh@jack.ngo; 'amini@jack.ngo'; 'Shuaib Shahram'; ahmad@jack.ngo; =
Takal@jack.ngo; Faiq.sediqi@jack.ngo; Obaid.shahzad@jack.ngo; =
haseeb.shirzada@jack.ngo; dr.tokhi@jack.ngo; =
syusofzai@jack.ngo Subject: TPM-WHO findings on Kabul and =
Parwan Sehatmandi projects (BPHS/EPHS)<o:p></o:p></div></div><o:p>&nbsp;</o=
:p>Dear =
colleagues in Kabul and Parwan<o:p></o:p><o:p>&nbsp;</o=
:p>Greetings =
<o:p></o:p><o:p>&nbsp;</o=
:p>We received =
the TPM report of the assessments conducted on 17 provinces from Aqrab =
to end of Jaddi 1400. The Kabul and Parwan projects were included in the =
assessments. The assessment components were HMIS verification, health =
facility functionality, and drug quality. Though we had good =
performances in many areas, we received a number of undesirable =
observations listed below. Could you please go through carefully and =
provide your comments/justifications for each of them in the attached =
format so that we can argue against and rebut the findings where =
possible. <o:p></o:p><o:p>&nbsp;</o=
:p><p class=3DMsoListParagraphCxSpFirst =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:22.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level1 lfo2'><![if =
!supportLists]>1.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>TPM findings on Kabul =
Sehatmandi: <o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>a.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS (Minimum =
Standard of Services) for staff availability, as per SOP/BPHS =
guidelines: None of the provinces met the minimum standards of =
facilities with SOP staff availability score (present during visit+ =
verified 3 months) as defined in revised SOP/BPHS =
guidelines;<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>b.&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of medicines: None of the 17 provinces met the minimum =
standard of facilities with a drugs availability score &gt;90%, as =
defined in revised SOP/BPHS guidelines. This indicator is persistently =
problematic and has remained low since the first round of the TPM =
verification;<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>c.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of equipment: None of the 17 provinces met the minimum =
standards of facilities with an equipment availability score &gt;95%, as =
defined in revised SOP/BPHS guidelines. This indicator has also remained problematic =
since the first round of TPM verification;<o:p></o:p><p =
class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>d.&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of at least one female community health worker (CHW) per =
health post: Out of the 17 provinces, 10 provinces met the minimum =
standards. The six provinces not meeting the MSS were: Wardak, Takhar, =
Parwan, Nangarhar, Logar, =
Kabul, and =
Faryab.<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:22.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level1 lfo2'><![if =
!supportLists]>2.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>TPM findings on Parwan =
Sehatmandi: <o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>a.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS (Minimum =
Standard of Services) for staff availability, as per SOP/BPHS =
guidelines: None of the provinces met the minimum standards of =
facilities with SOP staff availability score (present during visit+ =
verified 3 months) as defined in revised SOP/BPHS =
guidelines;<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>b.&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of medicines: None of the 17 provinces met the minimum =
standard of facilities with a drugs availability score &gt;90%, as =
defined in revised SOP/BPHS guidelines. This indicator is persistently =
problematic and has remained low since the first round of the TPM =
verification;<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>c.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of equipment: None of the 17 provinces met the minimum =
standards of facilities with an equipment availability score &gt;95%, as =
defined in revised SOP/BPHS guidelines. This indicator has also remained problematic =
since the first round of TPM verification;<o:p></o:p><p =
class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>d.&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for =
availability of at least one female community health worker (CHW) per =
health post: Out of the 17 provinces, 10 provinces met the minimum =
standards. The six provinces not meeting the MSS were: Wardak, Takhar, =
Parwan, Nangarhar, Logar, =
Kabul, and =
Faryab;<o:p></o:p><p class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>e.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>BPHS MSS for all key =
staff present at least 70% of staff time during the verified three =
months: out of the17 provinces, 12 provinces met the MSS, while five =
provinces (Bamyan, Faryab, Parwan, Nooristan, and Saripul) did not =
reach the MSS for availability of key staff;<o:p></o:p><p =
class=3DMsoListParagraphCxSpMiddle =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>f.&nbsp;&nbsp;&nbsp;&nbsp; =
<![endif]>EPHS MSS for Medicines =
availability: Seven provinces (including Parwan) did not achieve the minimum =
standards;<o:p></o:p><p class=3DMsoListParagraphCxSpLast =
style=3D'mso-margin-top-alt:auto;margin-right:1.3pt;mso-margin-bottom-alt=
:auto;margin-left:58.5pt;mso-add-space:auto;text-align:justify;text-inden=
t:-.25in;line-height:150%;mso-list:l0 level2 lfo2'><![if =
!supportLists]>g.&nbsp;&nbsp;&nbsp; =
<![endif]>For EPHS services, out of =
the 8 provinces with EPHS facilities, six provinces achieved the optimal =
threshold of a HMIS score greater than 95%, as defined in the SOP 2020. =
Just two provinces, Parwan and Wardak =
scored lower than the optimal threshold, with a HMIS score of 94.9% (Parwan) and 92% =
respectively.<o:p></o:p>The deadline for submission of our comments/justifications is =
tomorrow morning, thus, I would most appreciate if you can send the =
responses by tonight.<o:p></o:p>I most appreciate your continuous hard work and =
resilience.<o:p></o:p><o:p>&nbsp;</o:p><o:p>&nbsp;</o:p>=E2=80=98Together we can achieve =
more=E2=80=99<o:p></o:p><o:p>&nbsp;</o:p>Best Regards,<o:p></o:p><o:p>&nbsp;</o:p><img width=3D49 height=3D38 =
id=3D"Picture_x0020_21" src=3D"cid:image001.jpg@01D851D4.05EA7E00" =
alt=3D"cid:image003.jpg@01D4B669.F250F440"><o:p></o:p>=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<o:p></o:p>Abdullah =
=E2=80=9CAsady=E2=80=9D MD, MMDSc (Malaysia)<o:p></o:p>Head of Monitoring, Evaluation and =
Research <o:p></o:p>Just for Afghan Capacity and =
Knowledge&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =
&nbsp;=D8=A8=D9=84=D9=86=D8=AF =D8=A8=D8=B1=D8=AF=D9=86 =
=D8=B3=D8=B7=D8=AD =D8=AF=D8=A7=D9=86=D8=B4 =D9=88 =
=D8=AA=D9=88=D8=A7=D9=86=D9=85=D9=86=D8=AF=DB=8C =
=D8=A7=D9=81=D8=BA=D8=A7=D9=86=D9=87=D8=A7 (=D8=AC=DA=A9)&nbsp; =
<o:p></o:p>Address: First Street of Karta-e-Chahar, Kabul =
Afghanistan <o:p></o:p>Behind AWCC Main Office, House # =
08<o:p></o:p>Ph: +93(0)731 087928 =
<o:p></o:p>Email: <a =
href=3D"mailto:asady@jack.ngo">asady@jack.ngo</a>&nbsp; <o:p></o:p>Website:www.jack.ngo <o:p></o:p>=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=
=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=
=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=
=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=3D=
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