USAID Supported Health Facilities in Khost Province, Afghanistan: Observations From 20 Site Visits
Abstract
I am writing to report the results of site inspections to verify the locations and operating conditions at 20 USAID-supported public health facilities in Khost province, Afghanistan. The facilities we reviewed are supported by USAID through the World Bank-administered System Enhancement for Health Action in Transition (SEHAT) program, which is scheduled to run through June 2018. Previously, the Ministry of Public Health (MoPH) received funds through direct bilateral assistance from USAID to fund operations at these health facilities. SIGAR found substantial inaccuracies in the geospatial coordinates USAID previously provided for many of these 20 health facilities, including 15 facilities that were at least 10 kilometers away from coordinates USAID provided. We also found that not all facilities had access to reliable electricity. USAID has made it clear that since the termination of the PCH program, it now relies almost exclusively on reports from the World Bank to provide oversight for its funds used to support those facilities. USAID's Automated Directive System (ADS) lists the World Bank as a Category 1 Public International Organization (PIO). ADS general guidance for grants to approved PIOs states that, "once funds have been disbursed in accomplishment of a significant purpose of an award, the funds are no longer considered USAID's, and the Agency's policies and proceduresno longer apply." SIGAR maintains that, given USAID's intention to contribute approximately $228 million to the World Banks SEHAT program, USAID should take steps to ensure that its funds are used as intended. In the case of SEHAT, that means, in part, using accurate GPS data to help ensure that the correct populations are receiving intended health care services.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 01, 2017
- Accession Number
- AD1139782
Entities
People
- John Sopko
- Matthew Dove
Organizations
- Special Inspector General for Afghanistan Reconstruction