KABUL - The Integrity Watch (IW) called on the leadership of the Ministry of Public Health (MoPH) and the National Unity Government (NUG) to address the shortcomings that were identified by the “Life Matters: Caring for the Country’s Most Precious Resource” report launched by Integrity Watch last month, according to a statement on Saturday.
The report highlighted some of the serious challenges that health facilities were facing such as structural and maintenance problems; poor hygiene and sanitation conditions; lack of electricity; inadequate availability of medicines; inadequate female staff to attend to female patients; and poor accessibility to the health centers that had been identified in many of the 184 health facilities surveyed by IW in eight provinces.
It is unquestionable that these inadequacies deterred delivery of very basic health care services to the people, which should be a matter of grave concern for NUG that critically needed people’s support for legitimacy building.
IW Afghanistan maintained that its study was based on the premise that people’s (service users’) needs are more important than guidelines and protocols cited by the MoPH as excuses for not providing services in certain “types” of health facilities.
The response from the MoPH leadership had been unprofessional and confusing. Citing no records of its own, which may contradict IW findings, the MoPH first rejected the report, with the excuse that the study is not scientific.
Then, MoPH directorates in some provinces joined the MoPH leadership in their social media campaign to discredit Integrity Watch’s report. Later, contradicting the earlier rejection of Integrity Watch’s report and the anti-IWA social media campaign, the Minister told H.E. President Ghani at a High Council of Rule of Law and Anti-Corruption (HCAC) meeting (dated August 31, 2017) that the IW report is very useful for improving health service delivery. Later, in another meeting of the HCAC (dated September 13, 2017) the Minister again criticised the report and did not respond with a clear plan and commitment to address the problems identified in the report. Afghan people deserve a clear and a responsible answer from the MoPH.
While Integrity Watch stood firm by its findings, it calls on the MoPH and NUG leadership to address issues of management and governance and potentials of corruption in the health sector – a demand that the Afghan people have expressed over the years. 
Response to MoPH review
The Integrity Watch study was designed to assess capacities of public health clinics and hospitals to deliver quality (not necessarily “high” quality) basic health care. The capacity of the health care delivery centers was assessed with 5 simple indicators: (1) Physical condition and maintenance of the facilities from where health services are delivered; (2) Hygiene and sanitation conditions at the health care facilitates; (3) On-site availability of equipment and medications; (4) Presence of trained medical and health profession related workers, including female professionals; (5) Accessibility to health care facilities.
The study assessed the capacities of facilities by applying these indicators using tools of limited inspection, interviews with on-site staff members (service providers) and community members or the clientele (service users).  This is a perfectly valid and acceptable formula for research in social sciences. The Lessons Learned discusses the findings (which are not positive), followed up with recommendations. The findings are not flowing from opinions or any type of judgment as stated by the MoPH in their review of the report. The findings flow from an observational study, well-accepted in the world of social sciences.
The comments made in the MoPH review of the IWA report clearly display that either the Integrity Watch report was not reviewed carefully or that its findings showing weaknesses in service delivery and management were conveniently set aside, tactfully distracting attention to scientific theory issues.
Integrity Watch does not claim that there was no gap in its study- rarely any study can claim this. Even the study on which Einstein’s Theory of Relativity was based had gaps. For years, the tobacco lobbyists have been flagging the gaps in the study of cancer caused by tobacco, without much success.
Lobbyists have not won. The MoPH reviewer has desperately attempted to deny any problems in the health delivery system by nitpicking on any simple gap as an excuse to dump the entire study and its findings, without providing any evidence contrary to the findings of the Integrity Watch study. All countries in the world, including countries with highly socialized and people oriented health delivery agendas- UK, Canada, the Nordic countries- recognize problems in their health delivery services and attempt to meet accountability requirements to the people on a continuing basis with no fool proof “scientific” studies undertaken. Integrity Watch would like to ask the MoPH if it can cite any study that the ministry has undertaken, addressing global standards, with perfect precision? (Pajhwok)