TY - JOUR T1 - Calculating the Cost and Financing Needs of the Basic Package of Health Services in Afghanistan: Methods, Experiences, and Results JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-21-00658 VL - 10 IS - 4 SP - e2100658 AU - Khwaja Mir Ahad Saeed AU - Salma Osmani AU - David Collins Y1 - 2022/08/30 UR - http://www.ghspjournal.org/content/10/4/e2100658.abstract N2 - Key FindingsWe show the 2018 cost and financing needs of the Basic Package of Health Services (BPHS) in Afghanistan based on modeling done by the Ministry of Public Health.The results indicate that the BPHS has been underfunded for the services it has provided, has not been reaching all the population in need, and would require significant additional financing for scale-up.Key ImplicationsThe lack of adequate financing for the BPHS has contributed to under-coverage, poor quality of care, and unaffordable out-of-pocket costs for many people.Dynamic modeling tools such as CORE Plus can help assess whether universal health coverage is being achieved and analyze gaps in financing.The resulting analysis should be used for advocacy and for financing and planning with the Taliban government and donors funding the BPHS.The Basic Package of Health Services (BPHS) is the basis for primary health care in Afghanistan and should be accessible to all citizens. Most of these health services have been provided by nongovernmental organizations with support from donors. Studies before 2018 found that utilization and quality of services were lower than they should be, partly due to insufficient resources, leading the Ministry of Public Health to conduct a costing study to determine the level of funding required for the BPHS.We expanded and refined that data analysis in this article. The main findings show that the total recurrent expenditure on BPHS interventions in 2018 was US$281 million (US$8.93 per capita)—only 62% of the US$452 million (US$14.34 per capita) required for good quality of care. It also showed that the need for services was probably not fully met by public facilities, with actual utilization less than 50% of the need in some cases. Furthermore, scaling up to entirely meet the need could require 2 to 3 times the resources used in 2018.Following the change of government in 2021, economic problems, food shortages, reductions in donor funding, and other factors have increased the need for public health services while the capacity and quality of those services have deteriorated. Nongovernmental organizations continue to provide the BPHS, which remains the main platform for primary health care services in Afghanistan, and international organizations are working to rebuild and support these health services. But additional donor support is needed. The results of this study provide important information on the cost and financing needs of the BPHS that can be used for advocacy and for financing and planning services. We also describe the methodology, challenges, and solutions that can be helpful to other countries interested in conducting similar analyses. ER -