Provision of Life-saving Trauma care Services in Nangarhar and Paktya hospitals, and Establishment of two FATPs in Khost HealthNet TPO (HNI TPO) has extensive experience in provision of primary healthcare services. HNI TPO started provision of primary health care services model under the name of Health Care Support Program Nangarhar in 1996 and further expanded it to other provinces by introducing innovative approaches which since then have become MoPH policies such as CME/CHNE program, Mental health, Malaria, PPP model etc. HNI TPO implemented life-saving trauma care in Nangarhar and Paktya hospitals during the last three CHF allocations. 
HNI TPO has significantly improved the quality of trauma care in Nangarhar Regional Hospital and Paktya PH since May 2014 through CHF supported project that ended on 12 May, 2016. This is acknowledged by different stakeholders at national and provincial level. 
In 2013, only 10,409 trauma cases due to conflict were treated in the 3 targeted hospitals of Khost, Paktya and Nangarhar, while in 2015/2016 this number increased to 37,072 cases managed by Nangarhar RH and Paktya PH. Out of these cases, 29,243 general trauma cases, 4,652 RTA, 3,010 fire-arm cases, and 167 earthquake victims were treated under CHF project in Nangarhar and Paktya hospitals which shows progressive increase in the number of trauma cases (See annex-1). In addition, the infra-structure of these trauma care units have expanded, renovated and well organized to manage massive casualties. The trauma units staff capacity is built through capacity building programs on MCM, preparation for emergency/ triage, use of emergency medical equipment's and other formal training.
In line with the CHF 1st standard allocation strategy 2016, HNI TPO proposed interventions are 1) Continuation of the life-saving trauma care through the Nangarhar and Paktya hospitals, 2). Establishment of a small Operation Theater within Nangarhar regional hospital trauma center to manage acute emergencies at trauma center, 3) Establishment of two First Aids Trauma Posts (One  Standalone FATP in Matun district and one integrated FATP in Terezayi/Alishir CHC) in Khost province.
Establishment of two FATPs in Khost will increase access of the emergency and trauma patients to the first aid trauma care services in Khost, because there is only one provincial hospital located 7 KM away from the city of Khost. The newly proposed FATPs will provide the following services, making a quick referral for casualties from the incident sits to the provincial hospital possible a) Triage, b) Stabilization, and c) Referral to surgical center (provincial hospital). The stand-alone FATP will  have 6 health professionals (Nurses), 3 cleaners and 2 drivers and will provide 24/7 trauma services, while the integrated FATP within the Terezayi/Alishir CHC will utilize the existing staff of the CHC (Nurses/MD) and the existing staff will be paid incentives to provide 24/7 first aid trauma care services.
HNI TPO’s approach for implementation will focus on current gaps to address the health issue/s of the target population. HNI TPO will coordinate with District Hospitals in Nangarhar and Paktya to further improve referral services. Community awareness and visibility activities in the trauma unit of Paktya provincial hospital and Nangarhar regional hospital will be further improved. Based on the need of a new hospital building Paktya, HNI TPO will further evaluate trauma care needs in order to provide quality care. 
As the project ended on 12 May, 2016, there is a funding gap from 13 May, 2016 to 30 June, 2016. For short term until the new CHF grant is approved, HNI TPO will  look into the existing SEHAT grant to explore from where the short term funding gap will be covered for trauma care. For the longer time, without CHF funding it will be difficult to continue the current scope of services. 
The project will be regularly monitored and supervised both from provincial and Kabul office level and will submit timely reports to UNOCHA while keeping MoPH/PHD and the health cluster updated.