Provision of essential integrated health services to earthquake-affected people in Spera district of Khost province The proposed project is designed in response to AHF 2nd Reserve Allocation 2022 to save lives and improve the well-being of the earthquake-affected people in the Spera district of Khost province through the establishment of temporary fixed health facilities (BHC+) providing dignified essential primary health, nutrition, MHPSS, and basic trauma care services.

HNI-TPO will establish two temporary fixed health facilities (BHC+) in easily accessible locations of Spera district earthquake-affected villages, which the HER project (BPHS) health facilities do not conveniently cover. The health facilities will be established using Conex containers for space purposes which are durable, safe, and easy to move. As the planned health facilities will have services profile higher than a BHC (addition of laboratory, MHPSS etc.) it will be a BHC+ in nature. Each health facility will be staffed with an MD doctor, a nurse, a midwife, a nutrition counselor, two vaccinators (male and female), two psychosocial support officers (male and female), a laboratory technician, and two support staff (guard/cleaner). In addition, each health facility will be equipped with the required medical and non-medical equipment recommended by the MoPH BPHS package for BHC+ (details of the required equipment are provided in the annexed BoQ). The health facilities will provide essential primary health care services, including reproductive health services (ANC, delivery, PNC, family planning, and newborn care), child health and immunization services, diagnosis and treatment of common and communicable diseases, nutrition services (under five and PLW screening, OPD-MAM, OPD-SAM, treatment of acute malnutrition in PLW), MHPSS, basic trauma care, health education, lab diagnostic services and referral for higher or secondary health services. The pharmaceuticals, medical/non-medical supplies, and HMIS forms will be provided to each health facility on a regular quarterly basis.

The health facilities will provide the intended services to around 24,000  earthquake-affected people who live in villages with no or limited access to HER project health facilities in the Spera district.

The services will be coordinated with the existing HER (BPHS/EPHS) project, currently run by HNI-TPO, to avoid duplication and missed opportunities in coverage and to create synergy among both projects. Furthermore, the project design is coordinated with the Health Cluster, OCHA structure/other working groups, Khost PPHD, and provincial/regional WHO representatives. Coordination with PPHD, provincial/regional and central WHO/Health Cluster and OCHA structures, other working groups, and district-level multisectoral partners will be maintained throughout the project implementation.

Equitable access to and for the target communities will be ensured by identifying convenient locations for establishing the health facilities in target villages of the Spera district. The health facility structure will follow the recommended MoPH setup for BHC+, whereby female health workers will provide services to the female clients. In addition to the intended services, COVID-19 RCCE activities and mechanisms for community feedback will be put in place to ensure two-way exchange of information. Particular attention is given to mainstreaming cross-cutting issues such as PESA, AAP, protection, gender, age, and disability in the project.

The services will be supervised on day-to-day basis by the head of health facilities and on a weekly basis by the designated provincial officer. The project will be monitored by the HNI-TPO country office staff on quarterly basis. The performance of the health facilities will be documented and monitored through the recording of data on the planned indicators. The project will prepare and submit technical and financial progress reports to the WHO and OCHA through ReportHub and HERAMS.