Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan
2011

Measuring Health System Performance in Afghanistan

Sample size: 5500 publication Evidence: high

Author Information

Author(s): Edward Anbrasi, Kumar Binay, Kakar Faizullah, Salehi Ahmad Shah, Burnham Gilbert, Peters David H.

Primary Institution: Johns Hopkins Bloomberg School of Public Health

Hypothesis

How can a balanced scorecard improve health service delivery in Afghanistan?

Conclusion

The balanced scorecard has successfully improved health service capacity and delivery in Afghanistan over a five-year period.

Supporting Evidence

  • There was a progressive improvement in national median scores across all six domains from 2004 to 2008.
  • Patient satisfaction increased significantly from 65.3% to 84.5% during the study period.
  • Provider satisfaction also showed improvement, rising from 65.4% to 79.2%.

Takeaway

This study shows that using a special scorecard helped make health services in Afghanistan better over five years.

Methodology

The study used a balanced scorecard to evaluate 29 key performance indicators through patient observations and provider interviews across 28 provinces.

Potential Biases

Potential courtesy bias may have influenced patient satisfaction ratings.

Limitations

The study did not measure health impact at the population level and faced challenges due to security and access issues.

Participant Demographics

The study included health facilities across 28 provinces in Afghanistan, with a focus on both patients and health providers.

Statistical Information

P-Value

p<0.0001

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1371/journal.pmed.1001066

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