Public Administration Reform in a Challenging Environment: A Review of the Establishment of the Health Economics and Financing Directorate (HEFD) within the Afghanistan Ministry of Public Health

The purpose of this article is to provide an example of recent public administration reform in Afghanistan. In 2003, the Afghan Ministry of Public Health (MoPH) established the Basic Package of Health Services (BPHS) and other health services. To date, service delivery has been conducted largely by NGOs, funded by the main international donors, and managed by the Grant and Contracts Management Unit (GCMU) of the MoPH. Despite these advancements, Afghanistan continues to face significant challenges in health service provision and policy. In 2009, the GCMU was restructured into the Health Economics and Financing Directorate (HEFD), which broadened the scope of the Unit to conduct important economic analyses. This article examines the MoPH's role in health financing as a developing institution engaged in applied health economics and policy analysis. This development will allow the MoPH to build evidence for policy-making and further establish its stewardship role in the health sector.