Skilled workers improve care in private Afghan hospitals

By Michelle Tolson and Aziz Gulbahari

January 5, 2016

Herat, Afghanistan – Private health clinics and hospitals are key providers of healthcare, with an estimated 73 percent of all healthcare spending in Afghanistan directed to the private sector.

As the eyes and ears of these clinics and hospitals, private health support staff have felt the stress, trying to manage the inflow of patients and other administrative tasks. There are only an estimated 1.95 skilled health management and administrative workers per every 10,000 Afghans, according to the World Health Organization.

The Afghanistan Workforce Development Program is changing this dynamic by training semi-professional workers to meet the market demand of these private sector healthcare facilities for stronger hospital management skills—a need the program identified in a 2013 Labor Market Survey.

The program—which is funded by the U.S. Agency for International Development and implemented by Creative Associates International—also helps workers to secure wages increases with competency-based skills they need to perform better at their jobs.

To date, the program has trained more than 26,000 men and women in multiple industries, including nearly 100 healthcare workers, across six major cities in Afghanistan. The program has placed and promoted, with salary increases, more than 17,000 skilled workers. Thirty-six percent of those trained, placed and promoted are women.

New sector, new workforce needs

USAID funds training programs for private hospital employees and job seekers in areas such as communications and financial management. Photo by Green Wish for Afghanistan Educational and Service Organization.

The need for trained semi-professional healthcare support staff is relatively new in the country, as private healthcare has expanded in recent years.

“Since private clinics and hospitals are something new in Afghanistan, they are not well institutionalized yet,” says Dr. Zubair Arshad, Director of the Private Clinics Association of Herat.

In his six years as the head of the association, the 37-year-old has come to understand the limitations of its workforce.

“Both private clinics and hospitals need a lot of support in different areas. Naturally, whenever hospitals or clinics hire someone as receptionist or in charge of registration or consultation, these institutions provide some briefing to those individuals. However, this is neither professional nor standard,” he says.

Better communication with patients

Recently, Arshad identified hospital staff who needed to increase their skills. With the support of the USAID-funded training provider Green Wish for Afghanistan Educational and Service Organization, these workers enrolled in a health communications training.

Twenty-two year old Maryam Abbasi, a receptionist at Sehat Hospital in Herat, is one of the course graduates.

Abbasi says she used to get very overwhelmed listening to the health problems of patients without knowing how to address them. After the training, she says she is better able to communicate with patients and understand their needs.

“Since I have completed these courses, it has very positively affected my working situation,” says Abbasi. “Now we can easily establish communication with the patients where we could not do that before.  Before, it was very tiring to make patients understand as we did not have the skills to do so. The Hospital Communications trainings increased our patience and reduced our tiredness.”

Abbasi, who has worked at the hospital for three years, also secured a salary increase.

In addition to boosting staff skills, the training has also improved the productivity and patient relations in the clinics and hospitals, says Dr. Arshad.

“Even though directors are the main decision makers of clinics and hospitals, they are not in direct contact with the customers,” he says. “Our staff must be ready to communicate the right message of the hospitals and clinics and help the patients in the right manner.”

Improved efficiency leaves more time for medicine

As administrative hospital staff improve their skills and efficiency through training, doctors are finding they spend less time managing support staff and more time performing their own jobs—such as caring for patients or educating doctors in training.

For Dr. Nangialay Ghows Alami, Director of the Afghan Swiss Hospital and Afghan Swiss Medical Institute of Higher Education, the improved efficiency of his staff has given him more time to train medical students rather than oversee hospital administration.

Through a financial management training course facilitated by the Afghanistan Workforce Development Program, 13 of Dr. Alami’s administrative staff gained new competencies in collecting payments from clients, drafting vouchers and invoices and data entry. Each employee was promoted with a salary increase of at least 3 percent.

An additional 12 of his administrative staff were trained in project management, also with salary increases.

“Before the training, my staff used to have to check with me a lot. The training has increased the efficiency of my staff. They are clear about the delegation of their responsibilities,” says Dr. Alami, noting that he increased the salary of one particularly well-performing employee by 30 percent after he gained new skills through training.

“This training has made my life easier,” he says.

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