Afghanistan Public Policy Research Organization State-Civil Society Relations in Service Delivery in Health and Education in Kabul, Herat, Nangarhar and Takhar August 2017 Project Report 1 www.appro.org.af 2 Acknowledgments This report was made possible through funding from the European Union Delegation – Afghanistan for the project “From Black Boxes to Building Blocks: Citizen-State Engagement for Transparency and Accountability in Health and Education” (CS), a partnership led by Oxfam Afghanistan and consisting of Afghanistan Public Policy Research Organization (APPRO), Afghanistan Civil Society Forum-organization (ACSFo), Afghanistan Institute for Civil Society (AICS) and Peace and Training Research Organization (PTRO). We wish to express our sincere thanks to all those who agreed to participate in this research in Herat, Kabul, Nangarhar and Takhar provinces. About the Researchers The APPRO research team responsible for this report consists of (in alphabetical order): Zahra Ghulami, Nafas Karimi, Ehsanullah Khalili, Zarghona Saify, Lima Sakhizai, Matiullah Dorman, Marzia Rahmani, and Ismail Zahidi. Zahra Ghulami and Lucile Martin authored this report. About the Project The CS project was designed to strengthen citizen-state engagement through facilitating civil society involvement in the budget process, particularly by capitalizing on the opportunities provided in the Provincial Budgeting Policy and the forthcoming Sub-National Governance Policy. The CS project has a thematic focus on essential services in health and education and is a follow on project from the Citizens First program, a partnership between Oxfam, PTRO, and APPRO which laid a productive foundation for state-civil society interactions by establishing District Advocacy Committees (DACs), Provincial Advocacy Committees (PACs), and the National Advocacy Committee for Public Policy (NAC-PP) as formal structures through which civil society could constructively engage with state authorities on basic needs of the citizens. For more information on NAC-PP, see: www.nac-pp.net About this Report In early 2017, APPRO conducted research in Kabul, Herat, Jalalabad and Takhar to assess the current status of service delivery in health and education. The research was designed to document views and perceptions of civil society organizations and state authorities basic service delivery and the opportunities provided for closer collaboration through the implementation of the Provincial Budgeting Policy. About APPRO Afghanistan Public Policy Research Organization (APPRO) is an independent social research organization with a mandate to promote social and policy learning to benefit development and reconstruction efforts in Afghanistan and other less developed countries through conducting social scientific research and monitoring, evaluations, and training and mentoring. APPRO is registered with the Ministry of Economy in Afghanistan as a non-profit non- government organization and headquartered in Kabul, Afghanistan with offices in Mazar-e Sharif (north), Herat (west), Kandahar (south), Jalalabad (east), and Bamyan (center). APPRO is the founding member of APPRO-Europe, registered in Belgium. For more information, see: www.appro.org.af and www.appro-europe.net Contact: [email protected] Photo: Oriane Zerah APPRO takes full responsibility for all omissions and errors. © 2017. Afghanistan Public Policy Research Organization. Some rights reserved. This publication may be stored in a retrieval system or transmitted only for non-commercial purposes and with written credit to APPRO and links to APPRO’s website at www.appro.org.af. Any other use of this publication requires prior written permission, which may be obtained by writing to: [email protected]. www.appro.org.af 3 List of Abbreviations ACSFo – Afghan Civil Society Forum- organization AICS – Afghanistan Institute for Civil Society AIDS – Acquired Immunodeficiency Syndrome AOG – Armed Opposition Group APPRO – Afghanistan Public Policy Research Organization AREU – Afghanistan Research and Evaluation Unit BC – Budget Circular BPHS- Basic Package of Health Services CSO – Civil Society Organizations DoPH – Directorate of Public Health EPHS- Essential Package of Health Services ER – Emergency room HIV – Human Immunodeficiency Virus IDLG – independent Directorate of Local governance IDP – Internally Displaced Person MAIL – Ministry of Agriculture, Irrigation and Livestock MDG – Millennium Development Goal M&E – Monitoring and Evaluation MoE – Ministry of Education MoEC – Ministry of Economy MoF – Ministry of Finance MP – Member of Parliament MoPH – Ministry of Public Health MoU- Memorandum of Understanding MRRD- Ministry of Rural Rehabilitation and Development NAP 1325 – National Action Plan for the Implementation of UNSCR 1325 and Related Resolutions NAPWA – National Action Plan for Women in Afghanistan NESP – National Education Strategic Plan NGO – Non-Governmental Organization NHP – National Health Policy NRC – Norwegian Refugee Council NUG – National Unity Government PBP – Provincial Budget Policy PDC- Provincial Development Council PPFMC – Provincial Public Financial Management Committee PTRO – Peace Training and Research Organisation SCA – Swedish Committee for Afghanistan SDG- Sustainable Development Goal TB- Tuberculosis TMAF – Tokyo Mutual Accountability Framework UNHCR – United Nations High Commissioner for Refugees UNICEF – United Nations’ Children Fund USAID – United States Agency for International Development WHO – World Health Organization www.appro.org.af 4 Table of Contents Executive Summary .................................................................................................................... 6 Recommendations .............................................................................................................................. 7 Background .............................................................................................................................. 10 Objectives and Methodology ............................................................................................................ 12 Organization of This Report...................................................................................................... 13 Provincial Budgeting Policy (PBP) ............................................................................................. 13 Legal and Policy Frameworks ................................................................................................... 15 Constitutional and Legal Provisions on Education ............................................................................. 15 Ministry of Education Strategic Goals ............................................................................................... 16 Constitutional and Legal Provisions on Health .................................................................................. 17 Ministry of Public Health Strategic Goals .......................................................................................... 17 Current Challenges in Health and Education ............................................................................ 19 Challenges in Education .................................................................................................................... 19 Challenges in Health.......................................................................................................................... 21 Findings from the Provinces ..................................................................................................... 23 Kabul ................................................................................................................................................. 24 Perceptions of Civil Society Organizations ...................................................................................... 24 Government’s Perceptions ............................................................................................................. 25 Herat ................................................................................................................................................. 27 Perceptions of Civil Society Organizations ...................................................................................... 27 Government’s Perceptions ............................................................................................................. 29 Nangarhar ......................................................................................................................................... 31 Perceptions of Civil Society Organizations ...................................................................................... 31 Government’s Perceptions ............................................................................................................. 33 Takhar ............................................................................................................................................... 35 Perceptions of Civil Society Organizations ...................................................................................... 35 Government’s Perceptions ............................................................................................................. 36 Recommendations ................................................................................................................... 37 Government of Afghanistan .............................................................................................................. 37 Civil