Strategic analysis of financing communicable diseases in Afghanistan

Afghanistan as a low-income country suffers from the heavy burden of Communicable Diseases (CDs) and their significant economic consequences. Therefore, this research is aimed to strategically analyze the financing system of CDs management in Afghanistan and provide effective solutions.

We conducted the qualitative research using interpretative phenomenological analysis (IPA). An interview guide was used to conduct the semi- structured interviews with 49 experts from the Afghanistan health system. We used the framework analysis method to analyze the results.

In this research, we found 12 strengths, 16 weaknesses, 9 opportunities, 21 threats, and 47 solutions. The main strength was diverse international funding sources for CDs control. The weakest points were the lack of a health insurance system, limited government budget allocation for health, high out-of-pocket expenditure (OOPE), fragmented donor's funds, poor managerial capacity, and donor-dependent health system. The main opportunity was the commitment and interest of donors to eradicate CDs. Lack of political commitment, cut of donors' aids, brain drain, low health literacy of people, and lack of drinkable water and sewage systems were the main threats. Increasing the government budget allocation, establishing health insurance system, implementing employees' retention strategies, integrating all CDs funds, strategic purchasing, strengthening public-private partnership (PPP), implementing appropriate user fees, and raising public awareness about CDs were the most important solutions.

The financing system of CDs management should be strengthened in such a way that it collects scattered financial resources, aggregates and transparently manages them. Then, they should be used to provide CDs control services that will reduce the CDs burden, improve people's health and protect from financial risks.