Hospital Accreditation Governance in Afghanistan: Challenges and Solutions

Hospital accreditation is a systematic evaluation program conducted by an independent external accreditation body. It is the most common health assessment approach for enhancing hospital quality and safety. However, its implementation in Afghanistan faces substantial governance challenges. This study examined accreditation governance challenges and proposed solutions in Afghanistan.

A qualitative study using interpretative phenomenological analysis (IPA) conducted in 2024. Semi-structured interviews carried out with 75 key stakeholders including policymakers, accreditation officials, hospital managers, and frontline providers purposively selected from 20 public and private hospitals in Kabul. Data analyzed thematically using Braun and Clarke's framework.

Study identified 32 governance challengers categorized seven major domains include: insufficient independent accreditation body, inadequate strategic vision, poor internal and external communication, lack of training systems, and absence of sustainable funding, digital infrastructure, and monitoring and evaluation. Key challenges, including: lack of institutional independence, absence of national strategic planning, unclear organizational mandates, insufficient trained surveyors, unstable financing, weak digital systems, and limited post-accreditation monitoring and evaluation program. Proposed 30 solutions, the important are need for establishing an autonomous accreditation body, developing national strategic plans, aligning standards with international benchmarks, establishing training and capacity building program, securing sustainable financing, strengthening digital platforms, and instituting continuous monitoring mechanisms.

This study identified hospital accreditation governance challenges associated with critical to its successful and comprehensive implementation in Afghanistan. These challenges require immediate and in-depth attention from healthcare leaders and policymakers.