Audit of USAID/Afghanistan's On-budget Funding Assistance to the Ministry of Public Health in Support of the Partnership Contracts for Health Services Program

Recommendation
1

USAID/Afghanistan, in collaboration with the
Ministry of Public Health, develop and implement a plan that (1) improves the nongovernmental organization contractors' supervision, monitoring, and problem solving at their health facilities; and (2) verifies the successful implementation of a reliable quality assurance mechanism by the nongovernmental organization contractors, including the establishment of quality assurance committees at each of the health
facilities.

Questioned Cost
0
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Recommendation
2

USAID/Afghanistan assist the Ministry of Public Health in establishing and implementing a plan to ensure that nongovernmental organization contractors are verifying that the requirement of second-person verification is being effectively implemented at health facilities.

Questioned Cost
0
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Recommendation
3

USAID/Afghanistan, in collaboration with the Ministry of Public Health, develop a plan to (1) identify a pool of qualified civil service employees who would benefit from capacity building training in order to sustain the ministry's capacity for managing the PCH program and (2) provide the training.

Questioned Cost
0
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Recommendation
4

USAID/Afghanistan work with the Ministry of Public Health and the Ministry of Finance to streamline the payment process to accelerate payments to nongovernmental organization contractors and health workers.

Questioned Cost
0
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Recommendation
5

USAID/Afghanistan work with the Ministry of
Public Health and the Ministry of Finance to (1) implement written policies and procedures that clearly define the roles, responsibilities, and approval authorities for the payment process and (2) provide further training on the advance/liquidation mode of payment process.

Questioned Cost
0
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Recommendation
6

USAID/Afghanistan work with the Ministry of Public Health and the Ministry of Finance to implement procedures limiting the frequency of changes made to the payment process and providing sufficient notification and clear instructions to nongovernmental organization contractors on any changes.

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0
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Recommendation
7

USAID/Afghanistan review its internal administrative procedures, such as the processing of implementation letters, to ensure the smooth and timely flow of the payment process for on-budget assistance agreements.

Questioned Cost
0
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Recommendation
8

USAID/Afghanistan issue a mission order to provide an organizational framework with clearly defined roles and responsibilities of all mission offices responsible for managing on-budget assistance activities.

Questioned Cost
0
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Recommendation
9

USAID/Afghanistan provide a formal designation
letter similar to an officer's technical representative designation letter to staff members
monitoring implementation of on-budget assistance agreements.

Questioned Cost
0
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Recommendation
10

USAID/Afghanistan work with the Ministry of Public Health to prepare a performance management plan for the Partnership Contracts for Health Services program.

Questioned Cost
0
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Recommendation
11

USAID/Afghanistan provide the Ministry of Public Health with clearly written definitions of Afghan Info performance indicators.

Questioned Cost
0
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Recommendation
12

USAID/Afghanistan implement procedures to review and verify the accuracy of data entered into Afghan Info and provide timely feedback to users.

Questioned Cost
0
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Recommendation
13

USAID/Afghanistan, in collaboration with the Ministry of Public Health, implement a plan to confirm and document accurate GPS coordinates for the ministry's health facilities.

Questioned Cost
0
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