Supporting the Leadership of Health Shuras in Afghanistan

Mahesh Shukla

Senior Technical Advisor for Public Sector Governance

The word “shura” derives its meaning from another Arabic word, shara, which means to extract honey from hives. The word acquired secondary meanings—consultation and deliberation—as these are akin to extracting ideas and opinions from peoples' minds. In the Holy Quran, the word is used three times as a process of decision-making by consultation and deliberation, and is said to be a praiseworthy activity. Shura is a cardinal principle of governance in Islam. Justice, equality and human dignity are at the heart of Islam's moral philosophy. These principles are best realized in personal and public life under shura governance. Shuras, or consultative assemblies, have a long-established tradition in conducting public affairs in Afghanistan.

The LMG Project in Afghanistan has had the privilege of working with health shuras at all levels of the health system: the provincial, district, health facility, and community levels. All 34 provinces in Afghanistan have provincial health shuras called Provincial Pubic Health Coordination Committees. These committees have been functioning as an effective forum for information sharing, coordination, and monitoring of health services. A few districts have district health shuras or District Health Coordination Committees. Shuras are also well-established at the health center and community levels; there are 10,000 of these community health shuras, and three out of four meet every month. Participation of women in these shuras remains marginal in spite of gender transformative policies of the government. Many communities are establishing separate women’s health shuras.

With a view to develop inspired leadership and transparent governance in all these health shuras, the health shura members are currently working consultatively with the LMG Project in drafting governance guides. These guides will assist the health shuras in discharging their role and responsibilities in a more effective, efficient, transparent, and accountable manner so that they are able to influence access to health care, quality of care, and overall health outcomes for the people living in the rural communities. The provincial and district health governance guides are being field-tested in three provinces and eleven districts at this time. On successful field-testing, the Ministry of Public Health is expected to use the guides nationally to improve health governance in the provinces, districts and the communities.

Please check back regularly for information on these guides and for more success stories from LMG/Afghanistan.

Mahesh Shukla, MD, MPA, is the Public Sector Governance Senior Technical Advisor for the LMG Project.