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Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

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  • Anbrasi Edward
  • Binay Kumar
  • Faizullah Kakar
  • Ahmad Shah Salehi
  • Gilbert Burnham
  • David H Peters

Abstract

Anbrasi Edward and colleagues report the results of a balanced scorecard performance system used to examine 29 key performance indicators over a 5-year period in Afghanistan, between 2004 and 2008. Background: In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings: Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p

Suggested Citation

  • Anbrasi Edward & Binay Kumar & Faizullah Kakar & Ahmad Shah Salehi & Gilbert Burnham & David H Peters, 2011. "Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan," PLOS Medicine, Public Library of Science, vol. 8(7), pages 1-9, July.
    • Handle: RePEc:plo:pmed00:1001066
    DOI: 10.1371/journal.pmed.1001066
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    Cited by:

    1. Wilbroad Mutale & Peter Godfrey-Fausset & Margaret Tembo Mwanamwenge & Nkatya Kasese & Namwinga Chintu & Dina Balabanova & Neil Spicer & Helen Ayles, 2013. "Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-11, March.
    2. Olena Kalinichenko & Carla A. F. Amado & Sérgio P. Santos, 2013. "Performance Assessment in Primary Health Care: A Systematic Literature Review," CEFAGE-UE Working Papers 2013_03, University of Evora, CEFAGE-UE (Portugal).
    3. Edward, Anbrasi & Branchini, Casey & Aitken, Iain & Roach, Melissa & Osei-Bonsu, Kojo & Arwal, Said Habib, 2015. "Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system," Social Science & Medicine, Elsevier, vol. 145(C), pages 173-183.
    4. Wilbroad Mutale & Jeffrey Stringer & Namwinga Chintu & Roma Chilengi & Margaret Tembo Mwanamwenge & Nkatya Kasese & Dina Balabanova & Neil Spicer & James Lewis & Helen Ayles, 2014. "Application of Balanced Scorecard in the Evaluation of a Complex Health System Intervention: 12 Months Post Intervention Findings from the BHOMA Intervention: A Cluster Randomised Trial in Zambia," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-10, April.
    5. Faten Amer & Sahar Hammoud & David Onchonga & Abdulsalam Alkaiyat & Abdulnaser Nour & Dóra Endrei & Imre Boncz, 2022. "Assessing Patient Experience and Attitude: BSC-PATIENT Development, Translation, and Psychometric Evaluation—A Cross-Sectional Study," IJERPH, MDPI, vol. 19(12), pages 1-29, June.
    6. Faten Amer & Sahar Hammoud & Haitham Khatatbeh & Huda Alfatafta & Abdulsalam Alkaiyat & Abdulnaser Ibrahim Nour & Dóra Endrei & Imre Boncz, 2022. "How to Engage Health Care Workers in the Evaluation of Hospitals: Development and Validation of BSC-HCW1—A Cross-Sectional Study," IJERPH, MDPI, vol. 19(15), pages 1-29, July.
    7. Muhammad Asef Shaiq & Ali Akbar Barati & Khalil Kalantari & Ali Asadi, 2022. "Dimensions of Poverty in Kunduz Province of Afghanistan," World, MDPI, vol. 3(4), pages 1-14, November.
    8. Frida Betto & Alberto Sardi & Patrizia Garengo & Enrico Sorano, 2022. "The Evolution of Balanced Scorecard in Healthcare: A Systematic Review of Its Design, Implementation, Use, and Review," IJERPH, MDPI, vol. 19(16), pages 1-22, August.

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