The AMOR Afghanistan Health Organization (AAHO) which funds and operates Afshar Hospital in Kabul, Afghanistan, uses a business model unique to the country. Generally hospitals in Afghanistan are either privately owned for-profits, or government owned. The private hospitals charge a large fee that is not affordable for many, whereas government hospitals charge no fees. While the government does not charge a fee, it is a standard practice for the patient or his family to pay a bribe to the physician in order to receive treatment. The level of care received by the patient is determined by the amount of the bribe—the larger the bribe the better the care.

Afshar Hospital opened in 2009 as the first nonprofit hospital with charitable programs in the country. In addition to the main hospital in Kabul, AAHO operates six clinics in nearby under-served communities. The clinics provide access to medical care to those who do not have access due to a lack of vehicles, petrol, or money. It is estimated that 75% of the families in these communities are suffering from these deficits. Health education that teaches skills for healthy living is taught throughout the AAHO system, and is considered essential to breaking the cycle of poverty. AAHO successfully navigated logistical obstacles, cultural and traditional differences, educational inadequacies, security issues, and the inherent risks of corruption, to establish one of the leading health centers in all of Afghanistan. Proudly providing the highest levels of medical care to impoverished Afghans in excess of 50,000 annually.

While AAHO does charge for service, fees are minimal and based on the patient’s ability to pay. For example, delivering a baby at Afshar only costs $125; compare this to $3,500, which is the average cost to deliver a baby in the United States, according to the Agency for Healthcare Research and Quality. At Afshar, those that cannot pay at all are treated with dignity and respect and receive healthcare from the same specialists as those who do pay. No one is turned away, all are treated equally!

The oversight of AAHO and the manner in which Afshar Hospital operates has not gone unnoticed by the Afghanistan Ministry of Public Health (MOPH). AAHO has become a model for the MOPH as they work to fulfill their goal of establishing a sustainable healthcare system through the implementation of a sliding scale, fee-for-service model. In June of 2015, a delegation from the MOPH toured Afshar hospital and were briefed on AAHO’s approach of: equal care for patients without regard to their ability to pay- the procedural guidelines for the fees; and how the Charity Committee oversees charitable programs. The MOPH has also inquired into the feasibility of adding specialty and preventative care.

What began as a desire to bring healthcare services to an under-served population in one country has become a dynamic healthcare system that is influencing a nation to change how they have provided care to their citizens.