Special Inspector General for Afghanistan Letter to USAID regarding site inspections conducted to verify the location data and operating conditions of 29 U.S.-funded public health facilities in Badakhshan province, Afghanistan.
The letter notes:
-- SIGAR found substantial inaccuracies in the geospatial coordinates USAID provided for 29 health facilities supported by USAID's $259.6 million Partnership Contracts for Health (PCH).
-- SIGAR requested updated data from USAID, but an agency official stated that USAID no longer maintained such data and that obtaining it would require a specialized request to the Afghan government, which USAID was unwilling to make.
-- SIGAR site inspections revealed that the actual geospatial coordinates for 12 of the 29 facilities were more than 10 kilometers from the USAID coordinates; one of which was more than 700 kilometers from the USAID coordinates.
-- SIGAR maintains that, given USAID's intention to contribute approximately $228 million to the World Bank's SEHAT program, USAID should take steps to ensure that its funds are used as intended. In the case of SEHAT, that means, in part, ensuring that the correct populations are receiving intended health care services through the use of accurate GPS data.
-- SIGAR's analysis indicates that the data currently available to USAID regarding individual facilities is unreliable because it places health facilities in incorrect districts, provinces, or even in neighboring countries. SIGAR mapped GPS coordinates for the 79 health facilities in Badakhshan and found that coordinates for 22 of the health facilities were not located in the districts listed in the most recent information available to USAID, including:
- Coordinates for three health facilities were located in Takhar province.
- Coordinates for three health facilities were located in Tajikistan.
- Coordinates for two health facilities were located in Pakistan.
-- SIGAR observed some basic structural concerns at most of the facilities, such as cracked walls, leaking roofs, broken doors, and shattered windows.
-- Five of the health facilities appeared not to have electricity, and others did not appear to have adequate or consistent power required for proper lighting and refrigeration of some pharmaceuticals and vaccines. Ten of the 29 facilities appeared not to have running water.
-- In an interview with SIGAR, USAID officials stated that the agency is not collecting data on, not asking for, and has no insight as to how the World Bank or the MoPH are tracking GPS coordinates for the health facilities supported by USAID through SEHAT. USAID officials also noted that the agency does not intend to maintain coordinates for SEHAT clinics going forward and would not submit specialized data requests to obtain updated GPS coordinates.
-- USAID's current position regarding its monitoring responsibilities is troubling. In previous SIGAR letters, we have repeatedly cited USAID's own contracts, Requests for Proposals, and other documents that highlight reliable project location data as a critical tool in providing effective oversight and mitigating corruption.