Date of Award

Spring 5-16-2014

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Douglas W. Roblin, PhD

Second Advisor

Rodney Lyn, PhD., M.S.


Patient safety is an issue of global concern, which is sometimes missed due to the complexity of the healthcare systems. There is an increasing concern for negligence of patient safety in developing countries, especially countries with poor healthcare systems and less reliable data. In 2005, the Ministry of Public Health in Afghanistan developed the Essential Package of Hospital Services (EPHS) in order to promote quality of care in Afghan Hospitals. Patient safety, as one of the key objective of the EPHS, appears to need additional attention and evaluation. The main purpose of this research proposal is to develop a validated patient safety culture instrument and to evaluate the use of the instrument in Afghan Hospitals. The proposal introduces a framework for sampling hospitals followed by a plan for conducting a cross-sectional study using the survey instrument. The proposal also includes an assessment of the psychometric properties of the instrument. The findings achieved from the administration of the survey are intended to compare 12 dimensions of patient safety culture among different groups of providers, categories of hospitals under EPHS and the overall grade of patient safety culture within Afghanistan and with results from use of the instrument in other countries. The proposed research will have important implications for both the hospital management systems and policy making. The findings will help hospital managers and decision makers understand different dimensions of patient safety. Results should assist hospitals and health departments redesign strategies and policies that are focused on attitudes, behaviors and practices to improve the overall culture of safety. Additionally, hospitals will recognize their weak and strong points and will contribute in exchange of experiences and share their best practices.