Evaluation of the Afghanistan Health Initiative Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0990 Midwife	Form	New	Available
Form 0990 4 YR Resident Physician	Form	New	Available
Form 0990 3rd Year Resident Physician	Form	New	Available
Form 0990 2nd Year Resident Physician	Form	New	Available
Form 0990 1 year Resident Physician	Form	New	Available
Form 0990 Midwives	Form	New	Available
Form 0990 1-4 Year Resident Physician	Form	New	Available
Form 0990 Attending Physicians	Form	New	Available
Form 0990 Management Interview Guide	Form and Instruction	New	Available
0990-EvalulationofAfghanistan.doc	Supporting Statement B	Uploaded 2008-07-09	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Source copy available
0990-evaluation of AfghanistanAppendix B_20 questions_with cover June25.doc	Supplementary Document	Uploaded 2008-07-10	Available
0990-AHI Eval_OMB Supp Statement_V22.doc	Supporting Statement A	Uploaded 2008-07-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
185761	Midwife	Form	New
185760	4 YR Resident Physician	Form	New
185759	3rd Year Resident Physician	Form	New
185758	2nd Year Resident Physician	Form	New
185757	1 year Resident Physician	Form	New
185756	Midwives	Form	New
185755	1-4 Year Resident Physician	Form	New
185754	Attending Physicians	Form	New
185753	Management Interview Guide	Form and Instruction	New

ICR Details

OMB Control No: 0990-0332	ICR Reference No: 200807-0990-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Evaluation of the Afghanistan Health Initiative Project
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/28/2008
	Date Received in OIRA: 07/18/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2011	36 Months From Approved
Responses	186	0	0
Time Burden (Hours)	291	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Office of Global Health Affairs(OGHA) and the Assistant Secretart for Planning and Evaluation(ASPE), with in the U.S.Department of Health and Human Services(HHS), are requesting Office of Management and Budget(OMB) approval for collection of information to evaluate two components of the Afghanistan Health Initiative (AHI) which is authorized by the Afghanistan Freedom Support Act of 2002.

---

Authorizing Statute(s): PL: Pub.L. 107 - 327 103 Name of Law: Afghanistan Freedom Act
   US Code: 42 USC 301 Name of Law: 241
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 18800	04/07/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 39312	07/09/2008
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Management Interview Guide	0990	Management Interview Guide
Attending Physicians	0990	Clinician Interview Guide
1-4 Year Resident Physician	0990	Clinician Interview Guide
Midwives	0990	Clinician Interview Guide
1 year Resident Physician	0990	Y1R SBMA
2nd Year Resident Physician	0990	Y2R - SBMA
3rd Year Resident Physician	0990	Y3R- SBMA
4 YR Resident Physician	0990	Y4R - SBMA
Midwife	0990	MW-- SBMA

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	186	0	0	186	0	0
Annual Time Burden (Hours)	291	0	0	291	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection

---

Annual Cost to Federal Government: $547,732

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/18/2008

---