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The provision of private charitable hospital care in west Africa--a case study
1PHLS Communicable Disease Surveillance Centre, London.
Insights
The Hôpital Protestant de Dabou (HPD) faces declining services due to funding cuts and rising costs. It must choose between becoming a high-cost facility or seeking aid to maintain affordable healthcare for its rural community.
Area of Science:
- Global Health
- Healthcare Management
- Rural Health
Background:
- The Hôpital Protestant de Dabou (HPD), a rural private charitable hospital in Ivory Coast, experienced a significant decline in services since the 1990s.
- This decline primarily impacted pediatric and general medicine departments, affecting healthcare accessibility for the local population.
Purpose of the Study:
- To evaluate the determinants of declining activity at HPD.
- To explore strategic options for the hospital's future sustainability while adhering to its founding principles.
Main Methods:
- The study involved an evaluation of factors contributing to the hospital's reduced activity.
- Analysis of financial support, pricing structures, and drug availability was conducted.
Main Results:
- Key factors identified include reduced government and aid agency funding, increased service costs making them unaffordable, and drug shortages.
- HPD faces a critical decision between financial self-sufficiency through high-cost care or continued pursuit of external support to maintain affordability.
Conclusions:
- HPD's sustainability is challenged by financial constraints and rising costs.
- Maintaining affordable, quality healthcare requires either a strategic shift towards high-cost services or securing sustained external funding to preserve its mission.
Abstract:
The Hôpital Protestant de Dabou (HPD), a private charitable hospital located in a rural area of the Ivory Coast, has seen its activity decreasing significantly since the beginning of the 1990s. The decrease affected mainly the paediatric and the general medicine specialties. An evaluation suggested that this appeared to have resulted from a combination of determinants including decreasing level of financial support from government and aid agencies, rise in the hospital price list rendering services financially inaccessible to the local population, and episodes of drug shortage. The HPD is facing two options, the first being to evolve towards a self-sufficient organization offering expensive health care to the wealthiest part of the population, thus departing from the original driving principles of affordability and value for money. The second option is to try to stick to these principles by actively seeking greater financial support from government and aid agencies. External donors may find that only with their continued support can the qualities of responsiveness, flexibility and innovation displayed by the HPD and other comparable hospitals be preserved.