The provision of private charitable hospital care in west Africa--a case study.
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.
PHLS Communicable Disease Surveillance Centre, London.
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D000349:Africa; D003906:Developing Countries; D005380:Financing, Government; D006788:Hospitals, Voluntary / Q000191:economics*; D006801:Humans