Hospital In sub-Saharan Africa Research Articles

Public autonomous hospitals in sub-Saharan Africa: trends and issues

Since the late 1980s, many countries in Africa have been granting increased autonomy to their main teaching hospitals. This policy has significant international support but has been evaluated little from either theoretical or empirical perspectives. This paper attempts to fill this gap by assembling evidence from policy documents, theoretical debates and empirical evidence of related policy changes in other contexts such as the development of trust hospitals in the UK NHS. The paper attempts to locate the policy in the broader context of the package of health sector reform measures proposed at international level, and to identify the role it is intended to play in the achievement of the implicit objectives of that package. The objectives identified are improvements in allocative efficiency and equity, improvements in internal efficiency and improvements in responsiveness, accountability and choice. Each of these objectives presents difficulties which suggest that only modest short-term expectations of the policy can be justified. Given the lack of evidence from existing experience, a research agenda is suggested, which aims to provide information to guide further implementation of the policy.

On an average: the rural hospital in sub-Saharan Africa.

The general impression of a heavy workload for rural hospitals in sub-Saharan Africa is illustrated by a quantification for 16 parameters, based on data in 120 annual reports from 40 hospitals. The figures presented in this study can be looked upon as “figures of reference” which hospitals can use for reflection on their own data. Comparison with other studies is made possible by presenting the figures after conversion to an assumed population of 100 000. Marginal notes are made on the comparability of the data as presented by the hospitals.

Left anterior hemiblock masking inferior myocardial infarction.

A case is presented in which transient left anterior hemiblock masked the electrocardiographic signs of old inferior wall infarction. The electrocardiographic features are correlated with the anatomopathological findings. This case re-emphasizes the need for careful evaluation of patients with chest pain and left anterior hemiblock.