Table 4 Managerial and technical dimensions of DHs A and B performance
Characteristics | District hospital A | District hospital B | |
|---|---|---|---|
Governing bodies | Committee | Regional faith-based coordination committee of the Health | Hospital management committee |
Hospital Management Board | |||
Leadership | Leadership strength | Strong | Weak |
Shared | Centralised at the directorate level | ||
Resources generation | User fees collected | 222.49 million FCFA 86% of revenues managed by the hospital in 2010 | 37.9 million FCFA, 77% of revenues managed by the hospital in 2010 |
Subsidies from the Ministry of Health | Irregular funding (35.4 million FCFA in 2010) used on the basis of hospital needs | Regular lump funding every six months used on the basis of directives from the central directorate (progressively decreased from 15.4 million FCFA in 2001 to 10.84 million FCFA in 2010) | |
No wages paid to staff | Wages to technical staff | ||
Search for external funding from donors | Pro-active | Low | |
Regular external support in terms of technical expertise, equipment, drugs, infrastructure rehabilitation and construction from foreign organisations | Little support from local associations in 2010 (beds and mattresses) | ||
Management | Scope of management practices | Related to faith-based values | Administrative procedures |
Financial resources | Based on hospital needs and strategic plans | Based on guidelines from the Ministries of Health and of Finances, and are bureaucratic | |
Human resources | Decentralised management by hospital committees | Centralised management | |
Feedback to staff | Openly discussed at weekly meetings | Rare, with some aspects withheld | |
Maintenance | Well-equipped support services (e.g., woodwork, electricity and plumbing) | Scarce support service | |
Support and administrative staff | 22 | 9 | |
Human resources | Number of staff | Technical staff: 41 | Technical staff: 23 |
Medical doctors | 2 (2003–2006); 3 (2007–2010) | 1 (2003–2006); 3(2007–2010) | |
Inhabitants per medical doctor | 50,872 inhabitants | 23,817 inhabitants | |
Equipment | Number of beds | 157 | 49 |
Technical equipment | Good | Poor | |
Radiograph, 2 echographs, Mammograph, cardiotopograph, 2 well-equipped surgical theatres, electronic sphygmomanometers in each ward, oxygen | A small surgical theatre with little equipment | ||
Amenities for patients | High-quality ward | Not available | |
Tap water and electricity permanently available | Tap water only available in the morning, frequent electricity cut-offs |