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Table 4 Managerial and technical dimensions of DHs A and B performance

From: The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

  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