Transcript CHRISTIAN HEALTH ASSOCIATIONS IN AFRICA

CHRISTIAN HEALTH
ASSOCIATIONS IN
AFRICA
Presented at CCIH Annual Conference
May 29, 2005
Frank E. Dimmock
P.O. Box 1266, Lilongwe
MALAWI
[email protected]
Countries with CHAs - 12
•
•
•
•
•
•
•
•
•
•
•
•
Lesotho – CHAL
Zimbabwe – ZACH
Zambia – CHAZ
Malawi – CHAM
Tanzania – CSSC
Kenya – CHAK & KEC
Uganda – UPMB, UCMB
Sudan - CHAS
Nigeria - CHAN
Ghana – CHAG
Liberia – CHAL
Sierra Leone - CHASL
Characteristics of the Associations:
LESOTHO – founded in 1974, 8 hospitals
& 75 HCs, ~40% of NHS, decentralised in
1984 to HSAs, formal agreement w/ GoL in
1991, Professional staff salaries + 20%
operating budget/yr from GoL. Currently
being restructured to District level. All health
facilities digitally mapped.
Southern Africa
ZIMBABWE – founded in 1974, 52 hospitals & 68 HCs,
~45% of NHS, 8 DDH, fees set by Gvt., Gvt. Grant reduced
by revenue amt., Gvt supports training schools.
ZAMBIA – founded in 1970, 30 Hospitals & 60+ HCs,
~ 30% of NHS, Professional staff paid by GRZ, MoU
signed in 1996, Church Hospitals given 75% operating
budget, decentralised to District Health Boards, CHAZ
now includes non-institutional members. Mapping of
facilities in process (05/05)
MALAWI – founded in 1966, 28
Hospitals & 125 HCs, ~ 37% of NHS,
MoU signed in 2002, All established
positions reimbursed by GoM,
Decentralisation now w/ district-level
service agreements. All Health facilities
digitally mapped.
CHA features cont’d
TANZANIA – founded in 1992, 81 Hospitals + 2
TH, 68 HCs, 21 DDH w/ 100% op expenses
covered by Gvt., ~ 48% NHS, Block grants to
Church hospitals, service agreements in prep.
KENYA – founded as CHAK in 1982, 24
Hospitals,43 HCs, 298 disp., 51 Church Health
Progs., ~40% NHS, restructured in ’97, Area
Coord. Cttees., new CHAK-GoK TWG formed,
no gvt. grants rec’d since 1996. Digital mapping
of Health facilities in process
KEC = Catholic Health Association
East Africa
UGANDA – UPMB – founded in 1955,
17 Hospitals, 115 HCs, ~20% NHS,
annual service-level agreements @
district level, Gvt. seconded staff.
- UCMB - founded in 1955,
27 Hospitals, 232 HCs, ~32% NHS, Gvt.
supports ~ 30% operating expenses,
PPPH office assists in collaboration w/
Gvt.
PNfP providers CR from fees = 43%. ~
30% from gvt support. Service contracts
since 2000. PPPH office established to
enhance collaboration. Digital mapping of
all Health Services in process
SUDAN – CHAS Founded on Friday, May 6, 2005. Lead
Agency in the formation is CEAS (Churches Ecumenical
Action Sudan) Currently 4 general hospitals, 30 specialist
hospitals, 5 training schools mostly managed by IFBOs
~30% HS provided by Christian INGOs & Sudan Churches
SOUTHERN SUDAN
Renk
Kauda
West Kordofan
South Kordofan
Upper Nile
FashodaAburoc
Gumriak 1
Tonga
Abyei
Marial Bai
Nine Boli
Gok Machar
Aweil East
Unity
Northen Bahr el-Ghazal
Raja
Westen Bahr el-Ghazal
Ajiep
Bow
Udici
Bararud
Leer
Thonyor
Ayod
Tonj
Waat
Ayod
Tangyang
Yuai
Panyijar
Midel
Jonglei
Duk Payuel
Pochalla
Lekongole
Rumbek-cueibet
Adior
Rumbek
Akot
Wullu
Yirol
Yirol
Aluakluak
Billing
Lakes
Mvolo
Tambura
Western Equatoria
Ezo
Maridi
Yambio
Tarakeka
Juba
kilometres
Town/Settlement
200
Yei
Kapoeta
Haforere
Bahr el-Jabal
Yei
Kapoeta
Kimatong
Torit
Juba
Yambio
Eastern Equatoria
Equatoria
Maridi
100
Pibor
Boma
Mundri
Lui
Kotobi
Faraksika
0
Bor
Terekeka
Li Rangu
Nzara
Region (e.g. Equatoria)
Pibor Post
Awerial
Mundri
State (e.g. Western Equatoria)
Kolmerek
Yomciir
Baidit
Ramciel
Padak
South
Abuyong
Bor
Pochalla
Awerial
Tambura
County (e.g. Yambio)
Akobo
North Bor
Cueibet
KEY
Wanding
Kier
Thokliet
Akobo
Ganyiel
Mapel Tonj

Diror
Duk Padiet
Wuror
Nyal
Mapear
Latjor
Uriang
Urieng
Nasir
Jiech
Leer
Wau
Longochok
Kiech Kuon
Lankien
Bieh
Nabagok
Wau
Diem Zubeir
Udier
Nyirol
Koch
Warab
Sobat
Upper Nile
Duar
Guit
Bahr el Ghazal
Awada
Malakal
Nyilwak
Jaibor
Nimnim
Keew
Atar
Bentiu
Thokchak
Old Fangak Old Fangak
Atar
Mayom
TwicMaper
Malual Bai
Malualkon
Akon Panliet
Aweil
Alek
Gogrial
Aroyo Aweil South Gogrial Liethnom
Aweil West
Baau
Nyamlell
Celkou
Beneshowa
Rubkoana
Aweil North
Yabus
Oriny Fashoda
Ruweng
Raja
Blue Nile
Renk
South Darfur
Keyala
Budi
Chukudum
Torit
Nagichot
Kajo Keji
Mangalotore
Magwi
Parajok
Narus
New Cush
Ikotos
Nimule
NB: The boundaries and names shown on this map do not imply recognition/endorsement by the UN
Unicef/OLS Apr05
Features cont’d
NIGERIA - CHAN
GHANA – CHAG Founded in 1967, ~ 34%
NHS, Developed QA & Accreditation system
LIBERIA – CHAL
Founded in 1975, 5 Hosp,
67 HCs, ~47% NHS, collab
w/ MoH/SW in CBR, WASH,
FLE, PSS..
Little institutional support
SIERRA LEONE - CHASL
West Africa
Central African Republic
Rwanda
Togo
ASSOMESCA
BUFMAR
APROMESTO
Other Countries with Networks or Coordinating Agencies:
Namibia
NCC
Democratic
Republic of Congo
Botswana
SANRU
AMMB
~ 50% NHS by FBOs
Angola
Cameroon
CICA
FEMEC
Ethiopia
Senegal
CRDA
EPSCM
Summary Characteristics of Associations
• History of health networking
(CMC of WCC established in 1968)
• Members provide significant portion of National H.S. & training of
Health personnel
• Formal agreement / MoU with Government & service agreements
@ District level
• Participate in National Health Planning & Policy setting
• Have implemented and facilitated health programmes
• Most related w/ WCC, EPN, and other international bodies
Core Functions of CHAs

Advocacy (Planning & Policy Setting)

Technical Assistance & Training (constructive encouragement)

Capacity building / Institutional strengthening (SP, OD, HR)

Resource Mobilisation / Administration (facilitate partnerships)

Research (ARHAP, HIV/AIDS)

Monitoring & Evaluation (establishing standards)

Joint procurement (MEDS, JMS) & equipment maintenance

Communication, Health Information
Government
Donors
Association
Member Health
Units/Programmes
Church
Leaders
Challenges of Christian Health Associations:
•
•
•
•
•
•
•
•
•
Mandate / Authority (advisory vs control)
Financial Sustainability
Membership – composition & accountability
Diversity of membership (capacity variance)
Relationship balance (with 4 corners)
Communication
(external and internal)
Coverage (Geographic and programme)
Leadership (turnover and commitment)
Publicity (profile & evidence)