Brazzaville, 25 October 2006 -- Delegates from 10 countries and the Network of Hospitals in Africa, the Indian Ocean and the Caribbean (RESHOAC) attending a meeting on strengthening the role of hospitals in national health systems have made recommendations on ways of implementing orientations adopted by Member States during the fifty third session of the WHO Regional Committee for Africa held in 2003.

At the end of their meeting in Brazzaville on Friday, the participants recommended that to improve effective community participation in health action and foster government stewardship in health development, African hospitals should have clearly articulated vision and mission statements as well as time-bound strategic action plans. Governments should also develop and regularly review national hospital policies and assign advisory roles to community members who should have at least 10% representation at board level.

Participants also agreed that in order to ensure enhanced collaboration between hospitals and other levels of the health system, health promotion and prevention activities should be co-opted as a function of hospitals. Also, all levels of referral systems between public hospitals, and between them and private sector health facilities should be further strengthened and developed.

On the critical issue of human resources for health (HRH), the workshop urged governments to promote policies aimed at developing a critical mass of health personnel; place emphasis on pre- service, in-service and post-graduate training, and develop appropriate career structures and income packages to motivate and retain health workers. They also recommended the setting up and strengthening of independent accreditation bodies and the establishment of quality assurance programmes and structures.

On hospital financing mechanisms, the meeting urged governments to provide adequate funding for salaries and equipment; design user fee exemption guidelines which ensure access of the poor to services; encourage public-private partnerships, and make deliberate efforts to provide special funding for the management of HIV/AIDS; opportunistic infections and tuberculosis.

In addition countries that have benefited from debt relief should allocate funds otherwise meant for debt servicing to hospital development financing. Recommendations for improved organization and management of hospitals include:
decentralization, to grant hospitals more autonomy to improve management; the definition of an essential package of services and care appropriate to the level of the health facility, and the introduction of the health management courses in the curricula of health training institutions

Other recommendations relate to prompt response to emergencies and referrals to save life, and improved communication between health workers and their clients.

In recognition of the important role played by traditional medicine in the region, the meeting recommended: the institutionalization of traditional medicine in national health systems; the development of a legal framework for traditional medicine practice; the development of a national traditional medicine policy as well as code of ethics; the undertaking of joint research on traditional medicines used for priorities diseases, and the development of mechanisms for protecting intellectual property rights and traditional medical knowledge. Other outcomes of this important meeting include: agreement on an essential list of hospitals’ performance indicators, establishment of networks between hospitals and development of a directory of hospitals’ specialized services and centers of excellence

Closing the workshop, the Director of Programme Management at the WHO Regional Office for Africa, Dr Paul-Samson Lusamba-Dikassa said: “Services provided by hospitals need to be properly integrated so that there is a maximization of available resources to produce the desired outcome for patients.

“We do recognize that there is much work to be done in improving the performance of hospitals given the magnitude of difficulties encountered in running them efficiently and effectively. I can assure you that WHO will continue to encourage countries to develop their capabilities in improving the management of hospitals.”

The five-day meeting was attended by 17 participants from Cameroon, the Republic of Congo, the Democratic Republic of Congo, Malawi, Guinea (Conakry), Niger, Nigeria, Uganda, South Africa, Zambia, the French Co-operation Agency and RESHOAC.

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