Project description

Title: Rehabilitation of the Regional Hospital in Diourbel
Client: Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung (BMZ)
Country: Senegal
Lead executing agency: Senegal Ministry of Health
Overall term: June 1999 to May 2007

Context

The condition of the hospital in Diourbel, built in 1966 with the assistance of German development funds, had declined to an unacceptable level. For some years now, management and staff have not been able to cope with the tasks facing them, and funding has been insufficient for sound operations. In the region that the hospital was intended to serve, the poor quality of mother-and-child care is cause for particular concern. Statistics show that the state of health of the population in that region falls even below the national level, which is in itself relatively poor. A fifth of all children die before reaching the age of five.

Objective

Medical care in the Diourbel region has improved. The hospital there has sufficient suitably qualified staff, the equipment is better, and management is functioning efficiently. Access to health care has been facilitated for all levels of the population.

The regional hospital serves as a model in the region. With functional facilities, the confidence of the population in the quality of medical care recovers and the hospital is used more often.

Because people feel greater confidence in health care, the number of members in local health insurance schemes rises; the project supports consolidation of such schemes.

With overall development underway, hospital revenues increase. This leads to easier access to health care for socially weak population groups, because their treatment costs can be better covered by the increased income generated.

Approach

The focuses of GTZ advisory services are the quality of medical care, the hospital’s internal organisation, and a better image of its performance capability both internally and externally. Analytical bookkeeping and the keeping of records on patients are being introduced. Improvements are also needed in the laboratory and surgical departments. The establishment of municipal social security systems is also being promoted.

International partnerships enable improved networking between health care professionals in Senegal and specialist colleagues and institutions abroad.

The hospital was put in working order, and some new equipment delivered, with Financial Cooperation funding via the KfW Entwicklungsbank (KfW development bank).
 
The German Centrum für internationale Migration und Entwicklung (CIM) is also involved in this project in that it recruits and places experts for advisory purposes. These experts work on improving mother-and-child care and obstetrics in the hospital and in the region generally; they help bring about improvements in the internal organisation of nursing and in the quality of health care services.

Results achieved so far

Markedly improved hospital services have led to considerably increased revenues.  At the end of 2005, hospital income was at more than 35 percent of the amount provided through state subsidies, so that the hospital is now generating sufficient income to cover a quarter of its budget on its own.