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The Center for Global Development has convened the Hospitals for Health working group to find ways to improve the performance of hospitals as contributors to health in developing countries while strengthening their integration in the broader health delivery system. The group’s findings will inform the creation of a collaborative body for hospital performance that will facilitate a network of individuals and institutions dedicated to fostering improved policymaking, investment, and management for emerging-market hospitals. A consultation draft of the working group’s report is expected in late September, 2014, and will be presented at the Health Systems Global Symposium in Cape Town, South Africa.
Hospitals are a critical part of health systems worldwide. They serve as the first point of care for many people, offer access to higher level care, and often set standards and provide training for the national health system at large. Hospitals also play a major role in responding to global health priorities from reducing newborn deaths to treating multidrug-resistant tuberculosis MDR-TB to delivering basic surgeries, and they are critical to achieving the financial protection goals of universal health coverage.
Despite the centrality of hospitals, hospital policy and performance in low- and middle-income countries has largely been neglected by health policymakers and the development community. While only a small minority of hospitals in emerging economies — mostly private facilities serving higher income groups — meet global standards, even underperforming hospital systems require significant resources and can consume as much 70 percent of government health budgets in some countries regardless of performance.
The working group aims to provide evidence on what works to improve efficiency, safety, effectiveness, and impact of hospital care on health system objectives to help generate a more sensible response from international and domestic actors.
Working Group Members
Lawton Robert Burns,Wharton School, University of Pennsylvania Anita Charlesworth, Health Foundation Victoria Fan, Center for Global Development Gary L. Filerman,Independent Gerard La Forgia, World Bank Amanda Glassman, Center for Global Development Frederico C. Guanais de Aguiar, Inter-American Development Bank Frédéric Goyet,The Global Fund to Fight AIDS, TB and Malaria Bruno Holthof, Antwerp Hospital Network Nandakumar Jairam, Columbia Asia Hospitals Maureen Lewis, Georgetown University Giota Panopoulou, Department of Health, Mexico Kedar Mate, Institute for Healthcare Improvement; Weill Cornell Medical College; Harvard Medical School Division of Global Health Equity Mead Over, Center for Global Development Alexander S. Preker,Health Investment and Financing Narottam Puri,NABH Joseph Rhatigan, Partners in Health Jim Rice, Management Sciences for Health Eric de Roodenbeke, International Hospital Federation Laura Schiesari,National Brazilian Association of Private Hospitals Hasbullah Thabrany, Center for Health Economics and Policy Studies, Universitas Indonesia Steven J. Thompson, Johns Hopkins Medicine International Juan Pablo Uribe, Fundación Santa Fe de Bogotá, Colombia Miguel Ángel Lezana, Funsalud, Mexico
The global commitment to universal health coverage—target 3.8 of the Global Goals for Sustainable Development—is as ambitious as it is energizing. Ensuring everyone, everywhere around the world has access to quality health care without being forced into poverty will require stronger health systems that generate better patient services and improve people’s health. And, to that end, investments in hospitals and their performance will be key.
Hospitals are central to building and maintaining healthy populations around the world. They serve as the first point of care for many, offer access to specialized care, act as loci for medical education and research, and influence standards for national health systems at large. Yet despite their centrality within health systems, hospitals have been sidelined to the periphery of the global health agenda as scarce financial resources, technical expertise, and political will instead focus on the expansion of accessible primary care.
Where do you go when hit with a serious medical condition? “The hospital!” is an obvious answer for people in high income countries, but for people in low-income and emerging market economies, access to a proper hospital is often just a dream. Why are decent hospitals in the developing world so few and far between?