The Role of Mission Hospitals in African Health Systems: Case Studies from the Nile River Basin
Prominent among the faith-based institutions that provide health care in sub-Saharan Africa are mission hospitals established by Christian missionaries from the late nineteenth century to the present, as well as hospitals established by Africans as part of the legacy of Christian missions.
By focusing on pioneer and legacy mission hospitals in one region (the upper Nile River Basin) of sub-Saharan Africa, this research project seeks to answer three broad questions concerning the current state of African health systems. (1) How did things come to be this way? How have faith-based contributions to these health systems evolved from the earliest mission hospitals in the nineteenth century to now? (2) What precisely is the current role of these faith-based networks in African health systems? How are they financed? How are they managed? What portion of care do they provide, in what varying geographical contexts? What are the political, economic, and social factors that define their relationships with government, on one hand, and with the communities they serve, on the other? (3) Given their historical and current role in these health systems, what might the future hold? How might the past and the present realities of mission hospitals and their legacy inform the future of African health systems?
Research in progress.
In many countries, these hospitals anchor a large network of health facilities. In Uganda, for example, the Catholic Church and a small collection of protestant denominations, manage not only 47 hospitals, but more than 500 lower-level health facilities, many of them providing the only available care for Uganda's predominately rural population. This heavy dependence of national health systems in sub-Saharan Africa on faith-based facilities funded largely by external sources makes these systems vulnerable, especially when these facilities themselves are in crisis, as is increasingly the case with many mission hospitals. This research will inform debates about the ongoing role of faith-based facilities as part of national health systems in sub-Saharan Africa.