Why Healthcare Facilities Matter for Global Health Programs
There seems to be lack of consensus about what healthcare facilities are for in global health. To me this realization came as a surprise. As a doctor, I have been around health facilities for most of my life. I have seen very good ones, clean, well-organized and managed, in rich and poor environments. So I know it is not only about resources. I have also seen rundown facilities, that have the three “D”, that is, dusty, deserted and dilapidated in too many countries around the world- places where I would not like to get a paper cut, less deliver a child or get a vaccine. Our job in global health is to turn the latter into the former. It is that simple.
You may also wonder why healthcare facilities matter so much. Why our job in global health is to make sure they work efficiently and deliver quality health services. And why these healthcare facilities must consistently serve their communities according to the people’s needs.
Here is the reason:
You see, healthcare facilities do not only matter to the community and their doctors, nurses and other health workers. They matter to public health experts, program managers and donors working in global health, as well.
Healthcare facilities have many names such as hospitals, health centers, health dispensaries, aid posts and clinics. They are the basic building blocks of a health system. A healthcare facility is designed to provide a certain type of services based on the size of the local population and their epidemiological pattern. For that reason, there is usually a health center or clinic per every 5,000 to 10,000 people that provides primary healthcare services (PHC), that is, the essential preventive and curative care required to address the most prevalent conditions. That includes reproductive and maternal health, child health, nutrition and diagnostic and treatment services for most common conditions.
It is also from these PHC facilities that we run public health programs and community-based programs using community health workers and or volunteers. Everything must be managed by a responsible and accountable party, either government, private, civil or faith-based organization. I must stress the importance of coordination and accountability in managing the PHC facilities and programs in any country.
The patients with less frequent conditions that require specialized diagnostic and treatment services are referred to a hospital where specialists work, surgical treatment and more complex medical technology can be accessed. That is why countries usually have a district hospital every 20 to 30 thousand people and specialized hospitals that deliver secondary, tertiary and even quaternary levels of care for trauma, cancer, burns, etc. All that depends on geographic accessibility and on the epidemiological pattern of the population these facilities are to serve. For that reason, countries need to have an effective health surveillance and information system that allows them to plan and monitor effective programs to prevent and control diseases. It is the healthcare facilities that will implement public health programs, and why the people that work in healthcare facilities need to be trained, supported, responsible and resourceful professionals that are able to deliver the services the communities need when they need them.
Either be Ebola, Zika, Malaria, diabetes or cancer, a health facility must be ready and able to deliver quality healthcare according to evidence-based standards consistently to every patient every day everywhere in the world. That is why global health programs matter because they help us increase the number of well-organized and managed healthcare facilities that every day realize the right to quality healthcare everywhere in the world.
To learn more about health system strengthening and how to implement the steps above, contact RGH at programs@realizingglobalhealth.com
