Strengthening hospital infrastructure in a war context: the case of the Mopti regional hospital.

Abstract

In sub-Saharan Africa, public hospitals should play a key role in providing quality, affordable health care and contribute to robust health systems, particularly in war-torn contexts. In Mali, a multidimensional crisis has had a severe impact on the health of the people and on the overall health infrastructure and its capacity to respond to the crisis. Public hospitals suffer from multiple long-standing constraints that are rendered even more acute in the context of war. This paper presents governmental, development, and humanitarian efforts and interventions aimed at strengthening hospital infrastructure in Mopti, central Mali. Three key dimensions of hospital infrastructure are fundamental to ongoing operations: human resources, governance, and equipment/maintenance. The results revealed two approaches to strengthening hospital infrastructure: a developmental approach, aimed at constructing new buildings and implementing hospital autonomy-oriented reforms, and a pragmatic approach that focuses more on concrete solutions to the most urgent needs. The insights presented here argue for stronger linkages between these two approaches to reinforce the everyday functionality of health care infrastructures in destabilized contexts.