Network development for non-state health providers: African Christian health associations

ABSTRACT

Substantial effort has been put into forming and strengthening national networks of non-state, non-profit health providers in lower- to middle-income contexts. Christian health associations (national umbrella networks of faith-inspired health providers) were first established in the 1950s, and are currently present in an estimated 23 of the 54 countries in Africa. The establishment of CHAs was equally encouraged by faith-based health providers, governments, and external stakeholders. CHAs look different in each context, but perform similar roles: networking diverse institutions and facilities together into a loose system; and establishing a more cohesive sector to simplify and strengthen advocacy and engagement with the government.

Un effort conséquent a été consacré à la formation et au renforcement des réseaux des prestataires de soins non-gouvernementaux et sans but lucratif, exerçant dans des contextes de revenus faibles à moyens. Les associations chrétiennes de santé (ACS - des « réseaux ombrelles » de prestataires de santé inspirés par la foi) ont été établies dans les années 50, et il est estimé qu'elles sont actuellement présentes dans 23 des 54 pays d'Afrique. L'établissement des ACS a été également encouragé par les prestataires de soins inspirés par leur foi, les gouvernements et des parties prenantes extérieures. Les ACS ont une image qui diffère selon les contextes, mais jouent des rôles équivalents : la mise en réseau d'institutions et d'établissements divers dans un système souple ; et l'établissement d'un secteur plus solidaire pour simplifier et renforcer le plaidoyer et l'engagement auprès du gouvernement.

En contextos en que existen poblaciones de ingresos bajos y medianos se han hecho esfuerzos sustanciales destinados a formar y fortalecer redes nacionales de proveedores de servicios de salud no gubernamentales y sin fines de lucro. Establecidas en los años cincuenta del siglo pasado, las asociaciones cristianas de salud —acs— (redes coordinadoras de proveedores de salud inspirados en la fe que operan a nivel nacional), tienen actualmente una presencia en 23 de los 54 países del continente africano. Tanto dichos proveedores como gobiernos y actores externos alentaron por igual el establecimiento de estas acs. Aunque las mismas presentan diferencias en cada contexto, desempeñan papeles similares, enlazando a diversas instituciones e instalaciones en una red informal. Además, impulsan el establecimiento de mayor cohesión en el sector con el fin de simplificar y fortalecer las actividades de incidencia e intercambio con los gobiernos.

KEYWORDS:

• Civil society – Partnership
• Social sector – Health
• Sub-Saharan Africa

Acknowledgements

Some parts of this article have been previously published as part of a World Bank working paper series (Dimmock, Olivier, and Wodon 2012).

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Frank Dimmock is the Africa Mission Specialist with the Outreach Foundation and a Senior Technical Consultant to IMA World Health. He has over three decades of public health experience in east and southern Africa and has served on the boards of several CHAs. He is currently focused on trauma recovery with vulnerable children and families.

Jill Olivier is a Senior Lecturer and Research Coordinator at the University of Cape Town in the School of Public Health and Family Medicine, Health Policy and Systems Division. She is the Director of the International Religious Health Assets Programme (IRHAP) and holds a PhD in Development Sociology.

Quentin Wodon is a Lead Economist in the Education Global Practice at the World Bank where he leads global programmes on equity and inclusion in education, child marriage, and out-of-school children, as well as country work.

Notes

1. The African Christian Health Associations Platform is an umbrella body established to coordinate between CHAs in Africa, currently situated in Kenya; see www.africachap.org.

2. Before CHAs were established, there were some smaller networks in place. For example, the networks of Catholic facilities coordinated from a central Catholic “Health Desk”, or a Health Desk within an ecumenical Christian Council. However, these tended to be very lightly held. Some were adapted into CHAs, and others remain today, as networks within the CHA umbrella network.

3. Asante (1998) notes five fundamental principles commonly cited in Christian healthcare provider’s mission statements, and highly valued by all CHAs: should be dedicated to the promotion of human dignity and the sacredness of life; should assist all in need, with a preferential option for the poor and marginalised; are meant to contribute to the common good; should exercise responsible stewardship; and should be consistent with the teachings and moral principles of the church.