Essay Sample on Healthcare System on Central African Republic

Introduction

Following the fight which erupted in 2013, the Central African Republic has been faced by recurrent fights and insecurity which has dilapidated the operations of the nation. Accordingly, the fighting further cripples the country's already fragile healthcare system. Reports by UNICEF, UNDP and WHO shows that the Central African Republic is among the leading nations in the world with the least Human Development Index. For more than four decades, the Central African Republic has been afflicted by chronic political instability, poor governance, and underdevelopment. 2013 is what has been described and characterized as the worst crisis which reached its peak after the Seleka rebels annexed the country leaving hundreds of people dead a thousands of individuals displaced from their homes. The mortality rate of children below the age of five is alarming. Children are dying from easily preventable diseases such as malaria. In light of this statement, the objective of this project is to address various challenges facing the healthcare system of the Central African Republic. Therefore, this project intends to improve the quality of operations at the Bangui Paediatric Complex by December 2013 to achieve high results with well-trained and motivated staff.

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Project Description

According to the United Nations Development Program (UNDP) statistics, the Central African Republic is ranked the second lowest on the Human Development Index. The report has shown that the mortality rate is approximately 130 deaths per 1,000 live-born children - the primary causes of these deaths being the easily treated ailments like malaria which are in most cases intensified by malnutrition (Arieff, 2014). These easily treatable diseases account for more than 60% of the hospital admissions at Bangui Paediatric Complex. The Bangui Paediatric Centre is operated twenty hours in a day and provides primary as well as emergency care for children of up to a maximum of fourteen years. The hospital is tasked with performing hygienic and health education for families. Also, the Centre offers practical and theoretical training to national staff. As a result of the 2013 coup, the Central African Republic has been faced by overpowering insecurity and fighting which has crippled the nation has had a devastating effect on its fragile healthcare system. Therefore, in this context, the national emergency decided to offer its services to the health authorities and begun to work in collaboration with the public pediatric hospital across the country that is the Complex Paediatric in Bangui.

For more than four decades, the Central African Republic has been afflicted by chronic political instability, poor governance, and underdevelopment. 2013 is what has been described and characterized as the worst crisis which reached its peak after the Seleka rebels annexed the country leaving hundreds of people dead a thousands of individuals displaced from their homes. Indeed, this condition mostly worsened following the series attacks on fifth and sixth of December 2013 which triggered a wave of retribution across the whole country. Presently, there is a large-scale human rights violation which continues to be committed by the conflicting sides which include a broad spread gender-based violence as well as torture. As a result, many children lost their lives, other mutilated and others subjected to sexual abuse and recruited by armed groups. Consequently, the escalation of the bloodshed has left hundreds of individuals and many people displaced (Scherrer, 2012). The crisis remains a children's emergence with approximately 2.3 million children being affected and a majority remain at risk and continue being in need of protection and assistance. According to the statistical report, nearly half of the Central African Republic is made up of boy and girls who are amongst the most vulnerable groups including children of Muslim minorities who are continuously threatened by militia groups (Parashar, Hummelman, Bresee, Miller, & Glass, 2013). Even before the crisis of 2013, the children of the Central African Republic were still facing unfavorable conditions. For instance, one in every ten infants died before clocking the age of five. Approximately, 20 % of the Central Africans below the age of five were chronically undernourished with over 30 % of primary school-aged children being out of school (Welz, 2014). Thus, only less than half of the children could gain access to safe drinking water and proper sanitation.

In light of this statement this project intended to improve the quality of operations at the Bangui Paediatric Complex by December 2023 to realize high results with well-trained and motivated staff. The target of this capstone is to review the current services which include reception, support, and care of children at the Bangui Paediatric Complex. The project will also explore, propose and test innovative solutions adapted to the specific environment of the Central African Republic. On the same note, the project aims to contribute to a better organization, improved satisfaction for staff and hospital management and improved patient satisfaction.

Implementation Timeline

100% of the project should be designed and approved by the Management of the Pediatric Hospital by 31 January 2019;

100% of the plan approved by the Management of the Pediatric Hospital should receive the support of the Ministry of Health;

20% of the project should be implemented by 31 December 2019;

40% of the project should be achieved by 31 December 2020;

60% of the project should be delivered by 31 December 2021;

80% of the project should be performed by 31 December 2022;

100% of the project should be implemented by 31 December 2023.

Description of peer/external advisors with a plan for using them

External Advisors:

• Professor Gody, Director of the Bangui Pediatric Complex, 20 years of professional experience
• Dr. Danielle Kedy Mangamba, Medical Director and Head of Pediatric Unit, Pediatric Hospital Douala Cameroon, 15 years of Pediatric Experience
• Dr. Barry, Hospital Focal Point WHO CAR
• Dr. Mehoundo Faton, Hospital Focal Point UNICEF CAR
• Dr. Fotsing, Health Cluster Lead, CAR
• Lucie Leclerc, Management Degree in Health Care Administration, Risks Management Specialist

Upon my request and depending on their availability, my external advisors will provide all the necessary advice during the design of my Capstone project. We will be meeting when necessary online and on-site to review my capstone proposal and to monitor my progress. My external advisors will also play a key role in helping me evaluate my methodical choices and their feasibility. I also count on their contacts and field experience. Finally, I will be relying on my external advisors to ensure that all Capstone requirements are met.

Peers: PAG 6 team

My peers will help me challenge my thinking and assumptions while designing and completing my Capstone project. My peers could also ensure that all components of our ALUSB MBA have been taking into account while developing my Capstone project. Finally, my peers will also serve as rewriters of my Capstone project. As a student, I am sometimes struggling to deliver my assignments on time. When I face hard times, it's always good to receive support from my peers who ensure that nobody is left behind.

Terence Chambati

MBA Student

Class of 2019

Alois Mabutho

MBA Student

Class of 2019

I will be counting also on the support and advice from:

Diana Kizza

MBA Student

Class of 2020

Senior Program Manager

Sustainable Health Financing

Clinton Health Access Initiative

Key Objectives and Metrics

The primary objective of this project is to solve several problems which have been identified during the visits at the Bangui Paediatric Complex and during various interviews we had with the Director of this hospital and some staff acting at different levels of with responsibility. The main problems are:

• Poor quality of health services provided
• Insufficient results as highlighted by the management
• Lack of change/innovation mindset
• Staff shortage and lack of training
• Staff demotivation
• The laziness of the staff

All these problems have a negative impact on the quality of healthcare provided to patients mainly composed of children and affects directly infant mortality which is very high in this health center (9% in September 2018) and is in line with CAR's infant mortality rate which is one of the highest in the world.

Our project will impact the following stakeholders:

The Central African Republic: a high infant mortality rate gives an idea of the level of development of a country. The higher the percentage, the less developed the state is. Indeed, the fragility of a baby makes it extremely dependent on its immediate environment regarding health infrastructures, socio-economic development, education, management, but also regarding its geographic location (landlocked or not) among other factors.

Families, especially parents cannot be happy if the life and survival of their children cannot be guaranteed. It is also necessary to note the stress and anxiety related to the many and unforeseen expenses generated when a child is admitted into a health center (World Health Organization, 2017).

Children who find themselves caught in a health system that they do not master and who are forced to live in unhealthy conditions and who can keep sequels for the rest of their lives. Poor health care can lead to death or severe consequences for their future education.

Hospital staff who work in extremely difficult conditions and yet expect the best:

The management of the hospital that carries a huge responsibility, that of giving hope and giving life to unhealthy people in extremely difficult conditions.

The aim of this project through our observations made at the Bangui Pediatric Complex and through interviews conducted with its management and staff, to identify the significant problems and to recommend practical, workable and innovative solutions which could be implemented within realistic deadlines with the active contribution of all its stakeholders.

Our project aims to make an analytical study of the operative processes in force within the Bangui Pediatric Complex to identify its strengths and weaknesses and to propose solutions adapted to the realities of the CAR. More specifically, our project will analyze various aspects involved and related to entrepreneurship and innovation, strategy, marketing, operations, finance, and PECAB. Also, in its communication component, our project aims to draw the attention and to mobilize different stakeholders on the critical issues identified.

Regarding entrepreneurship and innovation, our project will focus on identifying the problem and proposing possible solutions to resolve this problem. We will also try to see how the proposed solutions could evolve during our study. Other related questions such as reorganizing the structure of the Bangui Pediatric Hospital will be part of our research.

Regarding strategy, our project will focus on studying the environment in which it will be carried out. It will identify the project needs as well as its stakeholders and the primary beneficiaries. This part of the study will also determine our unique advantage over other players in the sector. Another important aspect which will be included in this section is the identification of all risks associated with this project and measures to mitigate them.

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