Faith-based health care [1]

摘要

We thank Jill Olivier and colleagues for their helpful overview of faith-based health care in Africa.1 As a not-for-profit provider of faith-based health care in a hard to reach rural region of southwest Uganda, Kisiizi Hospital has recognised that a fundamental difficulty with public services in remote locations is the availability of healthcare staff in facilities. Olivier's report alludes to "intrinsic motivation" and the "faith-based organisational ethos". We frequently receive patients who have attended public facilities and found essential staff missing (eg, a child with intussusception where no surgeon was available, and a mother in obstructed labour where no anaesthetist was in the facility). Patients are brought to Kisiizi because members of the community trust that they will find a reliable 24-hour service. The challenge to universal health coverage is not just geographical, but also in the availability of access at all times of day and night. Kisiizi Hospital employs excellent Ugandan specialist staff who could earn far more in an urban setting, but their Christian motivation compels them to stay in a remote location to serve the very poor community. Kisiizi aims to offer "life in all its fullness" to patients, attendants, and community, encompassing physical, mental, spiritual, and community health. This is enhanced by the Kisiizi Community Health Insurance Scheme, the oldest community health insurance scheme in Uganda, with over 36OOO beneficiaries residing up to 60 km from Kisiizi. The insurance scheme aims to provide affordable access to quality health care for vulnerable, poor communities, with an annual premium for acute health-care cover equivalent to about US$2-8. Kisiizi has partnered with WHO to work on linking universal health coverage with patient safety, and quality.