Article Text
Abstract
Public hospitals in low-income and lower-middle-income countries face acute material and financial constraints, and there is a trend towards building new hospitals to contend with growing population health needs. Three cases of new hospital construction are used to explore issues in relation to their funding, maintenance and sustainability. While hospitals are recognised as a key component of healthcare systems, their role, organisation, funding and other aspects have been largely neglected in health policies and debates since the Alma Ata Declaration. Building new hospitals is politically more attractive for both national decision-makers and donors because they symbolise progress, better services and nation-building. To avoid the ‘white elephant’ syndrome, the deepening of within-country socioeconomic and geographical inequalities (especially urban–rural), and the exacerbation of hospital-centrism, there is an urgent need to investigate in greater depth how these hospitals are integrated into health systems and to discuss their long-term economic, social and environmental sustainability.
- health services research
- qualitative study
- hospitals
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Footnotes
Handling editor Seye Abimbola
Contributors VR had the initial idea for this paper with FC. FC coordinated the writing of the article, VR and LA wrote the section on Haiti. All authors contributed to the development of ideas and the writing of the manuscript, commented on drafts and approved the final version.
Funding Fanny Chabrol has received funding by Agence Nationale de la Recherche (http://dx.doi.org/10.13039/501100001665) and grant number: ANR-17-CE36-0006-01.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.