System Strengths and Vulnerabilities in Faith-Based Health Facilities: A Mixed-Methods Study from Sub-Saharan Africa
Domain:
healthcareRecord type:
paper
Creator:
EmaAndLauMar
Publisher:
Host:
Background: Faith-based organisations (FBO) are key providers of health services in sub-Saharan Africa (SSA), particularly in underserved areas. However, evidence on the challenges and resilience of FBO-managed facilities remains limited. This study aims to assess these dimensions to inform health system planning and strengthen government-FBO collaboration.
Methods: We conducted a cross-sectional study of 63 health facilities across 11 SSA countries within the project “Supporting Faith-Based Organizations on the Frontline of Healthcare Service Delivery in Africa”. Data was collected using two tools: the Health Facility Assessment Questionnaire (HFA-FBO) and the Disaster Preparedness Assessment Questionnaire (DPAQ), combining quantitative and qualitative components.
Findings: Facilities faced persistent shortages of specialised staff, limited surgical and emergency capacity, and recurrent stock-outs linked to weak procurement systems. Infrastructure constraints, including unreliable utilities and deteriorating buildings, were particularly pronounced in rural areas. Disaster preparedness was generally low, despite many facilities being located in hazard-prone settings. At the same time, strong community trust, staff commitment, and adaptive practices emerged as key sources of resilience.
Interpretation: FBO facilities remain essential frontline providers but operate under significant structural constraints. Strengthening workforce retention, infrastructure, supply chains, governance, and emergency preparedness is critical to enhance national health system resilience. Greater integration and strategic partnerships between governments and FBOs are needed to ensure equitable and sustainable service delivery.
Methods: We conducted a cross-sectional study of 63 health facilities across 11 SSA countries within the project “Supporting Faith-Based Organizations on the Frontline of Healthcare Service Delivery in Africa”. Data was collected using two tools: the Health Facility Assessment Questionnaire (HFA-FBO) and the Disaster Preparedness Assessment Questionnaire (DPAQ), combining quantitative and qualitative components.
Findings: Facilities faced persistent shortages of specialised staff, limited surgical and emergency capacity, and recurrent stock-outs linked to weak procurement systems. Infrastructure constraints, including unreliable utilities and deteriorating buildings, were particularly pronounced in rural areas. Disaster preparedness was generally low, despite many facilities being located in hazard-prone settings. At the same time, strong community trust, staff commitment, and adaptive practices emerged as key sources of resilience.
Interpretation: FBO facilities remain essential frontline providers but operate under significant structural constraints. Strengthening workforce retention, infrastructure, supply chains, governance, and emergency preparedness is critical to enhance national health system resilience. Greater integration and strategic partnerships between governments and FBOs are needed to ensure equitable and sustainable service delivery.
Similar
Assessing electronic health record potential for adaptive learning in multimorbidity care in Sub-Saharan Africa: a mixed-methods study of Zimbabwe's Impilo systemUnderstanding the complexities of unexplained stillbirth in sub‐Saharan Africa: a mixed‐methods studyStrengths and weaknesses of eye care services in sub-Saharan Africa: a meta-synthesis of eye health system assessmentsEvaluating the strength of faith: Potential comparative advantages of faith‐based organizations providing health services in sub‐Saharan AfricaNurse-Led Education and Engagement for Diabetes Care in Sub-Saharan Africa: Protocol for a Mixed Methods StudyFamily planning and reproductive health supply stockouts: problems and remedies for faith-based health facilities in Africa