HNRH: Working for Effective Health Service Delivery

Articles

Health is one of the inalienable rights of citizens enshrined in the Declaration of Human Rights. Eritrea has been working to enhance the health conditions of its citizens and is indeed one of the few sub-Saharan states that have achieved the millennium development goals ahead.

Among the enablers towards this achievement is the Halibet National Referral Hospital (HNRH) which was established more than 50 years ago. HNRH has seven departments that have their own units within. These are emergency department, outgoing patient department (OPD), permanent care department, laboratory, imaging and ultrasound, pharmacy and the finance and administration departments.

HNRH has ten wards and 180 beds that give service to orthopedic, bone and general surgery. It has 550 personnel, in general, of which 75% are health workers and the remaining are members of administration and finance. HNRH is the only hospital that gives skin graft, bone and burn related health problem service. Moreover, people with diabetes, blood pressure and orthopedic problems visit this hospital from all around the nation. Annually it is visited by thousands of patients. In the year 2017 alone, it gave service to more than 141,500 patients. Of these 74 thousand were served in the OPD, around six thousand were hospitalized, three thousand patients underwent surgery, and around 58 thousand were given imaging and ultrasound service. Overall, there has been an increase in number of outgoing patients, patients who underwent surgery and patients that were hospitalized.

The emergency department serves both outgoing patients and patients who are admitted. This department has given service to 9187 outgoing patients and provided treatment to 2451 patients. The outgoing patient department is where most people are served. Service is provided free of charge for OPD patients. In the last year it has given service to around 74 thousand, of which more than 40 thousand patients were people with diabetes, TB, hepatitis, blood pressure and others. Free medical care costed the hospital more than 3.35 million Nakfa.

The orthopedic department serves admitted and outgoing patients. There are three wards and 60 beds in this department which provided service to 1127 patients last year. One of the unique features of this hospital is that it gives endoscopic service and treatment.

The masculine and skeletal department treats patients from all around the nation. It has two wards where patients with any kind of bone disease and fractures are treated. The department has improved in equipment and capacity. As a result in 2017, it gave service to around three thousand patients and conducted surgery on around two thousand patients.

The general surgery department has units that deal with dental service, burn and internal surgery. Last year, performed different levels of surgery on 1548 patients and around 1400 patients were treated permanently. The number of patients underwent surgery in 2017 increased by 30% compared to the previous year, and the trend is even to be higher because the number of patients waiting for surgery is still high. This department is operated by national physicians and foreigners who come volunteer to give service.

The pharmaceutical department is operated by 23 pharmacists. It has received medical stuff worth 25.876 million Nakfa from PHARMECOR and other donors. HNRH has distributed medical tools to people with diabetes and victims of communicable diseases worth 5.16 million Nakfa free of charge.

The laboratory department is has six units - clinical chemistry, hematology, micro-biology, blood bank, parasitology and urinalysis. The services of the imaging and ultrasound department have improved following the resumption of power supply and the construction of additional rooms. This department was partially renovated this year, and, as a result its, it is providing more and better services.

The hospital has undergone various renovation phases in the last few years. HNRH electric power supply was connected with the Asmara Beer Factory, facilities that burn disposables were renovated, the sewage system was repaired, and some of the infrastructures were renovated which were instrumental in rendering better services.

The vision of HNRH is to become an internationally recognized center of research and education. To that end, it works to upgrade the qualification of its personnel. Through the opportunities provided by the Ministry of Health, many of its personnel have attended post-graduate programs. It is also providing technical and administrative skills training and education. Young members of the hospital are being trained in the hospital to gain experience and develop their knowledge through practical work. For example, to help increase their capacity the junior staff are made to work in different departments according to their related field of study. The contribution of foreign physicians cannot be underestimated. Currently there are 11 foreigners (the seven are Chinese and four Cuban) working in cooperation with nationals, of which. In 2017, a group of five bone fracture and plastic surgery physicians performed surgery and other treatments in the HNRH. They visited 337 patients and did surgery on 219 patients.

To increase its efficiency further the hospital needs to address issues of the maintenance of the infrastructure, bringing additional laboratory materials and laundry machines among others.

One of the reasons for the efficiency of the hospital in rendering service is its effective administration. Some of the virtues of the hospital are encouraging the junior physicians, securing power supply, giving opportunities of further education for the staff, engagement in research activities, and assessment of physicians on their performance.