The Provision of Curative Health Services in North Darfur State
4.3 The distribution of health facilities in North Darfur State
4.3.2 The distribution of health facilities in the private sector
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Table 4.12 Technical services for medical assistance in El Fasher compared to other districts in North Darfur State, 2010.
Health facility The ratio of medical assistance health facilities El Fasher District Other Districts
Blood Bank 67% 33%
X-Ray Unit 38% 62%
Laboratory 32% 68%
Endoscopy 100% 0%
Sound waves 100% 0%
Dialysis Unit 100% 0%
Source: North Darfur State Ministry of Health Survey Report, December 2010.
The other districts combined have a large share of X-ray units and laboratories but in other respects El Fasher dominates the State and is the only source of facilities for endoscopy, sound waves and dialysis.
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Note that private health facilities are confined only to six districts, with most of them situated in El Fasher. This is highlighted in Table 4.14.
Table 4.14 Private sector health facilities in El Fasher district, as compared to other districts in North Darfur State, 2010.
Type of health facility in the private sector
The ratio of health facilities in private sector El Fasher district Other districts
Private pharmacy 100% 0%
Public pharmacy 83% 17%
X-Ray Unit 100% 0%
Laboratories 77% 13%
Dental clinic 100% 0%
General-doctor clinic 57% 43%
Specialist clinic 100% 0%
Source: State Ministry of Health Survey Report, 2010.
El Fasher monopolizes all private pharmacies, X-ray units, dental clinics, and specialist clinics.
83%, 77% and 57% of public pharmacies, laboratories and general-doctor clinics, respectively, are also located in El Fasher District.
4.3.3 The distribution of health facilities in the NGO sector
NGOs are the most important partners of public sector health services in the rural areas of North Darfur State. The distribution of NGOs is not homogeneous; they work mainly in the most challenging areas and with the most disadvantaged groups. NGOs manage and support public health facilities, sometimes in partnership with the State Ministry of Health. The NGOs and the five districts where they are located in North Darfur State are presented in Table 4.15.
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Table 4.15 NGOs managing and supporting health facilities in five districts in North Darfur State, 2010.
Source: World Health Organization Report, 2010.
District NGOs Health facilities Total
El Fasher Management Support Rural
Hospital
Primary Health
Care Centre
Basic Health
Unit
Mobil clinic
Egyptian Mission Egyptian Mission - - 1 - 1
Humanitarian Aid and Development
Humanitarian Aid and Development 1 1
World Health Organization / United Nations Children's Fund / United Nations Population Fund
- - 1 - 1
Kuwaiti Patient‟s Helping Fund
World Health Organization / United Nations Children's Fund / United Nations Population Fund
- 1 - - 1
MALTESER MALTESER - 1 2 - 3
Mercy Malaysian Organization
World Health Organization/ United Nations Children's Fund / United Nations Population Fund
- - 1 -
1 Medicines Sans
Frontiers – Spain
Medicines Sans Frontiers – Spain - 2 - - 2
Partner Aid International
Partner Aid International - - 1 - 1
Partner Aid International/ World Health Organization / United Nations Children's Fund
- 1 1 - 2
Relief International Organization
Relief International Organization - 3 2 - 5
State Ministry of Health - 2 - 2
World Health Organization/ United Nations Children's Fund / United Nations Population Fund
- 1 1 - 2
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Table 4.15 NGOs managing and supporting health facilities in five health districts in North Darfur State, 2010.
District NGOs Health facilities Total
El Fasher Management Support Rural
Hospital
Primary Health care
Centre
Basic Health
Unit
Mobil Clinic Saudi Red
Crescent
Saudi Red Crescent - 2 - - 2
State Ministry of Health
Partner Aid International/ World Health Organization / United Nations Children's Fund
1 13 1 - 15
Saudi Red
Crescent / German Red Cross
Partner Aid International / World Health Organization / United Nations Children's Fund
- 1 - - 1
Kepkabiya Medicines Sans Frontiers – Belgium
Medicines Sans Frontiers – Belgium - 1 5 1 7
Relief International Organization
Relief International Organization - 1 - - 1
State Ministry of Health
World Health Organization / United Nations Children's Fund / United Nations Population Fund
3 - - - 3
Umm Kaddada
Relief International Organization
State Ministry of Health - 1 - - 1
Kutum Goal Ireland Organization
Goal Ireland Organization - 11 1 1 13
Source: World Health Organization Report, 2010.
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Table 4.15 NGOs managing and supporting health facilities in five health districts in North Darfur State, 2010.
District NGOs Health facilities Total
Kutum Management Support Rural
Hospital
Primary Health
care Centre
Basic Health
Unit
Mobil Clinic State Ministry of Health State Ministry of Health / World Health
Organization/ United Nations Children's
- - 1 - 1
Medicines Sans Frontiers – Spain - 2 3 - 5
United Nations Children's Fund / United Nations Population Fund
- 2 - - 2
World Health Organization / United Nations Children's Fund / United Nations Population Fund
1 - - - 1
Mellit African Humanitarian Aid African Humanitarian Aid - 1 1 - 2
Relief International Organization
State Ministry of Health - 1 1 - 2
State Ministry of Health United Nations Children's Fund / United Nations Population Fund
1 1 2
Saudi Red Crescent / German Red Cross
United Nations Children's Fund / World Food Programme
- - - 4 4
Saudi Red Crescent / German Red Cross
World Health Organization / United Nations Children's Fund / United Nations Population Fund
- - 5 - 5
Total 6 47 30 6 89
Source: World Health Organization Report, 2010.
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Over half of the NGOs are concentrated in El Fasher District. In North Darfur State 64 health facilities are managed by NGOs and only 25 by the State Ministry of Health, while 83 of health facilities are supported by NGOs, and only 6 are supported by the State Ministry of Health.
According to an interviewee (2-2, 25 December 2010, El Fasher) in the State Ministry of Health:
The State Ministry of Health neglected establishing new health facilities, in order to rehabilitate old ones affected by the conflict and needing maintenance. This is one of the greater problems which has increased the role of NGOs in economic and social activities, including health. Therefore, the role of government in establishing new health facilities has shrunken considerably. The lessening role of government in the health field is recognized as a risk in further weakening government health care delivery, and thus increasing the health care system‟s vulnerability after NGOs leave the State.