Chinese-built hospitals in Africa as a new health intervention – SINAFRHOSP

Public hospitals throughout Sub-Saharan Africa are in crisis. The recent Ebola outbreak in Western Africa has proven their powerlessness in the face of incredibly complex health risks. However, the hospital landscape is undergoing profound transformations that are linked to a diversification of health practices, the emergence of new political agendas (to strengthen health systems, to enforce equity in accessing services) and the growing role of emerging powers. China in particular is today a central actor who finances and builds dozens of hospitals over the continent. Although hospital-based health systems seemed to have reached their limits, the construction of new hospitals as « all inclusive » packages represent a new type of intervention and this project wishes to wonder about the reaffirmation of a hospital model approach to healthcare. I will undertake an in-depth study of the particular case of Niger, one of the poorest countries in the world where Chinese development cooperation and infrastructure construction is increasing steadily. I will study the organisation and functioning of the General Reference Hospital built by the Chinese and opened in August 2016 in the neighbourhood of Niamey the capital city. Main research questions revolve around the adaptation of the hospital in its urban and social environment, its consistence with national health strategies and international political economy.

In order to so, I will develop a mixed methods and multidisciplinary approach to this type of hospital, as an infrastructure of development that can be studied from the vantage of sociology of the State, anthropology of health, health economics and urban geography. The qualitative aspect is prominent and consists of a collective investigation (“ECRIS” or Rapid Collective Identification of Strategic Groups, developed by the LASDEL, main partner of the project), followed by individual observations within the hospital and semi-structured interviews with patients, health workers, health authorities and partners. The quantitative transversal study, in the form of a questionnaire will document patient’s experience and satisfaction with regards to this new hospital. Finally, a study in urban geography will document several aspects regarding the insertion of the hospital in its closest and largest environment and climate, issues of water, energy and waste management. I will secure the complementarity of approaches through collective discussions during fieldwork and analytic process.

From this in-depth empirical case study I wish to work on systematising a method to study hospital’s role in African health systems in mutation. I have gathered a multidisciplinary team of collaborator who will participate in different aspects of this research project and help me meeting this scientific challenge. It is my aim that this study will contribute to a better understanding of the forms taken by globalization of health and of the dynamism of African societies in coping with acute social, economic and political challenges.