With the recent health sector reforms in many poor countries, sometimes imposed on governments by international agencies and sometimes chosen by themselves, there is a move towards 'cost sharing'. In practice this means that parents have to pay more for the treatment than they used to. The lack of resources for health professionals and, in certain cases, poor management of staff and programmes has resulted in a marked lowering of staff morale. A key challenge for doctors and health managers is to restore a sense of enjoyment, pride in a 'job well done' and enjoyment to the work of health care. This needs, more than ever, a sensitive, sometimes incisive but always caring and compassionate spirit by leaders of health programmes.
Many staff now prefer to work in the Christian hospitals than government or private sectors.
The challenge is for Christian doctors to have a greater impact in all sectors. Parents worldwide desire a high quality of interaction with health professionals as much as effective therapy and health workers, inspired and strengthened by their Christian faith can make a major impact. Organisations will need to provide a basic, affordable service to poor people, using innovative 'insurance' and 'hardship' schemes combined with higher quality private patient care for those who can afford are desperately needed. Community services 'Outreach' clinics of vaccinators and other nurses who screen and treat at community sites have been very effective. Sadly outreach has become more difficult recently in many countries as a result of government cutbacks and immunisation coverage rates are dropping.