Financial sustainability of church implemented development projects: a case study of the Nandom hospital

During the past decades, many local Churches in Ghana have been deeply concerned about the degree of access of the majority of the people, especially the rural population, to basic facilities and necessities of life such as safe drinking water, good health, education and production for household consumption. In line with this mission, many of the Churches have adopted policies and carried out measures to improve the living conditions of especially the rural poor. Thus, most of the Christian Churches have substantially expanded their efforts in the fields of service delivery aimed at the poor. Principally, these efforts have been financed initially from donor grants or funds from partner churches and institutions abroad. Many of the facilities and services have continued to be maintained by outside funds. Now, the global and local experience is that these external sources of financial support are drying up. The local Churches are expected to be self-supporting and autonomous having been considered to have come of age. Consequently, they are expected to cover at (east recurrent operation and maintenance costs of the services and facilities they provide from locally generated revenue. The development of an effective local revenue base and proper management to cover these costs has become a great concern for Church authorities. The current approach is to check that every project to be initiated by the Church is financially sustainable and will have adequate funds to meet its commitments at each stage of its life. Why is this new emphasis necessary? Have earlier projects been developed without such considerations? What kinds of problems are faced by such projects and how do we now ensure their financial sustainability? Is a socially satisfactory project likely to be financially viable too? What should be the trade-off in the light of the Church’s mission and perspective? These pertinent issues underline the present study which focuses on a Catholic Church implemented health facility at Nandom in the Wa Diocese. The emphasis was financial sustainability of the health facility. Primary and secondary sources of data were collected and analysed to determine the extent to which the hospital is able to cover its costs from own sources revenue. The findings are that; I. At the beginning of its establishment, (1966), the Nandorn Health Facility was not able to contribute towards us recurrent operation and maintenance costs of the services and facilities .j provided from locally generated revenue. All salaries and wages were paid by the central Government and capital equipment was provided by the Diocese (Church) and Government. ii. Certain management practices militate against the financial performance (efficiency) of the health facility, for example, retention of heavy cash at hand and 1.O.Us which should be reduced. iii. Financial sustainability efforts of the health facility are potentially limited by the environment, the economic status of the people, income and literacy levels of the area in which it is located. iv. The beneficiary communities propose alternative payment arrangements for health care delivery service and to ensure (financial) sustainability of the facility in so far as it contributes appreciably to human and spatial development. v. Financial targets are not set and streamlined to motivate the staff to work towards (financial) sustainability. vi. There are several opportunities and potentials that can contribute towards financial sustainability of the health facility. On the basis of’ these findings, it was recommended among others that; 1. management sets financial targets and adopts practices like reduction of cash at hand and investment in treasury bills or bonds towards achieving financial sustainability. ii. the beneficiary communities adopt attitudinal changes and undertake alternative sources of generating income to enhance their economic status and project financial sustainability iii. the Diocese of Wa promote development and self-support towards ensuring financial sustainability of her programmes and projects. iv. government review the cash and carry system and adopt a preferential intensification of rural agricultural programmes to increase purchasing power and sustain health service provision. v. further investigation be conducted into the feasibility of instituting a Community Health Insurance Scheme among other community alternative payment arrangements.

Source: KNUST