The government of Somaliland covered the funds to run Burao Hospital services after MSF evacuation.

 BURAO REFERRAL HOSPITAL

Members of Somaliland cabinet  composed of minister of presidency Hirsi Ali Haji Hassan, minister of Health, Soleman Issa , and minister of livestock Dr. Abdi Aw Dahir Ali . Have been assigned to assess  Burao Hospital, after the evacuation of MSF from the Hospital, and to maintain the hospital functioning with its ongoing standard services

The mission has consulted with all concerned parties , including the Regional Health ,Hospital administration, regional Health Board, and medical Doctors. The ministers also has a meeting with a large number of Burao communities representing a wide range of the society, including merchants, religious leaders, intellectuals,chiefs,and youth groups. On the meeting ,the governor and the local government council have also participated.

In view of the above, the mission of the ministers come up with a two major important decisions.

I.  TO COVER THE FUNDS NEEDED TO RUN EFFICIENTLY THE HOSPITAL, AND MAINTAIN THE STANDARDS OF THE GOOD QUALITY SERVICES.

II. DEVELOPED A GUIDELINE TO ENSURE THE SUSTAINABILITY OF HOSPITAL  GOOD QUALITY SERVICE ACTIVITIES ,AND MAKE SURE SERVICES ARE COST EFFECTIVE :

1. MINIMUM ESSENTIAL Package

- Minimum needs on Both medical and supporting staff

- minimum needs on outpatient and inpatient activities

- minimum essential needs of basic incentives

- minimum essential hospital bed capacity.

2. PRIORITIZATION OF HOSPITAL ACTIVITY 

 The hospital should be designed  as referral l hospital for eastern Regions. It must execute an integrated package of health services mainly comprising of Obstetrics/gynecology , general surgery, medical, and pediatrics. However it should focus on EMERGENCIES and OBSTETRICS.

3. COST SHARING SYSTEM

All  concerned stakeholders should participate in the Hospital financing to ensure long term sustainability of the Hospital activities. This must include Central government, local government, community, other organizations and a minimum patient contribution.

4. DECENTRALIZATION OF MANAGEMENT: the hospital management should be mainly a community based hospital. While the role of the central government(MOH) will mainly focus on policies , guidelines, setting standards,and regulations. This will rise the feeling of ownership. To ensure that objective a strong , efficient HOSPITAL BOARD should be immediately nominated. The board should be selected by a criteria laid down by the Minister . The board will report to the RMO, DIRECTOR GENERAL, but it is accountable directly to the minister of health- who has the sole authority to dismiss them incase it arises.

5. EFFECTIVENESS AND EFFICIENCY ON MANAGEMENT. 

Good and effective management on finance, human resources, logistics and health services should be in place, with efficiency, whereby the human material resource input should directly reflect to the output of health services. This can be fulfilled at maintaining the MSF laid down management system , and keeping the efficient personnel in place.

6. FUND RAISING MECHANISM

There should be a continuous and timely system of fund raising in place. This will done by the HOSPITAL BOARD with the assistance of both the central and local government. This will focus all groups including the diaspora , and there will be especial account for the raised fund.

7. DRUG REVOLVING FUND

Available drugs (from MSF, MOH,UNICEF, WHO, and also from other possible sources ) should be given to the patients with minimal basic cost. Available money from the drugs will be in turn brought with new drugs ,so to maintain sustainability and ensure availability of continuous drugs in pharmacy at all times.

8. EXEMPTIONS FROM FEE

Poor people should be exempted from both service and drug fees. A system of exemption mechanism and criteria will be laid down by the Minister (MOH)with consultation of the board, hospital management and RMO.