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Introduction

Hospitals are an essential component of the health system; however, they are resource heavy, politically visible and costly. It is important therefore that they are run efficiently while at the same time ensuring quality and safety of care. The recommendations of the 56th session of the WHO Regional Committee (2009) and of the 65th session of the World Health Assembly (2012) on WHO reform highlighted the importance of hospital management. The resolutions of the 60th and 61st sessions of the Regional Committee in 2013 and 2014 also addressed health system strengthening and moving towards universal health coverage through strengthening service provision, including hospitals and hospital management.

Most of the countries in the Eastern Mediterranean Region have no established essential hospital service package. The lack of established national or local policies to specify hospital location, size and type of service is also evident. In addition, in many countries there is no balance between the capacity of the hospital system to deliver services and the needs of the population. The absence of hospital management training is particularly noticeable. Thus, the WHO Regional Office for the Eastern Mediterranean organized an expert consultation on regional hospital strategy development and capacity-building of hospital managers in Cairo from 6 to 7 April 2015. The Consultation was attended by professionals and experts in the area of hospital management and training from countries within and outside the Region.

The objectives of the meeting were to present a situation analysis of public hospitals; share experiences in the area of hospital management; identify key challenges and priorities in the area of hospital management; present experiences on hospital management training from outside the Region; and share the results of the training needs assessment of hospital managers and reach consensus on the outline of a training programme. The expected outcomes included identifying the key challenges and priorities in the area of hospital management in the Region, refining the outline of a training programme for hospital managers and identifying future actions to strengthen hospital management.

Proposed hospital care management training programme

The great need and demand for training of hospital managers in the countries of the Region through both short- and long-term courses was highlighted. The results of an on-line training needs assessment of 49 managers from 10 countries showed that the highest perceived value for training was given to financial management, operations management, linkage of hospital to the health care system, strategic planning and risk management. Using feedback and data from a number of sources (the results of the assessment, a review of 18 hospital management training courses in various countries, a review of academic peer-reviewed articles and reports and consultation with five experts from both developing and developed countries), the outline of a 10-day training course for experienced hospital managers and qualified academic experts was presented and discussed in the meeting. Most of the participants considered that the duration and the content of the course could be reduced: greater emphasis should be paid to issues related to hospital governance and leadership, and virtual facilities could be employed to conduct courses. Other suggestions included collaboration with academic institutions in conducting the course, training of trainers to build capacities at the country level and enable rapid expansion of the course across the Region; however, since the training needs of hospital managers in each of the countries could be different, a customized approach should be applied.

Recommended actions

A number of recommendations for action were proposed that would facilitate strengthening hospital management in the Region in line with the challenges identified (Box 1).

This article is abridged from the Report on the expert consultation on regional hospital strategy development and capacity-building of hospital managers, held in Cairo 6–7 April 2015. The complete report is available at: (http://applications.emro.who.int/docs/IC_Meet_Rep_2015_EN_16428.pdf?ua=1).