# Healthcare Facilities Established by the Eastern Orthodox Church in Sub-Saharan Africa: A Questionnaire Survey

## TL;DR

This study maps Orthodox Church healthcare facilities in Sub-Saharan Africa, showing their widespread presence and operational status.

## Contribution

The paper provides the first comprehensive survey of Orthodox Church healthcare facilities in Sub-Saharan Africa.

## Key findings

- 52 healthcare facilities were identified across 11 countries in Sub-Saharan Africa.
- 34 of these facilities remained operational during the COVID-19 pandemic.
- Most facilities provided primary care, with some offering secondary services like surgery and obstetrics.

## Abstract

Introduction: The Orthodox Church has a long presence in the African continent, and its philanthropic activity includes, among others, schools, universities, orphanages, and health centers. Although there are different healthcare facilities established by the Orthodox Church in Sub-Saharan Africa, there is a lack of detailed information concerning their current status. The study objective was to clarify (a) the geographical location of these facilities, (b) their operational status, (c) their existing infrastructure, (d) their staffing, and (e) the services provided.

Methods: A questionnaire based on the World Health Organisation's Service Availability and Readiness Assessment tool (SARA) was sent to the respective archdioceses and dioceses of the Eastern Orthodox Church in Sub-Saharan Africa, which are under the jurisdiction of the Patriarchate of Alexandria and All Africa.

Results: The response rate was 90% (27 out of the 30 archdioceses and dioceses). In total, 52 healthcare facilities were registered (two hospitals, 40 health centres, and 10 health posts/clinics). In Uganda, 17 healthcare facilities were confirmed, in Kenya 10, in Madagascar six, in Tanzania four, in Cameroon four, in the Democratic Republic of Congo three, in Sierra Leone three, in Zambia two, in Zimbabwe one, in Malawi one, and in Congo-Brazaville one. Out of the 52 facilities, 18 were urban while 34 were rural. From the 52 facilities identified, 34 were operational despite the COVID-19 pandemic. Out of these 34 operational facilities, 23 provided only outpatient clinics, while in 11, hospitalisation/inpatient monitoring was also possible. Various healthcare services were provided, mainly at the primary care level. Secondary level of care, such as surgical and obstetric services, was also provided in the larger facilities. Financing was mainly from donations, fees paid by the patients, and in a few cases, government contributions.

Conclusion: The Orthodox Church’s philanthropic activity in the field of healthcare in Sub-Saharan Africa is extensive. The 52 healthcare facilities established in 11 countries constitute a decentralised network covering a large part of Sub-Saharan Africa. This network might be a useful collaborating partner for universities and research institutions developing projects in the fields of tropical medicine, infectious diseases, remote medicine, or climate change and health.