Shisong Cardiac Center: Kumbo, Cameroon

Abstract

Purpose: To characterize the business and operational models of Shisong Cardiac Center, a heart hospital in Kumbo, Cameroon and to identify how it has managed to deliver high quality, specialized surgical care since 2009 despite its contracted financial and workforce capacity. Methods: Descriptive analysis with key informant interviews from Shisong Cardiac Center, the World Bank and the Ministry of Public Health. Results: Shisong Cardiac Center is able to generate annual profits, but it does so through its robust fundraising efforts to cover expenses. Its highest expenses stem from procurement of surgical materials and medications. Even with only one surgeon, the potential capacity at Shisong is 480 operations a year, yet only 100 operations are performed, suggesting that labor is not the ultimate bottleneck; rather, it is patients’ inability to pay. Conclusions: A surgical operating model reliant on donated funds can generate a profit, but it is highly inefficient. On the labor side, commuter care cannot replace the bandwidth and reliability of a local workforce. Attracting Diasporans home with competitive salaries and benefits to then boost local training is a viable path. As for addressing financial inefficiency, a dual effort from the private sector to maximize contribution margins for heart surgery through cheaper sourcing of surgical materials and medications and the public sector to reduce out-of-pocket payments is needed. Shisong should consider innovating to generate new streams of revenue while waiting for the government’s anticipated launch of national health insurance.