On September 27th & 28th 2023 a meeting was held at Christ Church, Oxford to share and debate ideas on the role of Hospitals in Universal Health Coverage. This meeting convened by Prof. Mike English and Prof. Nigel Edwards (former Director of the Nuffield Trust) and included experts from the World Bank, the World Health Organisation offices in Geneva, the Eastern Mediterranean and the European Regional offices, together with senior academics from the UK and a number of senior and early career academics from low and middle-income countries, particularly in Africa.
The premise of the meeting was that the role of smaller, typically general hospitals serving local primary care referral needs is a neglected area of scholarship and debate in global health despite the district hospital being defined as a key element of primary health care systems in the original Alma Ata declaration on health for all. Participants explored together issues of financing and governance, service organisation and service redesign, human resources and skill mix, patient experiences and community engagement in promoting responsive health care provision.
While participants paid special attention to First Referral of ‘District’ Hospitals and the essential hospital services that are likely needed in low and middle-income countries they also explored how hospital care has evolved and is continuing to evolve in higher income settings in response to widely-shared global opportunities and challenges. These include changes in disease patterns, the age-profile of patients, the rise in multi-morbidity and the role of new technologies in extending the scope of services and their redesign as new forms of care emerge.