As a result, many women may have only one choice—to give birth at home without medical help. Many patients could not pay their hospital bills, running away in the middle of the night. Tragically, the cases of patients disappearing from the hospital were not the exception.
To supplement the support received from the ASSP project, the community of Yakoma created a health cooperative that they named Tosalisana, which means “let’s help ourselves” in Lingala, the local language. These two entities have given the community better access to health care. The price of medical services dropped and became more affordable. For instance, the cost of a C-section is now about $10 and a regular birth is about $3.30.
For a fee of 3,000 Congolese Francs (about $2) per person for an annual membership in the cooperative, patients saw their medical bills reduced by 40 percent of the original bill. The cooperative covers the balance of 60 percent.
“With the establishment of Tosalisana, we have had a tremendous increase in the number of patients visiting the hospital,” Vungbo noted. “Before the health cooperative was established, the health center Cité received 158 new patients per month with a monthly revenue of $267,” Vungbo explained. “Now with the strength of the health cooperative combined with the support of ASSP, the health center currently welcomes about 500 new patients per month and makes about $485.”
The health cooperative has also benefited the medical staff. “Before ASSP, we were earning $82 per month. But now, a nurse can earn $182,” said an assistant head nurse at the health center Mission.
Tosalisana got off to a slow start due to Yakoma’s painful history with the previous organization that handled all of the hospital’s finances. That organization went bankrupt and suddenly disappeared in 2012. Many people in Yakoma lost the money they had contributed to that organization, which had partially functioned as a health cooperative. So, three years later when the new cooperative started its outreach activities in the health zone, the community was wary. Their reaction was, “What?! You’re back?!!”
Though, once the population began to see the benefits of the new cooperative, they again became interested in contributing. Patients began lining up for the consultations, medication and surgeries that they had not been able to afford in the past.
Located in an impoverished community of 102,244 inhabitants, the cooperative continues to gain membership. As of 2017, it had 5,151 members, already 50 percent of the necessary membership to operate at maximum efficiency.
In the past, all financial activities of the hospital were controlled by an external organization. Now, the hospital has taken charge of its operating expenses.
“This is an important aspect of the ASSP project,” said IMA Economist Alexandre Manunga. “It allows the health structure to manage its own funds and be in control of its own budget.” With an increase in patients, the steady income flow enables the hospital to plan for and efficiently manage their revenue and expenses accordingly. To further reinforce its financial health, an accounting system was recently installed at the hospital.
Overall, the financial performance of Yakoma’s hospital has been positive. Manunga concurred. “For a remote hospital in Northern Congo that has never managed its own finances,” he said. “These results are extremely encouraging.”
Founded in 1960, IMA World Health is a global, faith-based nonprofit that works with communities to overcome their public health challenges.