The State and public hospitals in Senegal

Doctor Mamadou SOW's thesis is a plea for hospital management autonomy in developing countries. Defended in Rennes in 1995, it was awarded the distinction "Tres honorable avec les felicitations du jury". The conclusion is that public hospitals, which have no management autonomy and are therefore simply an external service of the State, function poorly. The disadvantages associated with this status are described at length in the book, and ultimately result in users' expectations not being met. On the other hand, when a hospital acquires legal personality, it has its own management bodies, its own budget and its own assets (distinct from those of the State); and we can therefore hope for greater efficiency. However, the author insists on the accompanying measures that are essential to the success of the reform undertaken, as the change in hospital status alone is not enough to guarantee its success.