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Good News About Christian Hospitals in Africa

Study author praises staff members who “stay where their presence matters most.”

Surgeons operate in a pediatric ward in Benin.
Christianity Today October 14, 2025
Pascal Deloche/ Godong / Universal Images Group via Getty Images


A new study is shedding light on a rarely researched area: faith-based health care in low-resource settings. 

The study, published in JAMA Surgery, found dramatically lower surgical mortality rates at faith-based hospitals in East, Central, and Southern Africa than at public and private hospitals in the same regions.

The postoperative mortality rate at faith-based hospitals was 57 percent lower than it was at public hospitals and 47 percent lower than at private hospitals.

The study examined more than 100,000 surgical cases across 85 teaching hospitals in those regions of Africa from 2005 to 2020. Two physicians affiliated with Brown University’s medical school and an African surgeon at Tenwek Hospital, a mission hospital in Kenya, led the research. The Brown physicians also work at Tenwek, which serves a low-income population in rural Kenya.

“The point is not to pit sectors against one another,” said Robert Parker, one of the study’s authors from Brown University and Tenwek, in an email to CT. “It is to identify specific practices that save lives and help decision makers and hospital leaders invest in supervision, infection-prevention, early recognition, and critical care capacity where patients need them most. … Especially in rural settings, the need is so great that this is not a competition.”

The study comes at a significant moment for African health. Poorer nations face the headwinds of US aid cuts and the prospect of increased child and maternal mortality. And in the longer term, population growth threatens to outpace the number of African health workers.

On top of that trend, high-income nations have been aggressively recruiting African health workers away from the continent to fill their own gaps. Between 2021 and 2023, Zimbabwe lost 4,000 nurses and doctors—a large percentage of the country’s health workers.

The authors of the study have worked in public, private, and faith-based hospitals between the three of them, Parker said. Initial reactions to the study were mixed, he added, with faith-based colleagues appreciating the recognition of their work and colleagues in public hospitals questioning whether the surgical outcomes in different hospitals were comparable. 

“But as we have talked there has been a shared understanding that all of us are working within difficult systems,” he said. “We are all caring for patients who often present late after long periods of illness.”

Keir Thelander, executive vice president for the Pan-African Academy of Christian Surgeons (also known as PAACS), served for a decade as a surgeon at Bongolo Hospital, a Christian hospital in Gabon.

Thelander said the data shouldn’t be read as a condemnation of public or private hospitals, which face systemic issues like staffing or equipment shortages. But he said the study was evidence that faith-based teaching hospitals are valuable additions to their countries’ health systems overall.

PAACS supports the training of surgeons in Christian hospitals across Africa.

“Not all our graduates stay in faith-based institutions,” Thelander said. “We are overall helping strengthen the surgical systems. We’re all trying to contribute to solving this provision of surgical care. We’re not in competition. We’re on the same team.” 

Public health research has not closely examined faith-based institutions, which often play an outsize role in poor and rural areas of many African nations.

“Somehow, faith-based providers of health and education had disappeared off the policy and evidence map,” researchers wrote in a Lancet article back in 2015 about African health systems. “The slowly emerging evidence on [faith-based health providers] suggests that they are not simply a health systems relic of a bygone missionary era, but still have relevance and a part to play (especially in fragile health systems), even if we still know little about exactly how they function.”

This 2025 surgical study itself noted, “There are limited data about the overall impact of faith-based hospitals on surgical mortality in the region.”

Parker told CT that data at faith-based hospitals is often tough to gather because the facilities are “remote and under-resourced, so data systems have not been the first priority.”

Postoperative mortality in African hospitals is a “systemic issue,” the researchers said in the study, and is “often attributed to factors such as inadequate health care infrastructure, limited access to essential surgical services, and insufficiently trained health care personnel.”

The study controlled for factors like case complexity and removed obstetric and gynecological cases from the data because faith-based hospitals tend to provide more of that care, and those cases had a lower mortality rate.

These outcomes come even as faith-based health centers tend to serve lower-income patients, who often come to the hospital in bad shape and as a last resort.

A survey published in The Lancet in 2015 showed faith-based health providers served the largest percentage of the poorest quintile in the 14 sub-Saharan countries surveyed.

It continues to be the case, Parker said, that faith-based facilities are in remote and under-resourced areas.

“What stands out to me in the data and in daily work is the dedication of staff in faith-based hospitals,” said Parker. “Many could choose easier or more lucrative posts, yet they stay where their presence matters most. They are motivated by professional duty, faith, compassion, and a sense of calling. That spirit shows up in patient care in ways that are hard to quantify, and this analysis suggests it may be making a real difference.”

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