Haydom Lutheran Hospital: a sustainable health-providing organization or a "white elephant"? : as an Xtrata CSR objective, what best practices does HLH have that can be transferred to other areas in Tanzania?

Abstract

This paper provides an analysis of the sustainability of Haydom Lutheran Hospital (HLH) in Tanzania. Moreover, it discusses the local community’s dependency on the hospital. A smaller second part of the paper looks at Xstrata’s decision to use HLH as a corporate social responsibility (CSR) objective. The thesis further explores what services can be seen as best practices from HLH and therefore transferable to Xstrata’s possible mining site in Kabanga, Tanzania. HLH has since its inauguration by Norwegian missionaries in 1955 been highly funded by public and private financial, human and technological resources from abroad, especially from Norway. The open-system model, which consists of three main components—contextual, activity level and organizational capacity—is identified as the best analytical framework with which to assess the sustainability of health organizations. The empirical findings show that HLH has become too dependent on the Royal Norwegian Embassy, and has wrongly seen it as a secured long-term funding source. The activity level has been continuously increasing, though the financial resources have been unclear. Even though quality of care is higher at HLH than at most other mission hospital in Tanzania, a question arose within the paper about the cost of adhering to such high quality. The organizational structure has moreover been overly dependent on one person—the ardent soul—leaving a gap with him leaving this position. In the thesis’ second part the activity of reproductive, children health and maternity related services is found to be what should be initiated by Xstrata in Kabanga. Yet, it is also suggested that Xstrata has the possibility to adhere to strategic philanthropy CSR, instead of add-on philanthropy, and that this could have a greater social and economic development impact on its local community.