Research articles by German-African university and hospital partnerships

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Supported by GIZ, hospitals in different African countries join forces with German university clinics to improve staff capacity and quality of care. The ESTHER partnerships also strengthen research capacities and generate new scientific evidence.

German-African university and hospital partnerships: Partnering for capacity development, scientific evidence and better patient care

Demand for scientific knowledge, modern technologies and effective management and treatment processes is high among health professionals in low- and middle-income countries. German universities and hospitals have substantial expertise in these areas and are interested in extending their international networks. How do these potential partners get together? This is where German Development Cooperation comes in. 

As part of the European ESTHER Alliance (Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau), German Development Cooperation (via GIZ) has been supporting partnerships between German university clinics and hospitals in low- and middle-income countries through technical advice, facilitation and financial support since 2007. Now focusing on African countries, these partnerships help African hospitals to develop staff capacity in order to improve patient care, for example in terms of trainings, internships or the implementation of operational research projects. The partners collaborate on an equal footing and the partnerships benefit all parties: Experts in the African institutions gain knowledge and obtain access to state-of-the-art methods and techniques; this in turn results in better care for patients; German university hospitals extend their network of research partners; and German Development Cooperation can draw on the innovations created by the partnerships. 

The GIZ-managed German ESTHER secretariat is also initiating exchange among the partnerships and with other experts and it supports the partnerships in connecting with research programmes such as the European & Developing Countries Clinical Trials Partnership (EDCTP), which is financed by the European Commission. 

Limbe Hospital Laboratory

ESTHER partnership between Limbe Provincial Hospital in Cameroon and University Hospital Rostock in Germany

An example of how the partnerships work: In Rwanda, worm infection among children is a common but neglected health issue.  Researchers from Butare University and Charité Berlin, who are working together in an ESTHER partnership, succeeded in reducing the prevalence of worm infection from 16% to 1% among 700 children. However, re-infection was a persisting challenge: About a fifth of the children who had been successfully treated became re-infected within three months after deworming. Operational research conducted by the partnership confirmed that reinfection was caused by a number of social and hygienic factors.  As a consequence, the Butare University Teaching Hospital is currently broadening its laboratory and treatment services by establishing a parasitology unit. Moreover, Rwandan and German researchers are now jointly exploring the issue of drug resistant worm infections. 

Below you can find an overview of the GIZ-supported ESTHER partnerships per country as well as links to the peer reviewed journal articles that have been produced by some of them as a result of the operational research projects. 


(Former) partnership between the Bamenda Regional Hospital and the Bernhard Nocht Institute of Tropical Medicine, University Hospital Hamburg Eppendorf

  • Zoufaly et al. (2013), ‘Prevalence and determinants of virological failure in HIV-infected children on antiretroviral therapy in rural Cameroon: a cross-sectional study’, in: Antiviral Therapy 18(5),
  • Zoufaly et al. (2012), ‘High prevalence of hepatitis B and syphilis co-infections among HIV patients initiating antiretroviral therapy in the north-west region of Cameroon’, in: International Journal of STD & AIDS 23(6),

Partnership between the Limbe Provincial Hospital and the Department of Tropical Medicine and infectious diseases, University Hospital Rostock 

  • Kinge et al. (forthcoming), ‘The ESTHER partnership between the Regional Hospital Limbe, Cameroon, and the University of Rostock, Germany: Synergism between Capacity Building and Clinical Research’


Partnership between the Addis-Ababa-University, Department of Gynaecology and Pathology and School of Public Health, College of Health Sciences and the Clinic and polyclinic of Gynaecology, Martin Luther University Halle (Saale)

Partnership between the School of Health Sciences (SoH), Adama Science & Technology University (ASTU), Assela and the Clinic of Gastroenterology, Hepatology and Infectiology, University Hospital Düsseldorf


Partnership between the Komfo Anokye Teaching Hospital, Kumasi and the Bernhard Nocht Institute of Tropical Medicine, University Hospital Hamburg Eppendorf 

Partnership between the Battor Catholic Hospital, Battor and the Department of Gynaecology, Charité, University Hospital Berlin


Partnership between the Kamuzu Central Hospital (KCH), Lilongwe and the Institute of Public Health, University Hospital Heidelberg 

  • Agyeman-Duah et al. (2014), ‘Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi’, in: BMC Health Services Research 14(1),
  • Theurer et al. (2014), ‘Bloodstream Infections and Malaria as Causes of Fever among Adult Medical Patients at a Referral Hospital in Malawi’, in: International Journal of Tropical Disease & Health 4(2),

Partnership between the Lighthouse Trust, Lilongwe and the Clinic I for Internal Medicine, University Hospital Cologne


Partnership between the Butare University Teaching Hospital (CHUB) and the Institute of Tropical Medicine and International Health, Charité, University Hospital Berlin 

  • Ignatius et al. (2012), ‘High Prevalence of Giardia duodenalis Assemblage B Infection and Association with Underweight in Rwandan Children’, in: PLOS Neglected Tropical Diseases  6(6),
  • Danquah et al. (2013), ‘Anaemia, iron deficiency and a common polymorphism of iron-regulation, TMPRSS6 rs855791, in Rwandan children’, in: Tropical Medicine and International Health 19(1),
  • Staudacher et al. (2014), ‘Soil-transmitted helminths in southern highland Rwanda: assiciated factors and effectiveness of school-based preventive chemotherapy’, in: Tropical Medicine and International Health 2014 Apr 21,


(Former) partnership between the Bombo Regional Hospital, Tanga and the Clinic of Anaesthesiology and Intensive Care, Charité, University Hospital Berlin

Partnership between the Mbeya Referral Hospital and the Department of Infectiology and Tropical Medicine, Ludwig Maximilian University of Munich 


Partnership between the Holy Family Virika Hospital, Fort Portal and the Institute of Tropical Medicine and International Health, Charité, University Hospital Berlin


(Former) Partnership between Tribhuvan University, Teaching Hospital, Maharajganj, Kathmandu and the Centre for Interdisciplinary Addiction Research of Hamburg University

  • Ojha et al. (2014), ‘‘South Asian cocktail’ - the concurrent use of opioids, benzodiazepines and antihistamines among injecting drug users in Nepal and associations with HIV risk behavior’, in: Harm Reduction Journal 11(17),

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