In the last few years, MSF OCG has developed an Operational Policy with the ambition to increase and improve the quantity and quality of secondary health care structures (or inpatient care). This recognition has prompted the organization to take a closer look at the challenges, lessons and accomplishments in terms of hospital management to develop strategies that will enable the organization to successfully set up, govern, implement and exit inpatient projects in all types of contexts. The Hospital Management Review was extremely well received throughout the various layers of interviews; from the directors at the headquarters to the hospital managers of the MoH working with MSF in projects. OCG, while providing a higher standard of care for patients, must also contribute at a higher level to the management of the hospitals in which they intervene. There are some exemplary projects where the organization has attempted to introduce new ways of working and approaches that, in the long term, can yield some very positive results. The trial of a new hospital set-up in Haiti and the “integrative” approach at the Bol hospital in Chad are cases in point.