Parish Stewardship in East Africa: Faith, Finance, and the Holy Spirit Parish Babati Case in Manyara

This study assesses whether a parish in Manyara should prioritize a hospital or a pre-/primary school, integrating sectoral evidence within a Catholic Social Teaching (CST)–grounded multi-criteria decision analysis (MCDA). We combined education and health indicators in an observational comparative assessment. Education metrics were zero-score prevalence in reading comprehension (RC0), addition/subtraction Level-2 (A&S0), and measurement/number sense (MN0), plus a sign-consistent composite learning index (FLI; leave-one-out sensitivity). Health evidence centered on service-coverage signals—especially skilled birth attendance (SBA)—and nationally anchored maternal-risk and financial-protection metrics. Methods estimated proportions, absolute differences (Δpp), and risk ratios (RR) with 95% CIs and mapped outcomes to transparent 0–5 MCDA scores under CST-consistent weight sets. Results show a differentiated learning profile: A&S0 RR ≈ 1.24 (p<0.001), RC0 RR ≈ 1.10 (borderline), MN0 RR ≈ 0.92 (n.s.); FLI is 2.7 pp below the national reference (−5.8 to +1.6), with numeracy driving the gap. Health signals indicate SBA coverage shortfalls consistent with elevated maternal risk and financial exposure. MCDA rankings are weight-dependent: hospital first when life/dignity and option-for-the-poor are prioritized; school competitive when formation/community participation dominate. Limitations include non-experimental design and partial denominators. A phased pathway is decision-relevant: hospital investments address mortality/financial-risk gaps while low-cost instructional reforms target early numeracy/reading. Feasibility hinges on hospital archetype, CAPEX–OPEX, and payer architecture; an independent feasibility study and business plan should precede capital commitment.