Confidential Presentation Materials Prepared

for:

Regarding:
Overview of Ghana’s
Ghana s Healthcare
Landscape

March, 2011

STRICTLY PR I VATE & CONFIDENTIAL

 GHANA HAS MEDIAN LEVELS OF HEALTH CARE PERSONNEL AND
INFRASTRUCTURE VERSUS HER PEERS
With Private Sources Dominating Health Care Spend (66%)

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STRICTLY PRIVATE & CONFIDENTIAL
Sources: www.worldbank.org, www.nationmaster.com , www.who.org
 7 LEADING PRIVATE MEDICAL FACILITIES IN ACCRA HAVE <=60 BEDS,
ONLY 2 CT SCANS AND NONE HAS MRI
Are Mostly Focused on Fertility with Only 3 Having ICUs

Ghana
Nyaho
y Tema
Trustt
T Lister
Li t Provita
P it Canada
C d F
Focus
Medical Holy Trinity Womens
Hospital Hospital Hospital Medical Hospital
Centre Hospital
Centre
Beds 30 60 50 25 55 30 30 100
X-Ray √ √ √ √ × × × √
ECG √ √ √ √ √ √ √ √
MRI × × × × × × × √
CT Scan √ × √ × × × × √
Ultrasound Scan √ √ √ √ √ √ √ √
ICU × √ × √ √ × × √
General Surgery √ √ √ √ × × √ √
Dentistry √ √ √ × × × × √
Internal Medicine √ √ √ √ √ √ √ √
Gynecologist / Obstetricians √ √ √ √ √ √ √ √
Pediatricians √ √ √ √ √ × × √
Neonatology √ √ √ √ √ × × √
Psychologists /Psychiatrists √ √ √ √ √ √ √ √
Pharmacy √ √ √ √ √ √ √ √
Orthopedic Surgeons √ √ √ √ × × × √
Eye Specialist √ √ √ × × × × √
Dermatologists √ √ √ × × × × √
ENT √ √ √ × × × × √
Urologists √ × √ √ √ √ √ √
Mammography × × √ × × × × √
Ambulance √ √ √ √ √ √ × √
Dieticians √ √ √ √ × × × √

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STRICTLY PRIVATE & CONFIDENTIAL
Existing Proposed
 FAIRLY CONSISTENT PRICE POINTS EXIST ACROSS MARKET WITH LITTLE
DIFFERENTIATION BASED ON SERVICE QUALITY
And / Or Market Positioning
Ghana
Nyaho Tema
Service Charges by Holy Trust Lister Provita Canada
Medical Women’s Average
Institution ($) Trinity Hospital Hospital Hospital Medical
Centre Hospital
Centre
General
Registration 3 3 3 3 3 3 7 4
General Consultation 13 7 7 13 13 17 17 12
Specialist Consultant 25 20 19 13 13 17 27 19
Labs
Whole Blood 20 37 7 21
Random Glucose 3 5 3 4
Radiology
X R chest
X-Ray h t 11 7 10 11 10
Barium Swallow 43 43
MRI
ECG 12 0 13 27 33 33 17 19
Ultrasound 17 20 33 20 20 13 18
CT- Routine
CT 113 133 123
Abdomen 220 220
Brain 160 160
Mammogram 30 30
Delivery
Caesarian 1200 /
N/A  733 1533 1333 1333 800 1156
Normal 267 N/A  267 667 533 533 200 411
Admission
ICU 20 20
VIP room 52 30 47 70 33 60 49
Semi-Executive 41 17 57 33 33 36
General Ward 23 12 21 37 13 18 27 22
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STRICTLY PRIVATE & CONFIDENTIAL
 MEDICAL CHARGES IN GHANA ARE HIGH RELATIVE TO INDIA
B t Still Lo
But Lower
er Than So
South
th Africa
Africa, Where Most Affl
Affluent
ent Ghanaians and Go
Government
ernment
Officials Currently Seek Treatment

Comparative Reflective Charges by Country ($) 1

Ghana India South Africa

271

160
135

63 56 69
35 47 36
20 11 30 25
13 5

Specialist CT Scan (Head) VIP Ward ECG Mammography

Consultation Admission
1: Source: BSA Research

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STRICTLY PRIVATE & CONFIDENTIAL
 MALARIA IS THE LEADING CAUSE OF OUTPATIENT MORBIDITY (44%),
NEXT ARE UPPER RESPIRATORY TRACT INFECTIONS (7%)
Followed by Diarrheal (4%) and Skin (4%) Diseases

2: Source: Ghana Health Service Facts and Figures 2005

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STRICTLY PRIVATE & CONFIDENTIAL
 5 KEY CHALLENGES IN PRIVATE SEC. HEALTHCARE DELIVERY
Li it d S
Limited Service
i S Scale
l &S
Scope, Aff
Affordability,
d bilit StStaff
ff Att
Attraction/Retention,
ti /R t ti P
Poor S
Service
i
Delivery and Poor Clinical Outcomes

Challenge Manifestation Proposed Mitigation Strategy

Limited scale and scope • Highly fragmented private health • Using a shared ownership model by
service inviting equity participation to raise the
• Poor quality necessary funding to deliver a quality,
• Lack
L k off essential
ti l equipment
i t comprehensive
h i and d well-resourced
ll d product
d t
• Limited specialties

Affordability • High service charges • Innovative insurance schemes

• Absence of risk pooling • Differential pricing and cross-subsidization
cross subsidization
schemes

Attraction and Retention of • Absence of key specialists • World class state-of-the-art facilities
specialist and other key staff • Use of junior doctors/generalists • Margin based compensation schemes

Low staff motivation and poor • Poor service outcomes • Strict enforcement of service standards
service delivery • High patient turnover • Experienced management company

Poor clinical outcomes • High death rates • Will strive for International health care
• High morbidity accreditation through adherence to global
• Low confidence in local medical best practices in healthcare delivery
system • Comprehensive cutting-edge infrastructure
includingg Telemedicine capability
p y
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STRICTLY PRIVATE & CONFIDENTIAL