A report on health services in Africa published by the International Finance Corporation reveals that the demand for health care is expected to double in the next five years, bringing numerous opportunities but also challenges on the continent that is already enveloped by a fair share of ills.

Years of neglect towards the health sector seen in most African countries have resulted into decay especially in the government-run hospitals.

Poor pay coupled with absence of equipment in rural areas and difficulties faced by private health workers in accessing credit from banks have complicated matters leading to exodus of qualified health professionals in search of greener pastures.

The consequences are disappointing; Africa has the worst health care in the world despite billions of donor aid that has been sunk into improving the health of people on the continent.

And the situation is likely to get worse if countries and stakeholders continue business as usual: In a study titled: "The Business of Health in Africa" published by the International Finance Corporation (IFC), the World Bank estimates that by 2016, the demand for health care will have doubled.

This requires new investments of between US $25-$30 billion to buy beds and other physical facilities, let alone train training an additional 650,000 health workers.

The tremendous increase in demand is born out of the fact that the continent is experiencing fast growing and ageing population, an expanding size of the middle class on the one hand, and the declining or persistently low budgetary allocations to health care on the other.

During a recent workshop organized by the Ministry of health and USAid, stakeholders in Uganda's health care industry argued that in order to meet these challenges, there will be a need for concerted action by all stakeholders through Public Private Partnerships.
Already, numerous studies indicate that the private sector plays a crucial part of the health care industry in Uganda.

More than 65 percent of Ugandans use their money to pay for health care and most of them are poor.

The good news is that there are a number of initiatives that can facilitate mobilization of financial and logistical resources to enable rapid investments in the industry so as to meet the challenges.

Cheaper credit lines for health

Realizing the need to meet the Millennium Development Goals coupled with the need to take advantage of the opportunities in health care, the World Bank, through IFC - its private lending arm - has set aside US$ 1 billion for to facilitate long-term investments by the private sector through what is known as Health Care for Africa Initiative.

Dr. Khama Rogo, (Pictured above) one of IFC's executives told The Sunrise, that the WB was persuaded to make the investments because of very high lending rates that have proved to be binding constraints on the growth of Africa's private health sector.

Rogo argued that one major objective of the bank is to help bring down the lending rates to private and not-for-profit health establishments. In addition, the Bank wants to provide a source of longer term financing.

"Interest rates are obscene in this region. To expect private sector to invest is  impossible," said Rogo.

According to Rogo, some Kenya hospitals have started benefiting from a US$ 100m project called Oreos. IFC allows a wide array of investments including loans and equity.
Participants also implored government officials to push for the creation of a low-interest loan facility similar to Uganda's Agricultural Credit Facility that gives out loans at low interest rates.

New Pepfer project to train medics

Despite the fact that Africa has the highest disease burden of all regions, the continent suffers from an acute shortage of health care professions. It is estimated that the continent has only one percent of 1% of the global health workforce.

In an effort to respond to this deficit, the United States Government through the US government's President's Emergency Plan for Aids Relief (Pepfer) has set a target of training up to 140,000 health workers in Africa over the coming five years. Private and not-for-profit organizations were encouraged to take advantage of these resources, especially those that have training institutions.

Delegates however agreed that training of health professionals needs to be harmonized by instituting a single regulatory body to ensure strict adherence to high standards of quality.
The sheer lack of enough training facilities emerged as another hindrance to improving people's access to qualified medical personnel.

 Majority of East African students trained in India

It was revealed, that whereas 9000 Ugandan students qualify to join medical and nursing schools every year, there are only 800 vacancies available in the country. This acute shortage of training facilities has resulted into a situation where more students from the East African being trained in India compared to those trained within the region.

Private sector federation

The absence of unity among private health industry players was noted as a weakness especially when it comes to lobbying and pushing their interest to the highest level of policy making.

For example, Unlike in Uganda where private health practitioners have no say on matters of policy, Rogo informed delegates that an association of private health representatives has enormous influence and greatly influence policy in the country.

Ugandan practitioners led by Dr. Ian Clark of IHK agreed to embark on the process of establishing a private health workers federation as a body that will champion their interests with government and donor agencies.

Unite to minimize risk

It is acknowledged worldwide that the best way to bring about affordable and quality health care is through introducing some kind of health insurance whereby citizens pool resources as well as risks.

The commissioner of planning in the ministry of health Dr. Francis Runumi noted that while health insurance scheme has been delayed, it is one way through which private health care providers can dream of recovering their investments by joining the pool of providers.

But perhaps the more important message for private and not-for-profit health care institutions was that they've got to move faster than government.
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