Presentation on theme: "Private Healthcare in Sudan Dr Yagoub M A Magid, FRCOG Consultant, Assisted Reproduction Nile Fertility Centre Khartoum Sudan."— Presentation transcript:
Private Healthcare in Sudan Dr Yagoub M A Magid, FRCOG Consultant, Assisted Reproduction Nile Fertility Centre Khartoum Sudan
Whom does private healthcare serve ? Everybody including foreign community & patients from neighbouring countries.
Introduction: Private Healthcare is relatively new in Sudan It started with the deterioration of MOH services It is responsible for delivering of 25% health services
Objective of Private Healthcare: To deliver comprehensive modern healthcare services.
Requirements for Healthcare service : A)qualified staff I- medical staff ii- nursing staff & Paramedics iii- others ( administrative, catering staff..etc ) B) Suitable premises Purpose built hospitals / centres C) Provision of appropriate equipment Lab, OT, USS, CT, MRI..etc
Number of Private Hospitals/Centres – Khartoum State 2011 Private Room (N) Centres/ Polyclinic (N)Hospitals (N)Area 3253122UMD 2352120KRT N 4085746KRT 96810988Total
Type of Private Hospitals, Khartoum State 2011 Diabetes (N) Dermatology (N) Breast (N) ENT (N) Paed (N) Eye (N) Maternity (N) General (N) Hospitals (N)Area 01030401022 UMD 01 02051120 KRT N 01 02063646 KRT 010201 0508115788 Total
Major Private Hospitals in Khartoum State 2012 Dialysis Unit Cardiac Catheter lab P.T.OTNICULWICUMRICTX-rayUSLabA&ENo of Beds Unit Hospital √√√√√√√√√√ 59 Albaraha √√√√√√√√ 30 Aldwoli √√√√√√√ 40 Alfaisal √√√√√√√ 28 Alnil Alazrq √√√√√√√√√√√√√ 48 Alzeitona √√√√√√√√√√ 63 Asia √√√√√√√√ 50 Bestcare √√√√√√√√√√ 32 Doctors √√√√√√√√√√√ 103 Fedail √√√√√√√√√√ 70 Imperial √√√√√√√√√√√√√ 50 Royal care 573 Total
Number of case visited private hospitals Khartoum state 2011 Insured (%)All casesArea 40% - 60% 73791UMD 55191KRT N 55846KRT 184828 ?Total ? Only 3% of no. of cases visited MOH Hospitals/Centres Reason: Inaccurate recording Does not include cases seen at Private Rooms ( 1500000 ) = 27.5%
Number of cases visited government hospitals/ centres, Khartoum state, 2011 insuredTotal / Area 7133982431231UMD 5179841648049KRT N 3931342054515KRT 1624516 26.5% 6133795Total (3 areas)
What has been achieved so far ? i.Provision of acceptable service for patients Via i. Medical insurance ii. Employer iii. Self Funding ii.Improvement in quality of Nursing Foreign nursing staff
What has been achieved so far ? iii. Introduction of modern: Laboratory service imaging technology, USS, CT, MRI Key hole techniques Fedail Hospital G/E Endoscopy Diploma Training Programme, Totally Free)) Endoscopy ( Training programme, IVF/ Laparoscopy & Embryology 12 yrs ) Fertility treatment Dental Centres physiotherapy Service Purpose built hospitals
What has been achieved so far ? IV. Employment and Training of Junior medical and other staff V. Helping the poor ( PHC Help Group ) VI. Introduction of Private Healthcare Charter VII. Attraction of Medical Insurers International: e.g. BUPA, AXA, I G, GMC, Vanbreda Local: e.g. Prime Health, Shaikan !!
Problems: I. Concessions & Subsidies. Customs Red tape, Inconsistency, increasing charges. Taxation Sales tax, income tax. Local Council Rates Local tax, Garbage money, sewage money, Fire service charge. Electricity and Water Bill Huge prepaid at commercial rate
II. Limitation on Medical Equipment / Consumables Imports - Problems with Foreign currency ( availability and exchange rate) - Refurbished / Ex Demo equipment (X) - Imports office: wrong place ( pharmacy directorate ) red Tape, endless procedure, Junior staff no coordination with standards office - AMERICAN SANCTIONS Getting worse Round about way Can any one help?
III. Competition with Providers delivering PHC service within MOH premises e.g. South Block, Sharg al nil, Private wings ( UMH, KNH,..etc ) Advanced Medical centre, Jordanian Laboratories..etc
IV. Sending patients abroad for treatment Bank of Sudan, Foreign Ministry, NEC, Agric Bank, Sudatel..etc
V. Health Insurance Corporate ) ) - Limited to companies and government departments i.e. no individual cover policies - limited level ( ceiling ) of cover - small premium = no adequate) - Delayed or no payment ( Shaikan }
VI. Pharmaceutical Companies : - Problems with foreign currency.i.e. LC.etc - Drug registration Procedure = Red Tape Scarcity of drugs Encourages Black market and import by Street Traders !!
VII. Competition with Foreign Investors: - Ultra Lab - Al Mukhtabar Al Burj Lab- - Jordanian Lab - Others owned and supported by influential people
VIII. Media: Papers, Radio..etc Papers: Harassment & Negative Publicity All against doctors and PHC Radio: Nutrition Weekly programme Rx Pumpkin Seed Honey Remedy for all, Weekly programme Rx Bee Sting
IX. Doctors’ Problems - work long hours to earn enough no pension scheme, life/ income insurance or protection against litigations - limited opportunity for training, CME ( conferences, workshops..etc )
Doctors Problems: – Licensing to practice by SMC a- easy for visiting foreign doctors Advertising, Papers, TV Operate ( preop assessment ? & postop F U ? ) b- difficult for Sudanese doctors working abroad
Doctors’ Problems: - Role of Sudan Doctors Union towards patients & members Hardly any role at all
Way Forward: A long way to go : Provision of sophisticated modern PHC is unattainable in Sudan at present. Most of the Public live below the poverty line and health insurance provides cover for less 10% of those who need it at the moment. However, a reasonably good level of care can be achieved. What needed is: - More understanding and support from the government Special consideration: plot of land, Customs, Taxation, council rates, electricity & water bill, Fire service..etc
Way Forward: - Implementation of a comprehensive health insurance programme to to cater for all with positive contribution from the government & employer - Doctors union must play a positive role towards patients its members - Formulation of a positive charter for both government & private Healthcare