1. 'Private healthcare augmenting public health' Keerti Bhusan Pradhan- keerti.health@gmail.com

2. Overview
Setting the Context
The Intervention
Results
Lessons Learned

3. Insights into Healthcare in Africa
Health care in sub-Saharan Africa centers primarily on government activity, but the private sector plays a surprisingly significant and growing role in meeting the region's health care needs.
International Research findings show that $20 billion of additional investment in the region's private-sector health care infrastructure is needed in the coming decade to improve the woefully poor health outcomes.
Challenges are many
Inconsistent quality of care
Health worker shortages
Inadequate regulation to be addressed if the private sector is to most effectively benefit the health of Africa's people

4. The Cost of Global Blindness
Research by Frick and Foster estimated the cost of global blindness and low vision at $42 billion in 2000.
Without a decrease in the prevalence of blindness and low vision, it was projected that the total annual costs would rise to $110 billion by 2020.
However, if avoidable blindness is eliminated, this will be reduced to only $57 billion in 2020.
This equates to overall global savings of US$223 billion over 20 years.

5. The Need 37 million blind worldwide
9 million in Africa with preventable blindness
50-75% due to cataract
5% due to glaucoma

6. Preventable Blindness: A Cataract Operation
“Cataract surgery is one of the most cost-effective treatments that can be offered in developing countries. It can allow people to increase their economic productivity by up to 1500% of the cost of the surgery during the first post-operative year”. WHO 6
* Other causes include untreated refraction, alien bodies, trachoma 6

7. The Aravind Eye Care System is the largest eye care provider in the world with a renowned service delivery model, a facility for manufacturing high quality ophthalmic products at low cost – Aurolab and an institute for teaching and training – LAICO.
AECS and LAICO (Lions Aravind Institute of Community Ophthalmology), work in partnership with Shalina Group to provide cutting-edge clinical / non-clinical training and comprehensive eye hospital planning.
Right to Sight (RTS) mission is to eradicate the global crisis of preventable blindness through the use of proven, leading edge techniques in cost recovery, training and surgical practice.
RTS supports to facilitate capacity building through training and consultancy for development of the eye hospital through a Private-Private-Partnership Project.
Right to Sight works in partnership with Shalina Group to facilitate the planning of the clinic, focussing on training & capacity-building moving to sustainability.
Shalina Laboratories, a multi-million dollar pharmaceutical company in DRC with a good understanding of the local context and strong social responsibility.
Shalina Health Care and Shalina Foundation plan for an Eye Hospital in Lubumbashi. Project conceptualized in March 2007 when RTS & AECS representatives visited Lubumbashi to discuss eye care in the region.
With existing available space, it is decided the Eye Clinic can have approx sq.ft. and 25 Beds initially

8. Private Private Partnership
International NGO
Private Not for Profit
Tripartite
Partnership Model
Private Business
Firm
Private for Profit
NGO & Consulting
Partner
Private Not for Profit Consultancy Firm

9. Process Needs Assessment Visit Training and Capacity Building
March 2007
Training and Capacity Building
Vision Building and Strategic Planning
Nov 10-12, 2007
Project Implementation
Hospital Inauguration Dec 8, 2007

10. Affordable and Sustainable Eye Care Services in Katanga Province-DRC
Price
 Policy
Outpatient Services
Registration Fee $1
Valid for One Year
Examination Fee / Review $2
Valid for 30 Days / Any number of visits
Investigations
Laboratory Charges
$10-30
Spectacle
$20 to
$100
Surgical Services
Phaco with Acrylic / Alcon Lens
$550
Phaco with Aurofoldable Lens
$300
SICS with Rigid Lens
$200
SICS with Rigid Lens (Subsidized Fee)
$30
Subsidized for Patients who cannot afford
Other Surgeries (DCT, DCR, I&C)
$30-$50
Accommodation ( Room Rent)
Private Wards
$25
Per Day (Not charged)
Free Wards $0
Room rent is included in the Surgical Charges

11. Achievements
More than 35,000 Outpatients seen in the first year of operations (Dec.07-Nov.’08)
Surgeries in the first year of operations-2000
Capacity building of local Congolese staff happening simultaneously through osmosis/transfer of skills from expats to locals.
HR: 5 expats to 30 Congolese. (1:6)
SEC operational expenses broke-even by the end of first year

12. Steady stream of patients in Outpatient Department

13. Thank You Lessons Learnt Future Plans
Clarity and Dissemination of vision, goals and objectives, sustainability initiatives for Eye Care Institutions should be the criteria in Private-Private Partnership eye care model in Africa.
Operational ownership of Eye hospitals by the partners is vital to make a successful eye care venture in Africa.
Proof of Private-Private partnership model to be evaluated for learning in the African context and replicated in phases with a Vision to Eliminate Needless Blindness by 2020.
Future Plans
Shalina has a vision and plan to expand this Private-Private partnership model of Eye care delivery to 18 African countries with six centers planned in DR Congo in phases.
Based on the success of this model Right to Sight in partnership with Shalina Group and with other Private partners will roll out more such eye care facilities in Africa to eliminate needless blindness by 2020.
This pilot would provide road map for many private partnerships to have eye care services in Africa leading towards the goal of eliminating avoidable blindness by 2020.
Thank You 13