1. Investing on Health Services in Ethiopia – A Snap Shot of WDC
Dawit Hailu
Managing Director,
Wudassie Diagnostic Center
October, 2018
London, UK

2. Introduction
Let me share with you what I read, “Two entrepreneurs want to sell shoes in Africa. They came to Africa to explore the options. Both saw that some Africans would not wear shoes.
One of them felt excited because he perceived it Africa is a place to invest for there are many people who need shoes and he can sell to them – For him, the right place to sell shoes is Africa because of the need. He saw the absence of shoes as possibilities for his market.
The second man was disappointed that some people would not even wear shoes. He concluded that since they don’t wear shoes, Africa would not be a good market place. This guy could not see possibilities – he saw blockades.
Which one are you?

3. Location

5. Ethiopia’s Strategic Location
EAL is instrumental to connecting Africa to the world.
82 international destinations across 5 continents with over 200 daily departures
Operating 66 modern aircraft such as the B777s and B787s.

6. Ethiopia’s Strategic Location
Ethiopia is a seat for the UN offices next to the USA.
Ethiopia is also a seat for the African Union.

7. Population
Ethiopia is the second-most populous country in Sub-Saharan Africa with a population of about 100 million

8. Population 100 million + = 7 East African Countries
Eritrea
Burundi
Rwanda
Somalia
Djibouti
South Sudan
Tanzania
= ETHIOPIA

9. Population: Threat or Opportunity?
100+ million can be taken as an opportunity or threat.
As opportunity:
The human resources is the major capital of the country
We have millions of young people who can change the face of the Country.
We have so many talented, creative, educated people that can innovate and make a difference with exchange of technology.

10. As a Threat
The extreme poverty, inequity, high mortality and high fertility are linked in a vicious cycle.
Unbalanced infrastructure and people lead to deterioration of what is available.
High migration to city destroys urbanization provess.

11. Ethiopia’s Economic growth
According to Ministry of Finance and Economic Development, the country has registered over 11% Economic Growth rate for the past ten years.
The government aspires to reach middle income status over the next decade.

12. The Economist
“Ethiopia is recovering its past glory! Its economy is getting stronger....
It is time for you to seize business opportunities offered by Ethiopia in many sectors...”
See Mega projects of Ethiopia:
“Necessity is the mother of invention.” (Boserup)

13. Grand Renaissance Dam The largest dam in Africa With 6000 MW capacity
60% completed and expected to be commissioned in 2020
Total cost of 4 Billion usd

14. Condo Housing
- 865,000 people have been registered and started saving through blocked accounts in Addis Ababa.
Extensive construction of condo housing.
Over 200,000 units are already built and transmitted to residents.

15. Construction of Road Network
- The government completed 64,000 km of roads.
- This includes the roads connecting east African neighboring countries.

16. Addis Ababa Light Railway Transit
Total length 34.25km The locomotive is constructed in Ethiopia.
Two lines north-south and east-west
Capacity 8,000 people per hour
Cost 475m usd.
100% completed

17. Health Facilities under Construction
- 800 new hospitals are expected to be finalized by 2020
- Construction of 54% of the hospitals are on their final stage of completion.
- Procurement of high tech equipment is underway.

18. Health Care Strategies and Challenges in Ethiopia
New Technologies
Developments and Opportunities
The Role of Diagnostic Center in Ethiopia

19. Ten Strategic Objectives of Health Sector
Improve access to health services;
Improve community ownership;
Improve quality of health services;
Improve public health emergency preparedness and response;
Improve pharmaceutical supply and services;
Improve evidence-based decision making, harmonization and alignment;
Improve regulatory system;
Improve health infrastructure;
Improve human capital and leadership; and
Maximize resource mobilization and utilization.

20. Ethiopian health tier system
FMOH-MSD
Ethiopian health tier system
General hospital
( ) people
Health center
40000
Primary hospital
Health center
Health post
Tertiary level health care
Secondary level health care
Primary level health care
Specialized Hospital – 5.0 Million
Urban Rural

21. Distribution of Hospitals by ownership
FMOH-MSD
Distribution of Hospitals by ownership
MOH
Other governmental
Private for profit
NGO
TOTAL
Specialized 15
Regional 34
District 56
Total
105 30 49 11
195

22. Distribution of Hospitals by Regional States
Ethiopia is structured into 9 regional states and 2 cities.

23. Specialized Hospitals
FMOH-MSD
Specialized Hospitals
Examples include:
MCH: Gandhi Memorial hospital
Ethio Swedish pediatric hospital under AAUMF
Fistula :Hamlin Addis Ababa Fistula hospital
TBs: St Peter Tb specialized hospital
Psychiatric; Amanuel specialized mental hospital
Many Private hospitals providing -MCH, Cardiac, etc services

24. Hospital capacity and capability
FMOH-MSD
Hospital capacity and capability
No accreditation hence difficult to talk about international standard
National regulatory standard under preparation
Few high tech equipment such MRI,CT available
In response to this:
Procurement of high tech equipment underway such as MRI,CT,ICU and OR equipment for major teaching hospitals
Efforts underway to equip all hospitals as per national standard

25. Community based care Secondary care General Hospital Public/private
FMOH-MSD
Health Post
Health Center
Private Clinic
Primary Hospital
Primary care
Community based care
Secondary care General Hospital Public/private
Tertiary care specialized hospital Public/privat e
Community

26. Teaching hospitals MD Teaching Universities and Hospitals
FMOH-MSD
Teaching hospitals
MD Teaching Universities and Hospitals
Teaching university /hospital
type
output
AAU Medical Faculty
Gov 86
ST Paul Millennium college 38
Gondar University 65
Mekelle University
Hawassa University 37
Adama University
5nd batch
Bahir Dar University
6rd batch
Arba Minch University
Hayat Hospital
Private 35
Bethel Teaching Hospital 28

27. Health professionals Doctors to Patients raio - 1:36,158
FMOH-MSD
Health professionals
Doctors to Patients raio - 1:36,158
Nurses to patients ratio - 1:3869
Mid wives to patients radio -1:56,427
Health extension workers to patients -1:2301

28. Health Professionals Name of Specialty Public Private Total Number %
FMOH-MSD
Health Professionals
Name of Specialty
Public
Private
Total
Number %
General Practitioner
1,008
87.6
143
12.4
1,151
Internist 72
58.4 52
41.6
124
General Surgeon 91 65 49 35
140
Pediatrician 47
51.1 45
48.9 92
Gyneacologist 83
53.5
46.5
155
Ophthalmologist 50
72.9 19
27.1 69

29. Health Professionals Name of Specialty Public Private Total # %
FMOH-MSD
Health Professionals
Name of Specialty
Public
Private
Total # %
Orthopedist 14 70 6 30 20
ENT Specialist 9 36 16 64 25
Anesthesiologist 33
73.5 13
26.5 46
Dentist 23
62.8 17
37.2 40
Radiologist 43
52.9
47.1 83
Neurologist 7
63.6 4
36.4 11
Dermatology 8
44.4 10
55.6 18
Psychiatrist 21
88.5
11.5

30. Major Challenges: Unavailability, un affordability, poor storage
FMOH-MSD
Major Challenges:
Unavailability,
un affordability,
poor storage
irrational use of Resources and Drugs
Governments response includes:
Establishment of PFSA
Design of the LMIS
Implementing pharmacy services reform addressing supply and service
Opening investment opportunities in hospitals and manufacturing industry for foreigners.

31. Global Trends
By the year 2030, the three most prevalent causes of death in “low income” countries are expected to be: 1. Ischemic Heart disease (13.4%); 2. HIV/AIDS (13.2%) and 3. Ceredrovascular disease (8.2%). Hence, Cardiovascular diseases will continue to increase in the “developing world” like an epidemic!
The upside of the picture is that medical science has developed tremendously during the past few decades concerning CVD.

32. Opportunities
Unprecedented priority by the government is being given to the quality of services by hospitals lately.
The government openness for private public partnership in health care system.
The private health care still only services a very small percentage of the Ethiopian public, primarily in the major urban areas where less than 15% of the population lives. Health investment as partner as well as big projects such as hospitals, manufacturing of drugs is possible for foreign investment.

33. Opportunities
Introducing new technologies is an answer for resource constraints.

34. Business Perspectives – The Role of Diagnostic Centers
The demand for quality
Health sells
Demand for technology

35. Wudassie Diagnostic Center

36. BACKGROUND:
Wudassie PLC was established in 2004, and progressively incorporated multi-disciplinary retail and service providing business in Addis Ababa, Ethiopia.
Through the business, and role within community, we aim to support local causes, medical professionals, patients from government hospitals and people less advantaged.
WDC has restructured its operations by including partners and increased its capital as well as its operations.

37. BACKGROUND Established in 2009
Services Provided – Focuses on providing imaging and diagnostic services
MRI;
CT scan;
Digital x-ray;
Ultrasound and EKG;
GI Center
Complete Laboratory
Ambulance services

38. BACKGROUND CONT’D Major Milestones Target Customer
2009 – Established with twin slice CT
2010 – Added Digital X-ray
2011 – Added Ultrasound & EKG
2014 – Opened new branch, added 16 slice CT & additional Ultrasound
2015 – Added MRI at second branch
2017 – Added GI Center
2018 – Added Complete Laboratory
Target Customer
Referees from Hospitals and physicians,
Targets patients with low to middle income level status

39. Why Should the Business World Need to Assume Social Responsibility?
It is a global initiative and a human right issue.
It is poverty alleviation strategy.
It is being human to care for the less advantaged and benefiting others.
It provides personal satisfaction.

40. What is CSR to Wudassie? Experience sharing
CSR to Wudassie is
Our community: workplace, neighborhood, government hospitals.
A commitment to support local causes,
Involving in within our local community and the wider environment initiatives
Caring for the health and well being of our staff and ensuring they have sufficient training and development.
In addition to respecting human rights, WDC focuses on actively being involved in societal causes.

41. Conclusion Ethiopia attracts investment in the area of health.
Would you like to focus on the poverty and hence impossibility or poverty and hence opportunity?

42. Et

43. I will be your Master of Ceremony for today
Honorable His Excellency FAM XXX
Honorable His Excellency M
Dear Ethiopian Business Delegates
Invited guests, Ladies and Gentlemen
Protocol