Would you start your business in Nigeria

The health system is facing enormous challenges

Nigeria's health system is considered weak and underserved. In 2001 the member states of the African Union committed themselves to spending at least 15 percent of the public budget on health each year. Nigeria's spending is well below the target, averaging less than 5 percent per year. According to the World Health Organization (WHO), Nigeria spent about $ 75 per capita on health in 2017. In addition to the limited public funds, there is a high burden of communicable diseases (Covid-19, HIV / AIDS), non-communicable diseases (cardiovascular diseases, cancer, diabetes) and increased maternal and infant mortality.

In addition to the lack of adequate and modern facilities, there is a great shortage of qualified medical professionals. According to WHO estimates, there are around 35,000 doctors in Nigeria, but around 240,000 doctors are needed. In part, this is due to the migration of Nigerian skilled workers abroad.

As a result, Nigeria loses at least $ 1.5 billion in medical tourism revenue every year, according to the Nigerian Medical Association (NMA). Wealthy Nigerians, including many politicians, seek expensive treatment abroad, particularly in India, the United Arab Emirates, the United States, South Africa and Europe.

More medical facilities planned

To reverse this trend, the Buhari government has adopted a National Strategic Health Development Plan II for the years 2018 to 2022 and set up a fund for basic medical care. State money but also money from private actors such as the Bill Gates Foundation and donor institutions such as the World Bank and USAID are to flow into the fund.

The involvement of the private sector is seen as essential. Here, too, there will be more PPP projects (public-private partnerships) in the future. A few years ago, the Nigerian Sovereign Investment Authority (NFIA), in cooperation with the Federal Ministry of Health (FMOH), signed a number of agreements with private actors for the expansion of hospital capacities and diagnostic centers. The partners of the NFIA and the FMOH include the Lagos University Teaching Hospital, the Aminu Kano Teaching Hospital in Kano and the Federal Medical Center Umuahia. In 2019, the newly built cancer center of the Lagos University Teaching Hospital (LUTH) in Lagos went into operation, which was equipped with devices from the US company Varian.

Private sector launches initiative to improve care

Private sector representatives have launched the Adopt-a-Healthcare-Facility Program (ADHFP). The initiative is supported by the Private Sector Health Alliance of Nigeria (PSHAN) and the African Business Coalition for Health (ABS-Health). PSHAN is supported by the richest man in Africa, Aliko Dangote, and his group of companies. The aim of the ADHFP is to create universal access to health care for low-income citizens in rural and urban areas. Conceived as early as 2019, the urgency of such an initiative is now all the more clear due to the corona crisis. In total, medical facilities are to be created in all 774 local government areas (LGA), so-called primary health care centers. These should be set up and operated according to strict rules and guidelines. The program is currently in the drafting phase, which is being carried out by the international consulting firm Vesta Healthcare Partners. Components such as a legal framework, framework for PPP projects, facility and management standards, financing agreements and supply chain management are currently being developed. This is done with the involvement of development organizations such as Global Citizen, ABCHealth, the Bill Gates Foundation, United Nations Economic Commission for Africa, World Bank, International Finance Corporation (IFC), MTN Nigeria Plc, Dangote Group, Zenith Bank, Access Bank, Stanbic-IBTC Bank, PwC, Cisco, Ford Foundation, Nigerian Stock Exchange and Flying Doctors Nigeria. The program is to start with a pilot project at the end of 2020.

Industry could grow in the future

In general, the demand for health services is likely to increase due to the growing population and an increasing middle income bracket. Despite limited funds, the government is planning to build 14 medical centers and expand and modernize two intensive care units as part of its intervention against the Covid 19 pandemic and with the involvement of private individuals. In addition, more and more PPP projects are planned. For example, the state of Lagos is planning to build a medical park with 120 to 150 beds (MediPark) using a PPP model. The cost is estimated at around US $ 250 million.

There may also be opportunities for digitization services. Most hospitals use paper patient files. Market opportunities for inexpensive EMR (Electronic Medical Record) systems can arise here. In addition, medical expertise is still in short supply, medical education and training services as well as services in the administration and management of hospitals could be in greater demand in the future.

The area of ‚Äč‚Äčtelemedicine also experienced a boost as a result of the Covid 19 pandemic. For fear of stigmatization and fear of being infected with Corona, many people have refrained from visiting hospitals and instead increasingly turned to doctors for medical consultations via telemedical platforms. E-health providers were able to record an increase in new users here. This trend is likely to continue even after the pandemic has subsided. The government has also begun adopting this technology as part of its public health intervention programs.