26th - 27th September, 2013, Johannesburg, South Africa
The hospital sector is undergoing undeniable growth in the entire African continent, stimulated by increased active government focus on healthcare expansion. In the coming 10 years, not only an extra 500.000 to 650.000 beds are being built in the Sub-Saharan healthcare market, investments up to $35 billion are said to be made by 2016. The Africa Hospital Expansion Summit hosted government offi cials, doctors, management groups and hospital owners as well as consultants, architects, medical companies, equipment providers and service groups to discuss investment opportunities, quality issues and design as well as adequate hospital management and public private partnerships across Africa. The 2 Day conference was kicked off by Mr. Biju MOHANDAS, who presented us with an outlook of the Africa Healthcare Sector and how IFC contributes to the healthcare sector in Africa through both direct and indirect investments. He explained that, in Africa, the IFC is not only active on the investment side, but also deals with policy issues such as accreditation and quality, as well as health insurance through PPP, private investment and the government. Mr. Mohandas’ introduction was followed by Ms. Merissa KAMBANI, Chairman of the Private Hospital Association of Zimbabwe. She highlighted that only 1 out of 13 Zimbabweans have medical insurance and out of that group, only very few can benefi t from a private hospitalization. Ms. Kambani brought a very passionate presentation on the Private Hospitals Association of Zimbabwe and how they hope to reach more people in the future. She emphasized that Zimbabwe, after passing diffi cult years, is now recovering and that there is “brain fi ll” going on. She also focused on the need to rebuild the country and hopes to start with ensuring good quality healthcare to the people of Zimbabwe. After taking a look at the hospital sector in Zimbabwe, Dr. Sam THENYA, CEO of Nairobi Women’s Hospital introduced us to Kenya and presented a case study about the Nairobi Women’s Hospital. Dr. Thenya gave an overview of the transformation the hospital went through, the challenges they faced and how they got to the modern maternity hospital that is in place to ensure women’s health. Apart from the new infrastructure, a big focus was also laid upon education and training of quality staff. Dr. Thenya introduced their concept which is “plug and play”. They have a partner in real estate, the hospital is owned by a landlord and the equipment is “plug and play” so Dr. Thenya and his management can leverage with the funds available, and they can keep focusing on training and modernization. Right after the fi rst tea break, Dr. Carlos Alberto MASSECA, Secretary of State for Health of the Angolan Ministry of Healthcare, presented the delegates with the Angola’s Development Strategy 2025 pointing out that there is an absolute focus on primary health care and patient care in Angola. The Angolan health system and health care initiatives were explained and Dr. Masseca closed his session by looking and the latest healthcare investments in his country together with the challenges they still face. Dr. Masseca’s speech was followed by a call from Dr. Amit N THAKKER, Chair of the East African Healthcare Federation, to organize the private healthcare sector and to bring all the different associations and organisations together under one big umbrella association. At the moment, many good deeds erode in Africa through fragmentation and they need to move away from that. He stressed the need to shift from different competing organizations to one organized body in order to ensure better healthcare and have better control over funding, regulatory affairs and administrative matters. The example was given of the communiqué the different healthcare organizations of Uganda, Tanzania, Kenya and Rwanda signed to form the EAHF. A richly fi lled morning session which took us around East and Southern Africa was concluded by Dr. Simmardeep Singh GILL, COO of the Fortis Clinique Darné of Mauritius. He shared insights into how he turned the Clinique, which is one of the oldest on the island, into the modern hospital it is today. A case study was presented and it came out that the most important factor for bringing this modernization to a successful end was the “culture” factor: making staff aware of their responsibilities and that “how they have always done it” might not be the best approach. The easiest job, Mr. Gill said, is investing money, but the hardest job is managing the people and ensuring their commitment. The afternoon session started very vibrantly, with a 30 minutes interactive panel discussion moderated by Mr. Terence CARTER, Deputy Director General for Hospitals, Tertiary Health Service and HR Development of the National Department of Health, South Africa. Together with Dr. Carlos Alberto Masseca and Dr. Tânia Lourenço from the Angolan Ministry of Health and Dr. Jackson Orem, Director of the Uganda Cancer Institute, Mr. Carter addressed the burning question of how to ensure accessibility and affordable healthcare for everybody in Africa. Light was also shed on the challenges in Angola, Uganda and South Africa and on the work the ministries are doing to tackle these challenges. After the panel, Mr. Ben MAREE, Team Leader: Opportunity & SME Consulting, Sales at T Systems, impressed the audience with all the possibilities eHealth solutions can offer and concluded his interactive presentation by showing a demo of how you can manage different hospitals, merely by a click on your Ipad. Focus was then shifted to the design of hospitals and the impact of it on the management of hospitals. Dr. Nomsa DLAMINI, CEO of Sakhiwo Health Solutions and her colleague, Ms. Etha van der SCHYF, senior health planner, looked at different stages of strategic planning when designing a hospital and gave examples of how in many cases the design of a new structure exceeds greatly the actual need for the new structure, having an impact, not only on costs, but also on clinical efficiency, healthcare quality and work moral. Their insightful presentation was closed with some food for thought: Whilst Hospital Design has an impact on Management, Management also has an Impact on Design. Last speaker before the afternoon tea break was Dr. Jackson Orem, Director of the Uganda Cancer Institute. He reiterated the need for quality healthcare infrastructure by looking at the cancer burden in developing countries and more particularly in his country, Uganda. After addressing this burden, he showed how good infrastructure can help in fighting this disease and presented an overview of where they started years ago and what the new cancer institute will look like in the future. After another fruitful networking tea break, all the delegates came together to listen to Dr. Nkaki MATLALA, Director of Government and Industry Affairs of Mediclinic International. Dr. Matlala evaluated the existing healthcare systems and looked at how we can improve quality care. He made a direct link between hospital design and equipment on one hand and patient safety on the other hand. He clearly pointed out where improvements need to be made in order to enhance patient safety and shorten hospital visits. The fi rst day came to a close with 2 case-studies, one from within Africa and one from overseas. The fi rst case-study was presented by Dr. John A ADESIOYE, CEO of Utopian Consulting International. He presented on the project of the new Calabar hospital in Nigeria which has failed many times in the past and now, after Dr. Adesioye took over as a consultant, is looking at a bright future. This very interesting presentation was followed by another international case-study by Mr. Brody ATTERBY from JohnStaff projects. He showed the delegates an example of a new hospital in New South Wales in Australia where they managed to integrate not only the environment but also the culture of the local community into a health center that not only serve as hospital, but is designed to be a place of healing and a meeting place for the entire community. Following this presentation, Dr. Adesioye summarized the fi rst day of the conference and invited all delegates to Day 2 of the event. The second day started with a presentation of Mr. Mouhamadou NIANG, Manager, Industries and Services (OPSM2) of the African Development Bank. Dr. Niang opened his presentation with 5 key sectors the AFDB focuses on, which are all related to health: infrastructure, government, private sector development, regional integration and skills & technology. They lend to both the public and private sector and Dr. Niang explained the financial instruments the AFDB has in order to help clients in the healthcare sector. Second speaker of the day, Mr. Erwin TELEMANS, CEO of the Comprehensive Community Based Rehabilitation in Tanzania, explained to the audience how they reach out to the poorest in his country, Tanzania and try to serve as many as possible. They work through a system of volunteering ambassadors, doctors as well as cleaners and through their partnership with Vodafone, they can send money via a text message to the patient in remote areas, who then is able to buy a bus ticket to Dar Es Salaam to get treated in the center of Dr. Telemans. Dr. Telemans gave an overview of the different NGOs, academic institutions and governments they partner with and how through these PPPs they cannot only cure the poorest, but also make sure they are included in the community again and ensure that they work towards prevention as well. Dr. Dumisani BOMELA, CEO of the Hospital Association of South Africa continued the morning session of Day 2 by asking the question: “Is There a Need for Further Proliferation of Hospitals in South Africa?” Reason for this question is that the minister has stated that they are too hospicentric in South Africa and that they focus too much on hospitals. The minister wants a shift from hospitals to primary healthcare initiatives and this implies or gives the impression that there is no need for more hospitals in South Africa. However, HASA would like to argue that there still is a need for more hospitals. Dr. Bomela makes this point by showing that the disease burden has increased and that more and more people are also staying longer in the hospital.However there hasn't been any increase in the number of beds. In South Africa, there are only 2.3 beds per 1000 people, which is not even half of the average in the OECD countries. Therefore, Dr. Bomela concluded that the need for greater emphasis in primary healthcare interventions cannot be a trade-off or substitute for investment in hospital beds. HASA’s presentation was followed by many questions from the audience which continued during the fi rst networking session. After the first break, Professor Alta SCHUTTE, the Focus Area Director: Hypertension in Africa Research Team (HART) from the North-West University spoke on behalf of Omron Healthcare about non-communicable diseases especially hypertension in South Africa. Prof. Schutte gave a very detailed presentation on the disease burden in South Africa and especially the one from non-communicable diseases. She looked at treatment and control of these diseases and how only around 3% of patients in Mozambique are successfully treated against hypertension. Focus should therefore be put on prevention and early detection and NCDs should be integrated into all aspects of planning for the signifi cant growth of the hospital sector in Africa. Second after the networking session was Dr. Ashraf ISMAIL who with a very passionate speech stressed on the need of standards to improve the quality of patient care and in healthcare, there is a need to invest in all aspects, from great leadership to the right infrastructure and equipment to a high level culture of safety and quality. Dr. Ismail went over both evidence based and standard based design and showed that through these principles, the quality of patient care is considerably higher. This was followed by a case study, presented by Mr. Hans Jörg DROUIN, Director Turn Key Projects at the MMM Group. Mr. Drouin spoke about the Adamawa German Medical Center in Jimeta-Yola, Nigeria. This center was prefabricated in Germany and then fully transported all the way to Nigeria. Apart from the structure itself, German doctors and nurses also came to Nigeria to train in-house staff and transfer their know-how to the staff in Jimeta- Yola. To end the morning session, Mr. Marc KEYLARD from Wolters Kluwer Health gave a short overview of the different options Wolters Kluwer can offer them to easily gain important medical and clinical information. The last part of the summit started very strong with Dr. Margaret MUNGHERERA addressing the Millennium Development Goals and where Africa stands in respect to them. She also focused on the importance of universal health coverage for all and ended by stressing the need of great leaders. Dr. Mungherera herself is the fi rst African woman to lead the World Medical Association, starting on 19th October, and shared her ideas with the audience to strengthen the capacity of national medical associations, influence regional and national health policies and how to ensure that all African countries work together for a better healthcare and hospital care in Africa. A better hospital care also depends on the right procurement of equipment and infrastructure. Therefore, Mr. Gregory OTIENO, Group Procurement Manager Indirect Spend of Netcare, gave an introduction into the optimization of procurement,the objectives they have and the steps they follow to guarantee the desired outcome. His presentation was followed by a panel discussion about the market expectations towards suppliers in which Mr. OTIENO together with Dr. Margaret MAULANA, General Manager of the PSMI West End Hospital in Zimbabwe, gave their view of what is needed for the hospital, moderated by Mr. Paul HARDING, Managing Director of the South African Quality Institute. The panel made very clear that the expectations of a general manager and the objectives of the procurement team not always coincide and that there is still a lot of work to be done. Also, “quality” which has been the leading topic throughout both conference days was an important point. The controversy panel was followed by the last networking break of the conference after which Ms. Teresa JANSEN VAN RENSBURG, Director South Africa at HLM Architects drew one last time the attention to hospital design. She gave a short but highly informative presentation explaining how hospital design can contribute to energy saving solutions and hence also to cost savings in the hospital industry. The 2 day summit was finally concluded with a panel that looked at the future of the African healthcare and hospital sector. Moderator Dr. Amit N THAKKER, chair of the East Africa Healthcare Federation, together with panelists Ms. Merissa KAMBANI, chairman of the Private Hospitals Association of Zimbabwe, Mr. Keith BONSALL, co-founder and co-director Halcom Management Services and Dr. Margaret MUNGHERERA, president elect of the World Medical Association, drew a close to the event by giving some last personal insights into what needs to be done to ensure a better future for African healthcare. This panel was applauded by many of the delegates who, apart from questions for the panel, also presented their own experiences in their respective countries. Mr. Thakker then made closure remarks leaving the audience with few thoughts such as: What happened? Where did they go wrong? How can healthcare and patient care become at the center of Africa again? Noppen would like to express a special thanks to the sponsors of the Africa Hospital Expansion Summit: Omron, T Systems, Wolters Kluwer Health / Ovid, Manusa, Grupsa, Knauf, Metraco, Fanem, Communica, JohnStaff Projects and Legrand. We would also like to thank our Association Partner, the East Africa Healthcare Federation. We have no doubt that your contributions helped in making this event a success