Eye care in developing
countries: creative
financial options
Dr Kunle Hassan FRCS, FRCOph.
Eye Foundation Hospital Group
Lagos. Nigeria
S
The challenges of our
generation
How can we :
S Reduce blindness
S Grow outreach of eye clinics/hospitals
S Transform the financing of the eye care industry with
priority on sustainability
S Provision of quality, equitable, affordable and cost effective
and efficient eye care services for all
Financing Options
S
Sliding Fees Structure
S
Optical Services
S
Cross Subsidization
S
Insurance Schemes
S
Service Contract with Corporate Companies
S
Donor Funding
S
Government Funding
S
Loans
EYE FOUNDATION SERVICE DELIVERY
MODEL
S PRIVATE-PUBLIC-COMMUNITY BASED TRIPATITE
Eye care System.
Social Entrepreneurship model of equitable, affordable and
sustainable eye care delivery system.
The Eye foundation centre for the
prevention of blindness consists of:
S
hospitals with state of the art equipments. This is the private arm of
the establishment.
S Caters for the rich and the middle class and expatriates
S Has 100% cost recovery
S The public/Community hospitals: 30% cost recovery
S The community outreach programme: no cost recovery
S The private sector in 1 above sustains the public and community
based subsidised services.
EYE FOUNDATION PUBLIC
SECTOR
S These are separate Eye Hospitals running a Sliding Scale
Eye care services for the less privileged according to their
ability to pay.
S Here over 67% of Services are subsidized. 33% of the
Services are provided free:
S The Deseret Eye Center. Ikeja GRA Lagos
S The Deseret Eye Center, Ijebu-Imushin. Ogun State
PRIVATE SECTOR
S A Solid and well run private sector is key to the success of a
successful model.
S It provide the major resources from Surgeries, High tech
Investigation procedures, like OCT, FFA, Laser treatments and
Optical Services
S Cost recovery with profit margin is good.
S Hence a means of paying for expensive fixed cost, like
infrastructures and equipments.
PUBLIC SECTOR
S Volume driven service with the goal achieving critical break
even point is key to successes and sustainability.
S High Volume, low cost optical sales provide about 40-200%
profit margin.
S Drug revolving fund using effective and low cost generic
contributes about 20-40% of profit margin towards
achieving sustainability.
EXTERNAL FUNDING
S INSURANCE – via HMO is good where reimbursement is assured.
Privately organized Community Insurance scheme is the future in
SSA.
S Government funding is unreliable and laden with corruption. Could
be useful in providing infrastructure .
S Donor Funding – is important as a catalyst, but not as the primary
source of funding. Helpful in the start up stage. Better in form of
providing part of fixed cost (equipments and Infrastructure) or a
cushion in supporting variable cost like consumables. Never in cash,
it can undermine or blur your entrepreneurship and innovation
ability.
External Funding
S LOAN – with low interest rate and long term repayment is
critical to expanding eye care business and creating new
growth platform, especially in Private/Public Social
Entrepreneurship approach to eye care.
S The Eye Foundation Program in Nigeria, had an increase in
service provision coverage area by 300% and with an
increase of about 50% in the Private sector and 150% in the
Public and community sector, 3 years after our assess to the
EYE FUND LOAN and IAPB Capacity Building Grant
CONCLUSION
S A balanced Internally generated fund and external assess to
funding, with good and robust risk appetite that is well
defined, is key to creative financing of any successful and
sustainable eye care in developing countries.