Private Healthcare in Sudan
Dr Yagoub M A Magid, FRCOG
Consultant, Assisted Reproduction
Nile Fertility Centre
Khartoum Sudan
Whom does private healthcare serve ?
Everybody including foreign community & patients from
neighbouring countries.
Introduction:
Private Healthcare is relatively new in Sudan
It started with the deterioration of MOH services
It is responsible for delivering of 25% health services
Objective of Private Healthcare:
To deliver comprehensive modern healthcare services.
Requirements for Healthcare service :
A) qualified staff
I- medical staff
ii- nursing staff & Paramedics
iii- others ( administrative, catering staff ..etc )
B) Suitable premises
Purpose built hospitals / centres
C) Provision of appropriate equipment
Lab, OT, USS, CT, MRI ..etc
Number of Private Hospitals/Centres – Khartoum State 2011
Area
Hospitals (N)
Centres/
Polyclinic (N)
UMD
22
31
325
KRT N
20
21
235
KRT
46
57
408
Total
88
109
968
Private Room (N)
Type of Private Hospitals, Khartoum State 2011
Hospitals
(N)
General
(N)
Maternity
(N)
Eye
(N)
Paed
(N)
UMD
22
10
0
04
03
KRT N
20
11
05
02
01
KRT
46
36
06
02
01
01
01
01
Total
88
57
11
08
05
01
01
02
Area
ENT
(N)
Breast
(N)
Dermatology
(N)
Diabetes
(N)
01
01
01
Major Private Hospitals in Khartoum State 2012
Unit
Hospital
No of
Beds
A&E
Lab
US
X-ray
CT
MRI
ICU
LW
NICU
OT
√
√
√
√
√
√
√
√
√
Albaraha
59
√
√
√
√
Aldwoli
30
√
√
√
√
√
Alfaisal
40
√
√
√
√
√
Alnil Alazrq
28
√
√
√
√
√
Alzeitona
48
√
√
√
√
√
√
Asia
63
√
√
√
√
√
√
Bestcare
50
√
√
√
√
Doctors
32
√
√
√
√
√
Fedail
103
√
√
√
√
Imperial
70
√
√
√
Royal care
50
√
√
√
Total
573
P.T.
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
√
Cardiac
Catheter
lab
Dialysis
Unit
√
√
√
√
√
√
√
√
Number of case visited private hospitals Khartoum state 2011
Area
All cases
UMD
73791
KRT N
55191
KRT
55846
Total
184828 ?
Insured (%)
40% - 60%
?
Only 3% of no. of cases visited MOH Hospitals/Centres
Reason:
Inaccurate recording
Does not include cases seen at Private Rooms ( 1500000 ) = 27.5%
Number of cases visited government
hospitals/ centres, Khartoum state, 2011
Total / Area
insured
UMD
2431231
713398
KRT N
1648049
517984
KRT
2054515
393134
Total (3 areas)
6133795
1624516
26.5%
What has been achieved so far ?
i.
Provision of acceptable service for patients
Via
i.
ii.
iii.
Medical insurance
Employer
Self Funding
ii. Improvement in quality of Nursing
Foreign nursing staff
What has been achieved so far ?
iii.
Introduction of modern:
Laboratory service
imaging technology , USS, CT, MRI
Key hole techniques
Endoscopy )Fedail Hospital G/E Endoscopy Diploma Training Programme, Totally Free)
Fertility treatment ( Training programme, IVF/ Laparoscopy & Embryology 12 yrs )
Dental Centres
physiotherapy Service
Purpose built hospitals
What has been achieved so far ?
IV. Employment and Training of Junior medical and other staff
V. Helping the poor ( PHC Help Group )
VI. Introduction of Private Healthcare Charter
VII. Attraction of Medical Insurers
International: e.g. BUPA, AXA, I G, GMC, Vanbreda
Local:
e.g. Prime Health, Shaikan !!
Pictures;
Problems:
I. Concessions & Subsidies
. Customs
Red tape, Inconsistency, increasing charges
. Taxation
Sales tax, income tax
. Local Council Rates
Local tax, Garbage money, sewage money, Fire service charge
. Electricity and Water Bill
Huge prepaid at commercial rate
II. Limitation on Medical Equipment / Consumables Imports
- Problems with Foreign currency ( availability and exchange rate)
- Refurbished / Ex Demo equipment (X)
- Imports office:
wrong place ( pharmacy directorate )
red Tape, endless procedure, Junior staff
no coordination with standards office
- AMERICAN SANCTIONS
Getting worse
Round about way
Can any one help?
III. Competition with Providers delivering PHC service within MOH
premises
e.g. South Block, Sharg al nil, Private wings ( UMH, KNH, ..etc )
Advanced Medical centre, Jordanian Laboratories ..etc
IV. Sending patients abroad for treatment
Bank of Sudan, Foreign Ministry, NEC, Agric Bank, Sudatel ..etc
V. Health Insurance
- Limited to companies and government departments ) Corporate )
i.e. no individual cover policies
- limited level ( ceiling ) of cover
- small premium = no adequate)
- Delayed or no payment ( Shaikan }
VI. Pharmaceutical Companies:
- Problems with foreign currency .i.e. LC .etc
- Drug registration Procedure = Red Tape
Scarcity of drugs
Encourages Black market and import by Street Traders !!
VII. Competition with Foreign Investors:
- Ultra Lab
- Al Mukhtabar
- Al Burj Lab
- Jordanian Lab
- Others
owned and supported by influential people
VIII. Media: Papers , Radio ..etc
Papers: Harassment & Negative Publicity
All against doctors and PHC
Radio:
Nutrition Weekly programme
Rx Pumpkin Seed
Honey Remedy for all, Weekly programme
Rx Bee Sting
IX. Doctors’ Problems
- work long hours to earn enough
no pension scheme, life/ income insurance or protection against
litigations
- limited opportunity for training, CME ( conferences, workshops ..etc )
Doctors Problems:
– Licensing to practice by SMC
a- easy for visiting foreign doctors
Advertising, Papers, TV
Operate ( preop assessment ? & postop F U ? )
b- difficult for Sudanese doctors working abroad
Doctors’ Problems:
- Role of Sudan Doctors Union towards patients & members
Hardly any role at all
Way Forward:
A long way to go :
Provision of sophisticated modern PHC is unattainable in Sudan at
present. Most of the Public live below the poverty line and health
insurance provides cover for less 10% of those who need it at the
moment. However, a reasonably good level of care can be achieved.
What needed is:
- More understanding and support from the government
Special consideration:
plot of land, Customs, Taxation, council rates, electricity & water bill,
Fire service ..etc
Way Forward:
- Implementation of a comprehensive health insurance programme to
to cater for all with positive contribution from the government &
employer
- Doctors union must play a positive role towards patients its members
- Formulation of a positive charter for both government & private
Healthcare
Thank You