The fatal cost of illness in Africa
Wednesday, December 19, 2007
When friends carried Jennifer Uduma, bleeding from a gunshot wound to the head, to a government hospital in Lagos, staff turned her away because she could not afford to pay.
She ended up at the private R-Jolad clinic in the gritty Gbagada neighbourhood, where doctors removed the bullet without asking for cash up front. Two years later, she returned to give birth to a baby girl.
“R-Jolad saved my life,” says Ms Uduma, a 24-year-old student, nursing her day-old daughter Evelyn in the post-natal room. “Life is more important to them than money.”
The tale might sound strange to medical professionals who fear the profit motive behind private healthcare will skew Africa’s already stretched services further in favour of the continent’s elite.
But the authors of a new report argue that the R-Jolad clinic in Nigeria is an example of the counterintuitive notion that the private sector can make money from healthcare, while also helping improve conditions for millions of Africa’s poor.
The International Finance Corporation, the World Bank’s private investment arm, says in a study that about half the health expenditure on the continent is already captured by an array of private sector providers.
The IFC now wants to mobilise foreign investors to help private medical services expand even further, reaching many more of the majority of people reliant on Africa’s swamped state services, or unable to see a doctor at all.
Forecasting that the continent’s healthcare market will more than double to $35.4bn (?24.6bn, ?17.6bn) within the next decade, the IFC is launching debt and equity vehicles to swell private sector and donor government support.
Rather than ignore the widespread reality of official out of pocket payments or unofficial bribes, there are growing calls to apply business methods to tackle them, through private health insurance, clinics, drug manufacturer and distribution alike.
The question is which models will work and who will benefit. Nigeria’s sheer scale – accounting for a fifth of Africa’s population – make it the perfect testing ground.
Set amid rusting tin roofs, bus parks and expressways, the R-Jolad clinic shows that private healthcare in Africa does not just have to be about opening expensive hospitals to cater for wealthy patients. By treating more than 200 people a day and working all hours, a team of devoted doctors manages to keep costs low enough for many of the area’s market traders, teachers and factory workers to afford its fees.
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