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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:.
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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 : • 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 case visited private hospitals Khartoum state 2011
Number of cases visited government hospitals/ centres, Khartoum state, 2011
What has been achieved so far ? • Provision of acceptable service for patients Via • Medical insurance • Employer • Self Funding • 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 Fedail Hospital G/E Endoscopy Diploma Training Programme, Totally Free)) Endoscopy ( Training programme, IVF/ Laparoscopy & Embryology 12 yrs ) Fertility treatment 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 !!
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 Corporate ) ) - Limited to companies and government departments 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: NutritionWeekly 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