Transcript Investing in Health Infrastructure

Healthcare is a National Capital Investment:
10 Nov 2016
Hon. Bernard Haufiku:
Minister of Health and Social Services, MP, Namibia
Regional Namibia
Namibia Health Sector
Distribution of public/private facilities
Public/private facilities
Facility
Public
Private
Hospitals
35
13
Primary clinics
256
75
Health centers
42
8
Consulting rooms
N/A
557
Pharmacies
N/A
75
Total
333
844
“Quick facts”
HRH Cadre by Sector
3000
2500
Private
46%
2000
% private sector
HRH Cadres by Sector
Cadre
Public
Private
1500
1000
Total
500
Doctors
216
558
774
Registered
nurses
Enrolled nurses
1626
1363
2989
Pharmacist
assistants
Social workers
27
65
76
877
212
72
174
Doctors
70%
Registered nurses
Pharmacists
Social workers
100
90
239
250
89%
Geographic Distribution of HRH
2761
137
72%
0
25%
39%
32%
15%
68%
85%
80
70
Percentage
Pharmacists
1884
Public Sector
60
50
40
30
75%
61%
20
10
Sources: MoHSS 2008b
MoHSS website, 2010
0
Doctors
Nurses
Urban
Pharmacists
Rural
Social workers
Strategic Background
• The Ministry of Health and Social Services [MOHSS] long-term
Strategic plan provides the framework for the improvement of
Governance, development of Human Resource Development and
Healthcare Infrastructure development.
• This includes the development of correct levels of care,
development of specialist hospitals for Mother and Child, Mental
healthcare, Infectious diseases and Oncology care.
Strategic priorities for Vision 2030
•
“Transform into a Healthy and Food secure nation”.
• Priority 1: Health Sector Governance that will address coordination,
policy formation and strategic planning for the MoHSS;
• Priority 2: Training Healthcare Workers to escalate the development
and training of the Professional Healthcare workers, required for an
efficient and effective service delivery;
• Priority 3: Management to development a professional management
culture characterised by service quality and standards;
• Priority 4: Service Delivery to focus on the development of an
appropriate professional skill mix to manage the demands of the new
healthcare service platforms
• Priority 5: Development of Healthcare Infrastructure to provide
appropriate places for healthcare delivery based on the resource
capacity in the country.
Public Health Case for Health PPPs
For the Ministry of Health and government
 Improves access to key health services and products
 Leverages private sector resources – expertise and infrastructure – to health
 Increase efficiencies in service delivery
 Promotes greater equity and helps ensure universal coverage of health
HEALTH SYSTEM STRENGTHENING INITIATIVE
PATHWAY TO IMPACT
HEALTH PRIORITIES
Budget
Effectiveness
Efficiency
Delivery System
Procurement
Health Worker
Productivity
Supply Management
Levers for
Change
Facility
Maintenance
Equipment
Supplies
Adequate “On Time”
Drug Supply
Distribution
Attitude/Responsive
ness
Absenteeism/Waitin
g Time
Impact
Increased Patient
Satisfaction
Improving Care
Standards
BETTER OUTCOMES
Private Public Partnership and
Accelerated Service Delivery Approach
• The rationale for an accelerated funding structure for service delivery is a
priority.
• Infrastructure delivery for hospitals remains dependent on availability of
budget for capital works in terms of the MTEF, this means that the MOHSS will
not be able to achieve its goals in terms of the 2030 Road Map.
• Alternative models are being employed to achieve an affordable result for
Governments in capital intensive infrastructure delivery that keep the asset and
debt off balance sheet in a structured Concession Lease. These Concession
Leases can be classified as a Build Operate and Transfer (BOT) which is regarded
as a preferred PPP model.
Private Public Partnership and
Accelerated Service Delivery Approach
Business Case for Health PPPs
For the Ministry of Health and government
 Attracts private capital investment and managerial expertise (often to either
supplement public resources or release them for other public needs)
 Realizes long-term value-for-money through appropriate risk transfer to the
private sector over the life of the PPP
 Rationalizes the use of existing health resources and infrastructure – public and
private alike
 Reforms sectors through a reallocation of roles, incentives, and accountability
Projects in Planning
Indicative Ondangwa Project Program
TASK DURATION
CONSTRUCTION OF THE NEW ONDANGWA DISTRICT HOSPITAL
2016
Task Name
Environmental Impact Assessment
EIA Process
Environmental Scoping Certificate
Feasibility Study
Feasibility study approval
Site Clearance
Design and documentation
Tender period
Tender adjudication & approval
Construction
Fencing
Design and documentation
Tender period
Tender adjudication & approval
Construction
Bulk Earthworks and Bulk Services
Design and documentation
Tender period
Tender adjudication & approval
Construction
Buildings
Design and documentation
Tender period
Tender adjudication and approval
Construction
Training
Maintenance & asset management modalities
Beneficial Occupation
SUMMARY
Total Duration: 71.4 months
Start Date: Monday 16/05/2016
Finish Date: Wednesday 03/11/2021
2017
2018
2019
2020
2021
Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter Quarter
4
3
2
1
4
3
2
1
4
3
2
1
4
3
2
1
4
3
2
1
4
3
2
1
Otjiwarongo Hospital 250 Beds: Otjozondjupa Region
Ondangwa Hospital 330 beds: Oshana Health Region
Women and Child Specialist hospital 250 beds:
Khomas is scheduled as the first of its kind in Namibia. To be
followed by a facility in Oshakati and Rundu
Nankundu Mental Health Hospital 106 beds:
Kavango West Region.
Central Medical Store [CMS} Okahandja
National Public Health Laboratory:
Okahandja, Otjozondjupa region.
Expansion of Haemodialysis service units in public hospitals at Windhoek
Central Hospital, to be followed by Oshakati and Rundu hospitals to
address the demand experienced and to improve accessibility to
deserving patients.
For further information on any of these investment
opportunities please contact:
The Permanent Secretary of Ministry of Health and
Social Services Dr. Andreas M. Mwoombola.
[email protected]