Providing Quality Healthcare at an Affordable Price Still Remains a Challenge in Uganda

Dr Chirag Kotecha, Director at UMC Victoria Hospital, Avane Cosmetic Dermatology Clinic and Europa Pharmaceuticals, discusses the challenges to be faced by the healthcare sector in Uganda.

“In Uganda, healthcare is not one of the top priorities in the country for the average person. You have the basic requirements of food, shelter, and then health comes further down. Most of the healthcare in the country is paid for out of pocket by people or by government run healthcare centers. In terms of health coverage, less than 1% of the country has private health insurance. So, for most people, if they want to access healthcare they would have to go to a government facility, which most of the time is overstretched and underfunded because not a lot of the budget goes towards this area. I entered the private healthcare field because there was a large opportunity. The biggest challenge is that most people pay out of pocket. So, for more advanced medical care, they would need to sometimes put other things on as collateral or sell their properties to be able to afford extended healthcare. The biggest challenge comes due to the costs of healthcare in the private sector. In terms of the cost of capital, whether you are trying to raise money for new equipment, machinery, or infrastructure, commercial loans that are available are not necessarily given long repayment periods of 10 years. So, you are passing down the cost to the patient and this becomes prohibitive in most cases. Most of the people in Uganda access healthcare in a time of need. There is no preventative healthcare. With the rise of non-communicable diseases, such as western illnesses like diabetes, high blood pressure, etc., patients are caught with this problem towards the end when things get quite bad. The state of Ugandan hospitals and emergency rooms have improved. The new Minister of Health has implemented many things in the government setting so the government hospitals have a bit more funding which has improved access. The opportunity is that the middle class, especially in urban areas, is growing and they are seeking out affordable healthcare. Most people fly out of the country or have their medical checkups done when they are on holiday. I recognized that there was a need for this market. I started off with a small healthcare center in 2013, which was really an outpatient center. We have expanded it to a full 100 bed inpatient facility covering a variety of services from outpatient to inpatient care. We focused purely on advanced care and now people who are traveling for surgery could have it done locally. We started providing these advanced surgical suites and intensive care units. The challenge still remains the cost. It is a delicate balance to provide quality care at an affordable price and it will continue to remain a challenge in Uganda until we have some form of subsidies or the cost of capital is lower. Ultimately, as healthcare becomes more of a priority, which with COVID it has, this is a nice opportunity for the healthcare sector. Recently, we have had challenges in availability of medications and oxygen supply. The manufacturing sector gets electricity subsidies to be able to manufacture oxygen; however, the healthcare sector does not. There is not enough supply within the country at this crisis. Now, people are realizing that healthcare should be a priority, and it is a good opportunity to put healthcare at the forefront”, says Dr Chirag Kotecha.

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