Acute Trauma and Rehabilitation Centers
Acute Trauma and Rehabilitation Centers
Business Model Description
Construct and operate specialised health facilities to provide trauma and rehabilitation care to motor vehicle accident survivors.
Expected Impact
Provide specialised immediate medical attention and long-term rehabilitation support to motor vehicle accident survivors.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- Namibia: Otjozondjupa Region
- Namibia: Countrywide
Sector Classification
Health Care
Development need
While Namibia's spending levels on healthcare are high, estimated at 9% of GDP in recent years, and consistent with the Abuja target of 15%, the country's healthcare system is held back by substantial inefficiencies and inequalities and poor health outcomes; key challenges being the lack of human resources and limited productivity (IV).
Policy priority
In Namibia’s 5th National Development Plan (NDP5), the Government pledged to improve the country's health sector and aims to ensure that by 2022 all of Namibia's citizens will have access to quality health care (II).
Gender inequalities and marginalization issues
Health care, among others, generates significant multipliers on output, GDP and income. An increase in final demand for among others health care generates the highest impact on low-income households, and leads to the largest income multipliers for unskilled labourers (VI).
Health Care Providers
Policy priority
To achieve SDG 3 on Good Health and Wellbeing, the Government seeks to accelerate health infrastructure development and improve talent management, among others (V). In the Harambee Prosperity Plan, improved access to health infrastructure and the modernisation of the central medical store are priority areas for social progression (III).
Health Care Delivery
Pipeline Opportunity
Acute Trauma and Rehabilitation Centers
Construct and operate specialised health facilities to provide trauma and rehabilitation care to motor vehicle accident survivors.
Business Case
Market Size and Environment
< USD 50 million
Out of the total annual spending of USD 14.3 million by the Motor Vehicle Accident Fund (MVAF) of Namibia on patients from motor vehicle accidents, more than 50% is accounted for by payments made to public and private hospitals as well as rehabilitation centres for the treatment of patients (7).
Indicative Return
20% - 25%
The expected IRR varies depending on the scale of operation of the center; the Windhoek Emergency Care and Trauma Center for example reported an IRR of 23% (8).
Investment Timeframe
Long Term (10+ years)
Benchmark projects, such as the Windhoek Emergency Care and Trauma Centre, the Negla Park Hospital and the Katutura Medical Centre, had an investment timeframe of 20-25 years (8).
Market Risks & Scale Obstacles
Market - Uncertain frameworks and public-private dialogues
Market - Uncertain frameworks and public-private dialogues
Impact Case
Sustainable Development Need
19,000 road accidents occur every year in Namibia, leaving 700 dead and 7,000 others with lasting physical disabilities. This is the proportionally highest number of accidents of any African country (1).
Namibia lacks a dedicated specialist facility for treatment of trauma patients. The district hospitals have limited facilities, equipment and human resources to manage trauma effectively. There is an acute shortage of ICU beds in the hospitals to accommodate the casualties from road accidents (15).
Socio-economic consequences from the loss of employment and loss of breadwinners due to inadequate trauma rehabilitation puts major financial strains on families and the Government of Namibia (15).
Gender & Marginalisation
Dependents of road accident victims are particularly strained if they come from disadvantaged backgrounds as the loss of the victims' income affects the families' livelihoods particularly strongly.
Expected Development Outcome
Increased availability of ICU beds for motor vehicle accident victims.
Enhanced expert capacity to provide trauma and rehabilitation care specifically for motor vehicle accident victims.
Greater employment opportunities for trauma health professionals and other medical experts.
Gender & Marginalisation
Primary SDGs addressed
3.6.1 Death rate due to road traffic injuries
3.8.1 Coverage of essential health services
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Public sector
Indirectly impacted stakeholders
Corporates
Outcome Risks
Specialised centers may reduce operations of general health providers that are currently attending to road accident victims.
Impact Risks
Uptake especially for rehabilitation care may be hampered by limited willingness of Namibians to pursue long-term treatment of injuries.
Impact Classification
What
The outcome is likely to be positive, important and intended because the acute trauma and rehabilitation centers will provide care for road accident victims and prepare them for a productive life.
Risk
While the concept of acute trauma and rehabilitation centers is well defined, they operate under Government imposed health care regulations and compete with publicly funded entities.
Impact Thesis
Provide specialised immediate medical attention and long-term rehabilitation support to motor vehicle accident survivors.
Enabling Environment
Policy Environment
National Health Policy Framework 2010-2020, 2010: Provides the overall orientation for health and health actions in Namibia (9).
Health Sector Strategic Plan 2014-2018. 2014: Outlines activities towards making the country healthy in line with national and international development agendas (10).
Financial Environment
Financial incentives: Public Service Medical Aid Scheme (PSEMAS) assists its members with the cost of medical care (11). The Motor Vehicle Accident (MVA) Fund offers scope for contracting to deliver government-commissioned developments of health care facilities (7).
Fiscal incentives: Certain medical services are exempted from value added tax, such as medical, dental and paramedical services, and services and rooms supplied by a registered hospital; and funeral undertaking services are zero-rated (15).
Other incentives: The Motor Vehicle Accident (MVA) Fund is willing to subsidize user fees for MVA patients and use the Namibian Association of Medical Aid Funds (NAMAF) benchmark rates for other patients (15).
Regulatory Environment
National Health Act, 2015: Provides a framework for a structured uniform health system; consolidates the laws relating to state hospitals and services, and regulates the conduct of state hospitals and services; provides for financial assistance for special medical treatment of state patients (12).
Hospitals and Health Facilities Act, 1994: Consolidates and amends the laws relating to state hospitals and private hospitals, and regulates the conduct of health facilities (13).
Medical Aid Funds Act, 1995: Provides for the control and promotion of medical aid funds, and establishes the Namibian Association of Medical Funds (14).
Marketplace Participants
Private Sector
Investors such as VPB Namibia, which - through its Namibia Growth Fund - has a private equity investments in the sector. Existing and planned facilities like the Windhoek Emergency Care and Trauma Center, the Lady Pohamba Hospital, the MediClininc Hospital and the Katutura MediPark.
Government
Ministry of Health and Social Services, Medical Council, Namibian Association of Medical Funds.
Non-Profit
Namibian Association of Medical Aid Funds (NAMAF).
Target Locations
Namibia: Otjozondjupa Region
Namibia: Countrywide
References
- (I) SDG Center for Africa and Sustainable Development Solutions Network, 2019, Africa SDG Index and Dashboards Report 2019, Kigali and New York: SDG Center for Africa and Sustainable Development Solutions Network, https://sdgcafrica.org. II) Republic of Namibia, National Planning Commission, 2017, Namibia's 5th National Development Plan (NDP5), https://www.npc.gov.na/?wpfb_dl=294. III) Harambee Prosperity Plan II, 2021-2025, Republic of Namibia, https://www.met.gov.na/files/downloads/f0b_Harambee%20Prosperity%20Plan%20II.pdf. IV) Namibia - Health Sector Public Expenditure Review, 2019, Washington, D.C, World Bank Group, https://elibrary.worldbank.org/doi/pdf/10.1596/32111. V) Republic of Namibia, National Planning Commission, 2018, Implementation of Sustainable Development Goals, Voluntary National Review, https://sustainabledevelopment.un.org/content/documents/19880New_Version_Full_Voluntary_National_Review_2018_single_1_Report.pdf. VI) DNA Economics, 2021, SAM Multiplier Analysis for the SDG study in Namibia, Six Capitals.
- (1) EOS Capital Website, About NIDIF, https://www.eoscapital.com.na/nidif.
- (2) MOHSS, 2010, National Health Policy Framework 2010-2020, 2010, http://www.africanchildforum.org/clr/policy%20per%20country/2018%20Update/Namibia/namibia_healthpolicyframework_2010-2020_2010_en.pdf.
- (3) Amweelo, 2016, The Road Safety in Namibia: Focus on Road Traffic Accidents, http://repository.unam.edu.na/handle/11070/1751.
- (4) Chatukuta, 2019, Road traffic injuries in Namibia. A mixed methods study to analyse the trends in mortality and morbidity due to road crashes, and to investigate the long-term effects of road injuries, https://www.researchgate.net/publication/338866266_Road_traffic_injuries_in_Namibia_A_mixed_methods_study_to_analyse_the_trends_in_mortality_and_morbidity_due_to_road_crashes_and_to_investigate_the_long-term_effects_of_road_injuries.
- (5) Xinhua, 2019, Road fatalities a major concern in Namibia: official, http://www.xinhuanet.com/english/2019-09/27/c_138427299.htm.
- (6) World Bank, 2019, Namibia Public Expenditure Review Health Sector Public Expenditure Review, http://documents1.worldbank.org/curated/en/268141563376806867/pdf/Namibia-Health-Sector-Public-Expenditure-Review.pdf.
- (7) Motor Vehicle Accident Fund (MVA) of Namibia, Annual Report 2019, 2019, http://www.mvafund.com.na.
- (8) Feasibility Study for Windhoek Emergency Care and Trauma Center, 2011, conducted by Dr. Loneson Mondo (MBA, DBA), Available on request from Loneson Mondo (lonesonmondo@gmail.com).
- (9) National Health Policy Framework 2010-2020, 2010, Republic of Namibia, http://staging.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/namibia/namibia_policy_framework_2010-2020.pdf.
- (10) Health Sector Strategic Plan 2014-2018, 2014, Republic of Namibia.
- (11) Public Service Medical Aid Scheme (PSEMAS), https://mof.gov.na/medical-aid.
- (12) National Health Act, 2015, Republic of Namibia, https://laws.parliament.na/annotated-laws-regulations/law-regulation.php?id=491.
- (13) Hospitals and Health Facilities Act, 1994, Republic of Namibia, https://laws.parliament.na/cms_documents/1958---regulations-regarding-private-hospitals-0e0538be8e.pdf.
- (14) Medical Aid Funds Act, 1995, Republic of Namibia, https://laws.parliament.na/annotated-laws-regulations/law-regulation.php?id=144.
- (15) Ministry of Finance, 2020, Consultancy services for identification of Candidate PPP Projects in Namibia: Draft Report, CRISIL Risk and Infrastructure Solutions Limited in association with MPP Civils Namibia, Available upon request from the Ministry of Finance.
- (16) Chatukuta, M., 2020, Road traffic injuries in Namibia. A mixed methods study to analyse the trends in mortality and morbidity due to road crashes, and to investigate the long-term effects of road injuries, University College London, https://www.washingtongroup-disability.com/fileadmin/uploads/wg/Documents/MitchelChatukutaPhDFinal31December2019.pdf.