Healthcare Professional Training Academy
Healthcare Professional Training Academy
Business Model Description
Invest in B2B models for the delivery of capacity building by setting up private health care training centers for health workers including nurses, radiographers and other technicians by collaborating with existing hospitals and leveraging their infrastructure. Examples of companies active in the IOA space:
Amrak Institute of Medical Sciences is an allied Health Education Institute & healthcare staffing provider affiliated with Durdans Hospitals. They have 400+ full time enrolled students across 8 Undergraduate programs. Amrak strives to elevate the healthcare workforce in the South Asian Region working with experienced partners, academics and industry professionals (16).
Hemas Academy of health care is an academic establishment under the Hemas Group, affiliated to its Hospital and offering internationally recognized National Vocational Qualifications accredited with guaranteed post qualification employment opportunities (8). Hemas tied up with IFC for their Digi-health platform, to scale verticals, such as health education and medical care.
Lanka Hospitals Academy: Established in 2019 in order to produce skilled healthcare professionals. The academy offers comprehensive trainings including clinical trainings. Courses are available on full-time/part time basis. LHA has partnered with leading universities and educational institutes in Sri Lanka and in South Asia to provide clinical trainings (11).
Expected Impact
Address the need for skilled healthcare workers in the country leading to improvement in healthcare indicators and reducing the pressure on the public healthcare sector.
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
- Sri Lanka: Eastern Province
Sector Classification
Health Care
Development need
Primary healthcare is state-funded and is accessible to all. Sri Lanka has the lowest maternal mortality ratio of 30.2 of 100,000 live births in 2020 in South Asia and has achieved elimination status in the control of several intractable communicable diseases, yet Non-Communicable Disease accounts for 83% for all death and rising. (7)
Policy priority
National Health Strategic master Plan 2016 - 2025 is in place to ensure universal access to quality healthcare through proper planning and investment in both, infrastructure and health personnel.
National Medicinal Drug Policy for Sri Lanka ensures the availability and affordability of efficacious, safe and good quality medicines in a sustainable and equitable manner. (1)(2)
Gender inequalities and marginalization issues
Safe and reliable access to quality healthcare for the elderly, disabled and women, is a challenge due to various socio-cultural (negative attitudes, social stigma, violence, low health literacy), financial (poverty, unemployment, high transportation cost) and structural (inaccessible transportation facilities, lack of information) factors.
Investment opportunities introduction
Although Sri Lanka provides Universal Health Coverage there is a long wait for specialist and tertiary care and advanced procedures in the public sector. Reliable and affordable access to healthcare services still remains a challenge. As such, there are opportunities in increasing the service capacity and quality, especially in secondary and tertiary care.
Key bottlenecks introduction
Despite 51% of total health spending being financed out-of-pocket (4), catastrophic and impoverishing health expenditures have remained comparatively low because the public system still covers the bulk of inpatient care. Therefore, the burden on public expenditure and unmet needs are exceptionally high.
Health Care Providers
Development need
Due to a lack of Public-Private Partnerships and facilities, COVID-19 has taken a toll on the economy and wellbeing of the citizens. Affordable access remains as a challenge with under 2% of government spending on healthcare (4).
Policy priority
National Health Strategic master Plan 2016 - 2025 (1) is in place to ensure universal access to quality HC through proper planning and investment in both infrastructure and health personnel.
National Medicinal Drug Policy for Sri Lanka (2) ensures the availability and affordability of efficacious, safe and good quality medicines in a sustainable and equitable manner.
Gender inequalities and marginalization issues
The utilization of the private sector is mainly among the higher-income groups. Supply-side constraints in the state sector such as accessibility and availability of services, medications and investigations would cause poorer households, to utilize the private sector services, often at unaffordable price points.
Investment opportunities introduction
The private sector mainly provides ambulatory care, limited inpatient care and rehabilitative care. There is a shortage of technically skilled staff such as nurses and laboratory technicians to maintain and grow the private healthcare space and to supplement public sector efforts.
Key bottlenecks introduction
Since Primary healthcare is state funded, reducing the burden on primary healthcare through affordable secondary services would will ease bottleneck concerns and burden on public healthcare systems.
Health Care Delivery
Pipeline Opportunity
Healthcare Professional Training Academy
Invest in B2B models for the delivery of capacity building by setting up private health care training centers for health workers including nurses, radiographers and other technicians by collaborating with existing hospitals and leveraging their infrastructure. Examples of companies active in the IOA space:
Amrak Institute of Medical Sciences is an allied Health Education Institute & healthcare staffing provider affiliated with Durdans Hospitals. They have 400+ full time enrolled students across 8 Undergraduate programs. Amrak strives to elevate the healthcare workforce in the South Asian Region working with experienced partners, academics and industry professionals (16).
Hemas Academy of health care is an academic establishment under the Hemas Group, affiliated to its Hospital and offering internationally recognized National Vocational Qualifications accredited with guaranteed post qualification employment opportunities (8). Hemas tied up with IFC for their Digi-health platform, to scale verticals, such as health education and medical care.
Lanka Hospitals Academy: Established in 2019 in order to produce skilled healthcare professionals. The academy offers comprehensive trainings including clinical trainings. Courses are available on full-time/part time basis. LHA has partnered with leading universities and educational institutes in Sri Lanka and in South Asia to provide clinical trainings (11).
Business Case
Market Size and Environment
< USD 50 million
10% - 15%
Shortage of about 5,000 nurses and allied health workers and technicians.
There is a critical shortfall of health workers in nursing and allied health in Sri Lanka (~5,000). In the long-term, the industry will run into other skill-gaps and critical shortfalls including biotech, health data, health administrators and aged care indicating long term relevance of business models in this space.
Indicative Return
> 25%
According to industry experts, GP margins varies from 15-40% depending on the duration and type of program
Based on the views provided by the private sector experts who presently run healthcare academies, those with training schools for their hospitals have lower return figures with the fee provided at a subsidized rate while other academies generate higher return post the initial capital investments towards set up costs.
Investment Timeframe
Short Term (0–5 years)
Existing private sector companies are able to recover their initial investment within 2-3 years. Depending on the number of batches a year, the investment could be recouped much quicker for the different type of courses being offered.
The types of courses for Nursing varies from Foundation course, Higher Diploma in Nursing, BSc Nursing and BSc Biomedical science. Fees from certain institutions vary from USD 800 to 4200 depending on the type and duration of the course.
Certain academies subsidize the course fee so as to encourage enrollment and supplement their existing healthcare workforce post completion of training.
Ticket Size
USD 500,000 - USD 1 million
Market Risks & Scale Obstacles
Market - Highly Regulated
Business - Supply Chain Constraints
Capital - Requires Subsidy
Impact Case
Sustainable Development Need
Current epidemiological and demographic transitions, in particular for aging population in Sri Lanka, have led to an increase in NDCs, with the trends of going higher. The primary healthcare systems are not equipped to cope with such changing needs. Thus, it is important to address the likely demand for skilled, expert healthcare professionals, especially at secondary and tertiary care levels.(6)
Economic growth should lead to steady job creation, in particular in the healthcare sector, to drive inclusive development. However, the growth in healthcare sector employment in Sri Lanka is less than that in other public sectors. Health and social work jobs comprise only 1.8% of all employment. (6)
Investment in this space will help the sector in meeting local and global standards to create a globally connected allied health education sector.
Gender & Marginalisation
The economic crisis in Sri Lanka, coupled with the impact of COVID-19, is impacting the access to healthcare due to limited transportation, an increase in expenditure in particular for expecting mothers, and people with NCDs and those with disabilities that need expert care and services.
Increase participation of women in the healthcare workforce, particularly in skilled areas like nursing and as technicians, can help gain well-paying job opportunities, which can improve their livelihoods.
Expected Development Outcome
Increased service capacity with reduced management concerns and burdens over ratio (Healthcare professional: population) and increase in the quality of service. Reduced burden on public healthcare systems.
Potential to create employment opportunities especially for those engaged in healthcare professional education and training and for those who are interested in working in the healthcare sector (11)
Gender & Marginalisation
Improved accessibility for safe, reliable and high quality healthcare services for women, youth, elderly, disabled population and reduction in human resource shortage. For example, address prevalence of obesity and co-morbidities among 45 to 59 years age group, with 44.5% of it being women.
Increased opportunities for training and support to healthcare workers that would improve the quality of care, skills development and increased economic opportunities for women in the healthcare workforce.
Primary SDGs addressed
4.3.1 Participation rate of youth and adults in formal and non-formal education and training in the previous 12 months, by sex
Not Available
Not Available
3.c.1 Health worker density and distribution
Nurses/midwives per 10,000 population was 24.28 in 2019(9)
Nurses/midwives per 10,000 population - 38.2(9)
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Corporates
Public sector
Indirectly impacted stakeholders
People
Corporates
Outcome Risks
If the assessment frameworks for trainings are not aligned with international standards, unchecked growth of academies may end up reversing the intended impact on quality of care.
Potential differences in quality of training between private academies and state sector institutions may reinforce inequalities in the quality of the service.
In the absence of subsidies, there could be risk that the business model may not reach students from low income families because of high fee structures.
Gender inequality and/or marginalization risk: Given that most centers will be in the urban areas and close to hospitals, there will need for students to migrate out of their current locations.
Impact Risks
Healthcare workers trained in private institutions are not automatically authorized to practice in the public sector, thereby limiting opportunities. (11)
Migration of nurses is considered to be low as a large majority of nurses do not hold university degrees. Further training could see higher migration and attrition compared to current levels.
If the number of healthcare workers trained is not matched with employment opportunities, then it will lead to business model failure and possibly financial risks for the students paying high fees.
Gender inequality and/or marginalization risk: Could lead to increase migration of female nurses and caregivers to other markets with ageing demographics.
Impact Classification
What
Affordable access to healthcare skill education and training with global recognition and standards.
Who
Nurses and allied healthcare workers like radiologists and other technical healthcare professionals. Healthcare institutions also benefit with access to a skilled workforce.
Risk
Variation in the quality of training. Given the lack of acceptance by the public sector of privately trained nurses, there could be apprehension to join and the supply of trained professionals may exceed market demand.
Contribution
Provide reliable healthcare service at an affordable cost with high quality and accessibility contributing to the current market gap in the secondary and tertiary healthcare market.
How Much
Meeting the current shortfall of about 5000 nurses and allied healthcare workers with anticipated growth in the future demand for skilled healthcare workers for secondary and tertiary healthcare services.
Impact Thesis
Address the need for skilled healthcare workers in the country leading to improvement in healthcare indicators and reducing the pressure on the public healthcare sector.
Enabling Environment
Policy Environment
The National Health Policy of Sri Lanka (2016-2025) is focused on providing a people centered health policy focusing on SDG 3 and building a strategic partnership with all healthcare service providers and improving human resource management.
National Strategic Framework for Development of Health Services 2016-2025, specifically identified Human Resources for Health (HRH) as a main thematic area.
Human Resources for Health Strategic Plan (2009-2018) is focused on ensuring an adequate and equitable distribution of appropriately skilled and motivated health workers (13)
Policy on Healthcare Delivery for Universal Health Coverage focused to ensure UHC to all citizens, relevant to the disease burden experienced in the country through a well integrated, comprehensive and efficient health service (14)
The National Policy on Strategic Framework for prevention and control of Chronic Non-Communicable diseases focused on creating a country that is not burdened with chronic NCDs, deaths and disabilities (15)
Financial Environment
Capital allowance for depreciation of assets acquired or constructed is given for items such as machinery items, buildings, computers. This is a common provision for all companies and not specific to this sector.
The healthcare sector is taxed at the lower rate of 14% for corporate taxation as well as companies predominantly providing educational services.
Regulatory Environment
The Sri Lanka Medical Council is a statutory body under Medical (Amendments thereof) Act No.40 of 1998 for the purpose of protecting health-care seekers by ensuring the maintenance of academic and professional standards, discipline and ethical practice by health professionals who are registered with it.
A Nursing Council is established under the Sri Lanka Nurses Council Act No. 19 of 1988, which has similar functions as the Medical Council with regard to the nursing profession. There is no separate council for pharmacists, physiotherapists or other allied health professionals.
The Private Medical Institutions Regulatory Act requires all private medical institutions to obtain a certificate from the Private Health Services Regulatory Council (PHSRC). This council manages development and monitoring of standards of institutions and personnel.
Marketplace Participants
Private Sector
Amark Institute of Medical Sciences, International Institute of Health Sciences, Hemas Academy of Healthcare, Lanka Hospitals Academy, Asiri School of Nursing, Private Sector hospitals with academies.
Government
Ministry of Health, National Medicinal Regulatory Authority, Sri Lanka Medical Council
Multilaterals
World Health Organization, World Bank, Asian Development Ban, United Nations Children's Fund
Target Locations
Sri Lanka: Eastern Province
References
- (1) Fiscal Management Report 2020-21 https://www.treasury.gov.lk/api/file/98371b11-4978-45a1-adc2-abdf6f4229ff
- (2) National Health Strategic master Plan 2016-2025 http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/HMP2016-2025/Health%20%20Admin%20-%20%20HRH.pdf
- (3) National Medicinal Drug Policy of Sri Lanka http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/publishpolicy/8_Medicinal%20Drug.pdf
- (4) Sri Lanka health system review. New Delhi: World Health Organization Regional Office for South-East Asia; 2021.https://apo.who.int/publications/i/item/sri-lanka-health-system-review
- (5) The quality of outpatient primary care in public and private sectors in Sri Lanka – how well do patient perceptions match reality and what are the implications? Health Policy Plan. 30 (suppl 1):i59–74. doi: 10.1093/heapol/czu115.
- (6) Policy on Healthcare Delivery for Universal Health Coverage http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/2018/Policyonhealthcaredelivery.pdf
- (7) Health Labour Market Analysis in Sri Lanka: A Call to Action https://www.who.int/docs/default-source/health-workforce/health-labour-market-analysis-in-sri-lanka.pdf
- (8) Hemas Academy of Healthcare https://hemashospitals.com/
- (9) Ministry of Health (2019). Annual Health Bulletin 2019.http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/AHB/2020/AHB%202019.pdf
- (10) Nurses and Midwives per 1,000 population https://data.worldbank.org/indicator/SH.MED.NUMW.P3?locations=LK
- (11) Lanka Hospital Academy https://www.lankahospitals.com/en/lanka-hospitals-academy/
- (12) Sustainable Development Goals in Sri Lanka http://www.statistics.gov.lk/sdg/index.php/sdg/target/3
- (13) Human Resources for Health Master Plan (2009-2018) https://docplayer.net/13798441-Human-resources-for-health-strategic-plan-2009-2018-ministry-of-healthcare-and-nutrition-sri-lanka.html
- (14)Policy on Healthcare Delivery for Universal Health Coverage http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/2018/Policyonhealthcaredelivery.pdf
- (15) The National Policy on Strategic Framework for prevention and control of Chronic Non-Communicable diseases http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/publishpolicy/13_NCD.pdf
- (16) Amark Institute of Medical Sciences https://amrak.lk/