In this monthly column called “The Indicator”, we take a economic or financial statistic from East Africa and break it down into bite-sized nuggets of knowledge for investors.
This month’s indicator figure is 103.
103 of what?
This month’s indicator is 103, or the average number of doctors for every one million people in the East African Community countries.
What do you mean by doctors per million people?
Doctors are defined as registered professionals who diagnose, treat, and prevent illnesses, diseases, injuries, and other ailments in people through the use of modern (not traditional) medicine.
In this month’s column we can see that an illustrative country of 1 million people could expect to have 103 doctors and a country with 5 million people could expect to have 515 doctors.
We are focusing exclusively on doctors and not nurses or other medical professionals, as doctors typically are the pinnacle of health care provider leadership and supervision of medical standards and practices in a healthcare facility.
Which EAC country has the most and which the least doctors per million people?
Kenya has the most doctors per capita with 200 per million, followed by Uganda at 120 per million. Rwanda is lower at 60 per million and Tanzania has only 15% of its neighbor, Kenya, with 30 doctors per million residents.
How does the EAC compare to other regions of the world in number of doctors?
The World Health Organization (WHO) estimates that fewer than 2,300 health workers (physicians, nurses, and midwives only) per one million people would be insufficient to achieve coverage of primary healthcare needs, indicating that the EAC is significantly below WHO levels of healthcare sufficiency.
In the West, the city-state of Monaco has the highest number of doctors at 7,170 per million followed by the island nation of Cuba at 6,720 both over 65 times the density of doctors in East Africa.
On the African continent, Libya has the highest doctor density at 1,900 per million. Looking further south, Nigeria has 410 doctors per million and South Africa has 780 or 7.6 times the average doctor density of EAC countries.
Is the number of doctors per capita increasing or decreasing in the EAC?
Unfortunately for the sick and injured, this number is decreasing due to two reasons. The first is the future projections for population growth and also the long term trends around brain drain in the region.
EAC countries are experiencing increasing significant population growth, in some cases they are among the fastest growing populations in the world. This increases the millions of people seeking medical care throughout their increasingly longer lives.
On the flip side doctors are getting trained and leaving the EAC due to challenges such as low pay, late payments, bureaucratic challenges, poor working conditions and even hostility from the supervising agencies and governments.
For these reasons many doctors choose to leave their respective countries for other regions in the world, resulting in a brain drain that hurts the healthcare industry deeply.
To counteract this unfortunate trend in public health, many doctors in the EAC, especially in Kenya, are being offered good specialization career paths for more stimulating work to entice them to stay. Hopefully, this trend increases.
How does this affect the economies of East Africa?
A healthy workforce is a productive workforce. Therefore, quality healthcare is critical for the smooth growth and functioning of every economy.
The greater the healthcare capacity in the EAC countries, the better off every sector of the economy will be.
A higher amount of resources, technologies, doctors, nurses and other highly trained staff dedicated to these areas will guarantee higher returns to the economies of the EAC and a higher quality of life for all.
What is being done to increase the number of doctors in EAC countries?
In Kenya the East African Development Bank and the British Council are offering fellowships so doctors can specialize in particular medical fields. Many organizations offer scholarships for students headed abroad as long as they sign a contract stating that they will return to their home countries and work in their respective countries.
Expatriate doctors working in Europe and the United States still care about the situation at home and some have even formed organizations to advance healthcare in their home countries, like Nigerian Physicians in the Americas among many others.
What opportunities are created to solve these challenges?
It goes without question that there is an incredibly high demand for medical services in EAC countries. The following is a brief summary of a few market opportunities and investment ideas that could fill the gap where other medical services have been lacking:
- Private specialized clinics – investment into limited function clinics limit the complexity of medical diagnosis and treatment of the most common ailments for communities is largely untapped outside of major EAC cities.
- Telemedicine – the reduction of doctors in a country offers the ability of doctors in other locales to provide part time medical specialist services via teleconferencing systems, in some cases as simple as Skype, directing other medical staff on procedures and evaluation of diagnostic outcomes.
- Visiting doctors – doctors conducting a common specialized treatment can visit countries for short periods of time and conduct numerous surgeries and positively impact thousands of patients in a matter of weeks. This is currently done in certain types of eye surgeries and mouth surgeries largely by charitable organizations and could be expanded greatly with increased coordination of patients and treatments.
- Medical informatics – the limited nature of available medical information in the EAC combined with high accessibility to telecom networks could create investable opportunities for willing ventures.
- Motorbike ambulances – many cities in the EAC do not have adequate ambulance coverage. Traffic blockages prevent large trucks from attending to patients though motorbike emergency medical care can be provided in some cases through low cost motorcycle ambulances that can weave through traffic faster than full medical trucks.
- Pharmaceutical distribution – getting medicine to patients in disbursed areas of the EAC is quite a challenge. The company or companies that are able to solve this problem will surely achieve significant social and financial returns.
This is but a small list of potential and emerging types of opportunities to invest into the EAC medical industry to respond to the limited number of doctors among the population.
We can hope that the investment and venture communities will work to solve this increasing problem for the benefit of the health and welfare of your fellow human brothers and sisters living in East Africa.
How can I learn more?
To learn more about the topics in this article you can visit:
CIA World Factbook – Physicians Density: https://www.cia.gov/library/publications/the-world-factbook/fields/2226.html
The Financial Cost of Doctors Emigrating from Sub-Saharan Africa – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223532/
About the authors:
David L. Ross is Managing Director of Statera Capital and US Ambassador to the Open University of Tanzania active in growing companies in Eastern and Southern Africa through primary investment, investment advisory, strategic partnerships, and executive education. Connect on LinkedIn at http://tz.linkedin.com/in/davidlross1 or at [email protected]