A policy brief from the Health Sector Evaluation and Monitoring Unit notes: “Total Health Expenditure in Kenya was Sh346 billion in 2015/16, up from Sh271 billion in 2012/13. In net present values, the per capita expenditure increased from Sh6,602 in 2012/13 to Sh7,822 in 2015/16.”
Though data for 2017/18 was not given, such trends put the per capita expenditure to about $100 for 2019/20.
This is largely driven by rising expenditure on non-communicable diseases (NCDs) and cancer care, mostly in the private sector. Both national and county governments healthcare allocations mirror this.
Counties now average 30 percent budgetary funds earmarked to healthcare by the latest data. Sadly, most of these go to salaries. Still, a notable chunk remains to improve services, indicating opportunities for salespeople selling diagnostics, pharma, technology, infrastructure and utilities to the public health sector.
Total health spending in 2015/16 accounted for 5.2 percent of gross domestic product, down from 6.8 percent in 2012/13.
However, the Health ministry’s underfunding and unsuccessful strategies have contributed to the failure of the public health system, leading to an increase in private sector usage.
Though the private sector was previously dominated by a few such players, we now see well more than 20 franchises with multiple units. The top 10 chains alone account for more than 200 outlets whose entities are usually clustered within a two-km radius of one another.
Based on data from providers’ websites, Aga Khan network reports 46 outlets, AAR 23, Meridian Health 20, Avenue Healthcare 16, Gertrude 16, Nairobi Women’s Hospital 10, Nairobi Hospital seven, Mater Hospital six. The latest entrant is AIC Kijabe, which a year ago opened their first city clinic to complement two existing outreach ones, bringing their total presence to four.
While non-medics still own the majority of group clinics, one obstacle they all are wrestling with is an increasingly competitive market place.
Previously, their dominance was based on monopolies to the latest machines. Ease in access to capital and financing means even stand-alone clinics now have these services and equipment.
For instance, in radiology, more than 50 percent of CAT scans and MRIs are now in private stand-alone clinic hands. With insurers now opting to empanel such players, a shifting market dynamic means out-of-pocket payers are the group to fight for.
Doctors are now also partnering to spread their franchises across geographical limitations, while still maintaining distinct branding.
Despite the market size growing, so too is competition. With differences in sizes, the multiplicity of players’ with almost similar services, individualised sales and marketing approaches are the only way to stand out.
Medical care is now a service industry. Customer retention strategies are becoming more important. Sales strategist awake to patient mobility across providers is highly sought-after talent.
Regardless of the approach, it must coalesce around ease of entry into care and retention, cost, convenience and quality.