Acute Trauma and Rehabilitation Centers

The Mediclinic hospital in Swakopmund in the Namib Desert on the Atlantic Coast of Namibia.
Photo by Grobler du Preez / Shutterstock
Acute Trauma and Rehabilitation Centers
SectorMost major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care
Health Care Providers
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.

Indicative ReturnDescribes the rate of growth an investment is expected to generate within the IOA. The indicative return is identified for the IOA by establishing its Internal Rate of Return (IRR), Return of Investment (ROI) or Gross Profit Margin (GPM).
20% - 25% (in IRR)
Investment TimeframeDescribes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.
Long Term (10+ years)
Market SizeDescribes the value of potential addressable market of the IOA. The market size is identified for the IOA by establishing the value in USD, identifying the Compound Annual Growth Rate (CAGR) or providing a numeric unit critical to the IOA.
< USD 50 million
Direct ImpactDescribes the primary SDG(s) the IOA addresses.
Good health and well-being (SDG 3)
Indirect ImpactDescribes the secondary SDG(s) the IOA addresses.
Reduced Inequalities (SDG 10) Decent Work and Economic Growth (SDG 8)
Country
Regions
  • Namibia: Otjozondjupa Region
  • Namibia: Countrywide
SectorMost major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care
HC

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).

SubsectorMost major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care Providers
HC.3

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).

IndustriesMost major industry classification systems use sources of revenue as their basis for classifying companies into specific sectors, subsectors and industries. In order to group like companies based on their sustainability-related risks and opportunities, SASB created the Sustainable Industry Classification System® (SICS®) and the classification of sectors, subsectors and industries in the SDG Investor Platform is based on SICS.
Health Care Delivery
HC-DY
Investment Opportunity Area

Acute Trauma and Rehabilitation Centers

Business Model

Construct and operate specialised health facilities to provide trauma and rehabilitation care to motor vehicle accident survivors.

Market Size (USD)Describes the value in USD of a potential addressable market of the IOA.
< 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).

IRRDescribes an expected annual rate of growth of the IOA investment.
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).

TimeframeDescribes the time period in which the IOA will pay-back the invested resources. The estimate is based on asset expected lifetime as the IOA will start generating accumulated positive cash-flows.
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 - Uncertain frameworks and public-private dialogues
Lack of a formal platform for a dialogue framework between the public and private sector to realise healthcare opportunities.
Market - Uncertain frameworks and public-private dialogues
Uncertain policy and regulatory regime supporting private sector engagement in healthcare.
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.

Primary SDGs addressed
3 - Good Health and Well-Being
Good health and well-being (SDG 3)

3.6.1 Death rate due to road traffic injuries

3.8.1 Coverage of essential health services

Secondary SDGs addressed
10 - Reduced Inequalities
Reduced Inequalities (SDG 10)
8 - Decent Work and Economic Growth
Decent Work and Economic Growth (SDG 8)
Directly impacted stakeholders
People
Motor vehicle accident survivors benefitting from specialised care.
Gender inequality and/or marginalization
Dependents of accident victims whose livelihoods are sustained thanks to the provided care.
Public sector
Health care system with improved services and reduced long-term costs from accidents thanks to efficient care.
Indirectly impacted stakeholders
Corporates
Secondary businesses and suppliers of health centers.
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.

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.

Who

Motor vehicle accident survivors benefit from specialised immediate care and long-term rehabilitation support to recover from injuries.

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.

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).

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).

country static map
semi-urban
Namibia: Otjozondjupa Region
The Okahandja-Otjiwarongo road features the highest number of road accidents, and hence the greatest need for an acute trauma and rehabilitation facility is in the Otjozondjupa region (16).
semi-urban
Namibia: Countrywide
Potential to set up and operate acute trauma and rehabilitation centers exists throughout Namibia, given the occurrence of accidents and the limited health options for victims across the country.
Sector Sources
  • 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.
IOA Sources
  • 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.