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Key Findings

•Health care is regarded as the 4th most-attractive investment sector in Africa. Economic factors and the regulatory environment are the key aspects companies take into consideration when evaluating new markets.
•The increased prevalence of chronic diseases, the rising income levels, and the augmented health awareness drive the upsurge in the per capita total health expenditure in Kenya and Rwanda.
•More than x % of the total mobile penetration, along with ICT infrastructure and connectivity, will be the backbone of new mobile applications and mHealth startups in Kenya and Rwanda.
•Kenya has the most developed economy in East Africa. From 2004 to 2014, the country’s GDP averaged x %. However, due to lack of proper facilities, about x medical tourism patients from Kenya travel abroad each year, according to the Kenya Bureau of Statistics.
•HIV/AIDS is the major cause of adult death in Kenya. Effective low-cost point-of-care (POC) HIV diagnostic kits for nucleic acid testing (NAT) and immunodiagnostics hold potential as around 60% of the population live in rural areas without proper access to care.
•Around 60% of the total pregnancies in Kenya are handled by the private sector.
•According to the World Bank, in Kenya, out-of-pocket (OOP) expenses account for $ x out of every $ x spent on private health care. Annual private health care investments in East Africa grew by an average of x %, each year, from 2003 to 2013.
•In Rwanda, patients are often in the late stage of severe disease when they approach x of the x academic referral hospitals.
•The health transformation in Rwanda over the last x years was enabled, to a large extent, by community health workers (CHWs) who offer a solution to the financial, geographical, and infrastructural barriers in the resource-constrained country, thereby improving access to health in rural communities.
•Rwanda's per capita total expenditure on health has increased by more than x % between x and 2012.
•Although the number of health facilities in the country has increased over the past decade, approximately x % of the patients still travel more than x km to reach the closest facility. Physicians lack both the equipment and the training to provide specialized care.
•At the national level, the procurement and the distribution of drugs and medical supplies have made progress; however, the same cannot be said about the intermediate and the peripheral levels.
•By the end of 2017, Rwanda aims to provide 4G LTE technology to x % of its population.
•More than half of the country’s total health expenditure is funded by external resources. The salaries of doctors and nurses have been cut by x % due to the decrease in external assistance post 2011. Community-based national health insurance schemes do not include coverage at private health centres.
•Rwanda continues to be the most densely populated country in Africa with x persons living per square km. The high population growth rate is creating a huge demand for health care infrastructure.
•The formation of the East Africa Community (EAC) could provide opportunities for the insurance companies in the region.

Health care System

•From 2000 to 2013, Rwanda was the fastest-growing African nation with a yearly growth average of x %.
•The Ministry of Health (MoH) has started a public health scheme and set up training institutes, such as the Kigali Health Institute (KHI) and the College of Medicine and Health Sciences, University of Rwanda, Butare.
•In 2013, x % of the population was covered under public health insurance. The MoH is the major provider of primary, secondary, tertiary, and preventive health services.
•To improve the current situation, the government has increased national expenditure on health care by around x % (from 1996 to 2013). Over the same period, Rwanda was able to drastically reduce mortality rates due to diarrhoea ( x %) and maternal/neo-natal conditions ( x %).
•Rwanda’s health profile remains dominated by communicable diseases. The World Health Organization (WHO) classifies the HIV/AIDS prevalence in Rwanda as a generalized epidemic with a current prevalence of x % for the total population aged x x , which has declined from x % in 2004.
•There is a serious shortage of health care professionals in the country, with only x doctors and x paramedics per x people.

Table Of Contents

Health care System Development in Kenya and Rwanda : Unlocking New Opportunities in Sub-Saharan Africa
Executive Summary 7
• Key Findings 8
• Geographic Scope 10
Rwanda 11
• Market Overview—Health care System 12
Demographics and Disease Burden 13
• Population 14
• Age-Sex Structure 15
• Leading Causes of Death 16
• Child Health 17
• Health Transformation 18
• Economic Overview 19
• Overall Financial Assistance 20
Health care Facilities and Personnel 21
• Healthcare Facilities—Public 22
• Health care Facilities—Private 24
• Health care Personnel 25
• Role of CHWs in Delivering Care 26
• Pre-hospital Emergency Care Services (PHECS) 27
• Health Service Coverage and Utilization 28
Other Related Infrastructure 29
• ICT Infrastructure 30
• ICT in Health care 31
Expenditure and Funding 32
• Total Health Expenditure 33
• Health Expenditure—Per Capita 34
• Health Funding—Key External Aids 35
Health Insurance 37
• Structure—Public 38
• Health Insurance—Public 39
• CBHI Funding and Spending 40
• Social Health Insurance 41
• Health Insurance—Private 42
Legal Scenario 43
• Vision 2020 and Key Government Policies 44
• Current Scenario and Other Health Policies 45
• Investment Climate 46
External Challenges: Drivers and Restraints—Health care Market in Rwanda 47
• Drivers 48
• Drivers Explained 49
• Restraints 50
• Restraints Explained 51
Kenya 52
• Market Overview—Health care System 53
Demographics and Disease Burden 54
• Population 55
• Age-Sex Structure 56
• Economic Overview 57
• Demographic and Economic Indicators 58
• Public Health System 59
• Public Health Facilities 60
• Public Health Facilities—Structure 61
• Health care Personnel 62
• Leading Causes of Death 63
• Health Facilities 64
• Healthcare Facilities—Structure 65
Expenditure and Funding 66
• Total Health Expenditure 67
• Health Expenditure—Per Capita 68
• Health Funding 69
Health Insurance 70
• Health Insurance—Public 71
• Health Insurance—Private 72
• Economic Prospects 73
• Health Insurance - Current Scenario 74
External Challenges: Drivers and Restraints—Healthcare Market in Kenya 75
• Drivers 76
• Restraints 80
Opportunities and Key Strategic Recommendations 84
• Rwanda 85
• Kenya 88
Upcoming Projects 90
• Rwanda 91
• Kenya 94
The Last Word 97
Appendix 102

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