HEALTHCARE SCENARIO OF GUINEA
Are you planning to build or restructure or venture in any healthcare venture in Guinea? Looking for information about the major healthcare players in government, private diagnostic centres that are available in Guinea? Are you looking to find out which part of the cities is best to venture in or what all facilities are available and what all should be planned for a new setup? In this article, Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario of Guinea.
This is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on Hospaccx.India@gmail.com or you can visit our website on https://hospaccxconsulting.com/
INTRODUCTION:
Guinea is located in West Africa – Sub-Saharan Region. The country is faced with several economic problems. It has also major health problems.
There are communicable diseases and non-communicable diseases in Guinea. Nowadays, the burden of disease is the Ebola hemorrhagic infection. But, like every sub-Saharan country malaria is one of the deadly diseases in the country. TB is frequent, intestinal parasitic diseases are present. The Cholera is epidemic. It remains endemic in some regions.
The degrading health situation in Guinea is the real picture of the global economic and political situation in the Country. Corruption is embedded in the country. The education level is very low. Schools are overcrowded. The majority of teachers are incompetent due to the lack of a solid education. Health workers are not well paid and this has a negative impact on the services they provide to the population.
In Guinea, the hygiene is one of the biggest issues. It is evident that the hygiene is important for human life. Without clean water and proper sanitation, people would be exposed to various epidemics and endemic diseases.
Environmental health issues are major risk factors in the global burden of disease. Using a somewhat narrow definition of what is an environmental cause of disease, one study of the global burden of disease suggests that about 8.4 per cent of the total burden of disease in low-and middle-income countries are the result of three environmental conditions: unsafe water, hygiene, and excreta disposal; urban air pollution and indoor smoke from household use of solid fuels.
STATISTICS OF GUINEA:
GUINEA’S STATISTICS:
| Total population (2016) | 12,396,000 |
| GNI per capita (PPP international) | 1,160 |
| Life expectancy at birth m/f (2016) | 59/60 |
| Probability of dying under five (per 1000 live births (2018) | 101
|
SOCIO-ECONOMIC OVERVIEW:
Growth stood at around 10% in 2016 and 2017, before slowing to 5.8% in 2018. Growth nevertheless remains robust, driven by foreign direct investment (FDI) in the mining sector. The mining industry grew at an annual rate of roughly 50% in 2016 and 2017, while the non-mining sector posted a 5.4% growth rate in 2018, with investment in infrastructure and the expansion of the primary and tertiary sectors remaining strong.
Inflation, which stood at 9.8% in 2018, approached double-digit levels, owing to an increase in fuel prices and electricity rates.
The fiscal balance improved from -2.1% of GDP in 2017 to -1.1% in 2018, owing to reduced subsidies on fuel prices, higher electricity rates, and constraints on hiring and promotions in the public sector.
Despite these measures, tax revenue fell by 0.8% of GDP to 12.5% in 2018. An extraordinary transfer of 0.4% of GDP from the Post and Telecommunications Regulatory Agency helped improve the fiscal balance.
With respect to expenditure, investments fell by 0.8% of GDP despite an increase in capital expenditure of 0.7% of GDP financed by external resources. The budget deficit was essentially financed by external resources, which was due to the fall in domestic funding.
The risk of debt distress remains moderate, even though non-concessional external borrowing increased in 2018. The total public debt-to-GDP ratio fell from 39.6% in 2017 to 37.6% in 2018.
HEALTH INFRASTRUCTURE:
Guinea has been reorganizing its health system since the Bamako Initiative of 1987 formally promoted community-based methods of increasing accessibility of drugs and health care services to the population, in part by implementing user fees. The new strategy dramatically increased accessibility through community-based healthcare, resulting in more efficient and equitable provision of services. A comprehensive strategy was extended to all areas of health care, with subsequent improvement in health indicators and improvement in health care efficiency and cost.
Ethnographic research conducted in rural and urban areas of the Republic of Guinea explored perceived distinctions between biomedical and traditional health practices and found that these distinctions shape parental decisions in seeking infant health care, with 93% of all health expenditure taking place outside the state sector.
The Guinean government announced the establishment of an air solidarity levy on all flights taking off from national soil, with funds going to UNITAID to support expanded access to treatment for HIV/AIDS, TB and malaria. Guinea is among the growing number of countries and development partners using market-based transactions taxes and other innovative financing mechanisms to expand financing options for health care in resource-limited settings.
Lacking a sufficient response from the international community during the Ebola outbreak, the health infrastructure was augmented through laboratories and hospital facilities through non-governmental actors such as Doctors without Borders, UC Rural, or the Ebola Private Sector Mobilization Group (EPSMG).
HEALTH EXPENDITURE:
Guinea-Bissau spends a total of 6.9 per cent of GDP on health care, close to those of peers
However, the country relies heavily on out-of-pocket (OOP) payments and donor resources to fund health services. Neither of these are desirable means of revenue collection: high OOP payments expose households to financial shocks linked with ill health, 15 while dependence on donor resources has implications for sustainable health financing as it impairs long-term planning.
Total government spending on health is, however; significantly lower than some of its regional and economic peers. In 2016, public health spending represented merely 31.3 per cent of total health spending, less than Burundi (38.8 per cent) and The Gambia (46.6 per cent), but higher than that for Sierra Leone (9.0 per cent) and Comoros (13.4 per cent). Only 9.5 per cent of general government expenditure has been allocated to health, far below Abuja Target of 15 per cent.
Total health spending per capita in Guinea-Bissau is close to the LIC average but lower than the SSA average (Figure 5.9). In 2016, Guinea-Bissau spent US$39.5 per capita on health, while LICs spent US$35.3 per capita and the SSA average was US$84.9. Guinea-Bissau has seen an overall steady increase in per capita health spending, which more than doubled between 2000 and 2014, increasing from US$21.2 to US$43.9. This growth pattern in health spending has been in line with its West African peers, while the wider SSA region has seen a much faster growth rate, especially over the last ten years.
Households bear a high proportion of total health expenditures in Guinea-Bissau. On average, households spend 15 per cent of their non-food expenditures on health care, but this masks wide variation across different income groups. In 2015, OOP payments represented 37.2 per cent of total health expenditure, comparable to the SSA average of 36.3 per cent and below the LIC average of 40.4 per cent.
The share of OOP payments in Guinea-Bissau has been higher than 45 per cent of total health spending since 2000.
HEALTH SITUATION:
The health status of the Guinean population continues to give cause for concern. According to the integrated Core Survey for the Evaluation of Poverty (EIBEP 2002-2003), access to health services (Fewer than 30 minutes) is 38.9% and the rate of use is 18.6%.
Malaria is the primary reason for consultation (34%), hospital admission (31%) and death (14.2%) in all age groups. The prevalence rate of diarrhoea is 12.4% in children aged 0-59 months. Cholera has been endemic since 2003, peaking during the rainy season. In 2012 alone,
Guinea recorded 11 941 cholera cases and 156 deaths. Tuberculosis is a major public health problem with a case-fatality rate of 8%. The average prevalence of HIV in the general population has increased from 1.5% in 2005 to 1.7% in 2012.
In Guinea, 31% of children are chronically malnourished and 14% are severely malnourished.
For the first time, the country has had to face an epidemic of Ebola virus hemorrhagic fever.
General mortality has been running at 10.19‰ in 2015. Maternal mortality is 650 per 100 000 live births. Neonatal mortality is 33‰ of live births and mortality in children under 5 years is 101 per 1000.
This troubling picture is compounded by emerging and re-emerging diseases.
According to the STEPS survey conducted in 2009 on risk factors for non- communicable diseases in Conakry and Lower Guinea, the prevalence of diabetes was 3.5% in the population aged 15-64 and 5.2% in the population aged 25-64 and. Among cardiovascular diseases, the prevalence of high blood pressure alone was 28.1% in the survey population.
The Global Health Observatory reports that life expectancy at birth is 58 years.
HRH (HUMAN RESOURCE IN HEALTH) CHALLENGES FACING GUINEA INCLUDE:
Management problems including lack of objective criteria for assessment and decision-making lack of recruitment and re-deployment policies inequitable geographic distribution of health workers, with health workers – particularly female health workers – concentrated in Conakry, where 15% of the population lives lack of career planning and development a de-motivated workforce due to inadequate living and working conditions and lack of standardized job profiles lack of coordination and communication between the HRH training system and the health services, and lack of quality training.
The current National Health Plan includes the development of HRH as one of its key areas of focus.
The following strategies in the area of HRH in the current Plan include: strengthening HRH management; HRH planning and forecasting; initial training of health workers; and recruitment and re-deployment of health workers according to system needs. More recent achievements include the development of a draft HRH Strategic Plan and situation analysis document.
FUTURE DIRECTIONS AND INITIATIVES IN HEALTHCARE:
- Managing Expenses:
It is apparent that at the health centre level, there is little responsibility for managing expenditures. The vast majority of ongoing costs are managed at the provincial (or district) level. Furthermore, at the provincial level, there is very little systematic documenting of costs in relation to specific health centres.
2. Operational costs and medical supplies:
The rural health centres currently receive much less for operational and transport costs (including for drugs and medical supplies, patient transfers and outreach) than what the NEFC estimates are required for adequate service provision.
Increasing the amount and flow of operational funds to health centres appears to be a matter of urgency. It is the most strategic area for pro-active spending that would lead to improvements in access to and quality of care.
3. User Fees:
In part because of the lack of funds for day-to-day operations, most facilities charge user fees of some description. Fee systems are often quite complex with many different fees charged across the different services offered. A number of people find user fees are a significant barrier to accessing care.
4. Information Systems and Monitoring:
Currently, there is good data on outputs of each health centre, but the absence of systematic data on costs means that ongoing monitoring and analysis of performance is not really possible. We recommend augmenting the regular Centre reports to include key information on inputs/costs, particularly staffing levels and attendance. This will greatly increase the potential to use the data as a management tool, where output measures can be connected to “input” data (staffing, other costs, etc) to allow construction of simple performance measures as a means of monitoring productivity.
5. Staffing Levels and Placement:
The model’s preliminary analysis of outputs and staffing levels suggests that sizeable improvements in service provision would be possible by staffing centres with numbers which are proportional to service delivery needs. In addition, significant increases in levels of service provision are achievable through greater utilization of current staff.
6. Equipment and Infrastructure:
An immediate outlay on general (vehicles, water supply, and radios) and minor equipment (beds, medical equipment) to bring health centres up to the stated minimum standards level is clearly needed. The total cost of such an investment is not prohibitive. This investment is likely to both induce demand for services and increase the ability for staff to provide good quality services. Similarly, an immediate outlay is also required for rural health infrastructure improvement. However, care must be taken when estimating this requirement to link it to service provision needs where possible. For example, the Health Facilities Branch blueprint for the building of new Health Centres specifies a 20-bed inpatient ward. In contrast, analysis of current service levels in the 54 health facilities included in the sample shows an average of 3 inpatients per facility on any given day. Cost estimates are highly sensitive to the underlying planning assumptions of infrastructure requirements.
BURDEN OF DISEASES:
The above figure explains the percentage of total deaths caused by various diseases in Guinea. Most of the deaths have occurred due to influenza and pneumonia that is 23% (total deaths 14,497 per 100,000 population) and least number of deaths have occurred due to prostate cancer that is 1% (total deaths 768 per 100,000 population).
MAJOR HOSPITALS IN GUINEA:
Clinique Ambroise Paré:
The Clinique Ambroise Paré is a hospital in Conakry, Guinea, is considered to be the best hospital in the country. Ambroise Paré has an ambulance and is equipped for surgery. It is located on North Corniche next to USAID, southwest of the Conakry Botanical Garden.
Ignace Deen Hospital:
The Ignace Deen Hospital (Hospital Ignace Deen) is a hospital in Conakry, Guinea built during the colonial era. The hospital is situated next to the National Museum.
Since 2017, in collaboration with scientists from the United States and Denmark, Ignace Deen
Hospital has acted as a regional hub of neurological research.
Donka Hospital:
The Donka Hospital is a publicly owned hospital in Conakry, Guinea. It has inadequate facilities to handle demand, and many Guineans cannot afford its services. More than once in recent years the hospital has had to deal with a major influx of patients wounded in civil disturbances. It is the largest public hospital in the country, built-in 1959 just before independence.
CONCLUSION:
The healthcare system in Guinea is dangerously plunged due to the lack of leadership in the healthcare system. Administrators and Managers of the healthcare settings are nominated based on their political belief.
They are not appointed based on their skills and qualifications. The Healthcare System of the Republic of Guinea is the best example of the healthcare system of many African countries.
The Ebola infection is the best example of the global health problem in the world which is being stopped by a global response.
It is the superficial and macro-level study for more details kindly contact Hospaccx Healthcare business consulting Pvt. ltd on Hospaccx.India@gmail.com or you can visit our website https://hospaccxconsulting.com/
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