SAKHIWO Health Solutions: Health Industry to Benefit from Alternative Funding and Tech Solutions

In August 2019, the environment for SAKHIWO Health Solutions was looking good. The Pretoria-based turnkey results provider for the healthcare industry was facing a pipeline in excess of R10 billion of hospital development projects, ranging from affordable to best-in-class private facilities.

 Corporate Director, Johann Loubser told Enterprise Africa that SAKHIWO was “very bullish” and that it was “a time for us to move more aggressively in the market” 

But, like with many others, the Covid-19 pandemic has slowed down some of SAKHIWO’s investment and development plans. However, the outbreak of the virus has cast a light on ill-prepared healthcare facilities around the world, emphasising the need for ongoing innovation and investment.

 “Obviously, the pandemic has slowed things down in that area,” says SAKHIWO CEO, Dr Tebogo Mphake, talking about the company’s proposed movement into the affordable health provision sector. “But we are engaged with a process with the Development Bank of South Africa (DBSA) to look at a project preparation fund for four budget hospitals which will enable us to take them to full bankability and get investors in so we can take the idea forward.

 “The pandemic and the resultant economic slowdown, in our view, has not necessarily meant that there is decreased demand on our services. In fact, what happened is that it has exposed the soft underbelly of our healthcare systems throughout the world. Almost everyone realised that our healthcare systems are not geared towards managing and containing this and other possible future pandemics. What that has done is create pent up demand for infrastructure in order to ensure our healthcare systems, around the world, are resilient.”

SAKHIWO has built its reputation on quality and delivery, completing the development of Cecilia Makiwane Hospital, Frere Hospital Oncology and ICU for the Department of Health in the Eastern Cape, and is well on course to deliver on Limpopo Central Hospital in Polokwane and Siloam Hospital in Vhembe District, Limpopo for the National Department of Health.

 While some provide a singular approach, bringing just equipment solutions or staffing offerings, SAKHIWO’s unique proposition is its ability to bring a project from concept to reality, implementing every step of the process from financial viability to planning and design and construction management, through to procurement of equipment, training of staff and ongoing facilities management.

 ALTERNATIVE FUNDING

 In collaboration with international partners, SAKHIWO’s expertise in building funding models and finance solutions is unrivalled in the South African healthcare sector. With multiple projects funded effectively through innovative models, each package is tailored to the specific needs of the area, industry and requirements. During the pandemic, the way projects are funded has changed again, and investors have an even closer eye on returns.

 Perhaps an indicator on the strength of finance for the health sector in South Africa comes when looking at the country’s position globally in the Covid-19 vaccine rollout. To date, the supply of jabs into the country has been slow and there has been issues securing contracts with the major global providers with only a small percentage of the population receiving any form of vaccine. This is concerning considering that Finance Minister Tito Mboweni’s budget in March was heavily dedicated towards pandemic relief, coming at a cost to other healthcare priorities.

 “Obviously, the fiscus is under pressure,” says Mphake, “but government will have to manage that. We are seeking to work with our international partners to look at alternative funding models that will enable governments to deliver on social infrastructure, such as in healthcare. We are looking at export credit funding, with export credit agencies, which will result in us being able to deliver on Engineering Procurement and Construction (EPC) models of delivery. That means governments do not have to worry about putting a lot of cash up front but can enter into an agreement, even on a government-to-government basis, with export credit agencies who can ensure that those governments get credit on an affordable basis.

 “We are seeking to influence our government to think about these options so that we are able to roll out more projects so that the healthcare systems in African countries can be resilient and robust.”

 SAKHIWO is a partner of VAMED, Austria– one of Europe’s largest healthcare companies and collaborates with development funding institutions (DFIs); and through these partnerships can maximise knowledge and expertise leading to the development of unique funding and servicing solutions that suit local challenges.

 “Governments, on one hand, are struggling with the impact of the pandemic, but we know that there is a need to focus investing more into healthcare facilities. That will come with a need for reprioritisation of funds away from other programmes,” admits Mphake. “On the other hand, we are dealing with major infrastructure projects – hospitals the size of Limpopo Central Hospital of 488 beds – which are being identified by governments as major drivers of growth. From that perspective, we are very bullish about our business and what the prospects look like.” 

 Of course, the private sector has a major role to play in bringing about true change in the state of facilities across Southern Africa. For this reason, SAKHIWO is establishing partnering with various players along the healthcare value chain and in order to position the firm’s participation in public private partnerships.

 “An area that we will focus on is the opportunity for us, alongside government, to expand more on private-public partnerships, particularly in a time when the fiscus of our clients is under pressure,” says Mphake.

EMBRACING TECHNOLOGY

 According to the Lancet, sub-Saharan Africa is becoming a hotbed of innovation for digital health services. For patient management and disease surveillance and prevention, in a region which is underserved by healthcare providers and faces funding deficiencies digital solutions are being adopted quickly to help fill voids. By using Internet of Things (IoT) – connected systems and devices, including wearable technologies – new diagnostic concepts are being developed. Social media has been adopted to spread promotional messages around health across the region; and big data analytics have been employed to prepare for and manage outbreaks. Driven by the ever-growing use of smart phone and feature phone technology, and the desire of telecommunication companies to find new revenue channels, digital health strategies have so far been developed by 41 of the 54 African nations. With a population where 43% of people are between the ages 0 to 14 years, future projections are that technology and digital innovations will play an increasingly important role in Africa’s healthcare sector.

 “There is a need to focus on health technology across a broader continuum of healthcare,” confirms Mphake. “Focusing on equipment and ensuring we have the best available, but also ensuring that the equipment is serviced and maintained properly. Therein lies an opportunity to tap into the digital health space in terms of focus on how we can use IoT to ensure processes in hospitals are improved and to ensure, from a patient care perspective, that maintenance and management of medical equipment is first class. Data, AI and robotics will also become more important to the industry and therefore important to SAKHIWO. To that end, we already have a contract with the DBSA to have technology consultants on three community health centres where we can ensure that equipment is planned, installed and properly maintained.”

 Some reports suggest that, with $1.3 billion being poured into African healthcare between 2015 and 2020 through private equity and venture capital, digital healthcare concepts could become the next fintech-type arena, with large ROI to be made as well as solving problems for those in need.

 To implement digital strategies, it is imperative for SAKHIWO to be involved throughout the lengthy development process, to ensure cohesiveness. SAKHIWO’s approach to health facility development is centred around the deployment of appropriate technology right from the inception of any project. The process starts with the application of our industry leading Building Information Modelling (BIM) application, CodeBook and the latest architectural design softwares. Our design professional and engineers then ensure that any facility that we develop is future ready and incorporate the requirements of green technologies and digital health and facility management technologies. These digital technologies include machine learning, internet-of- things, robotics as well as virtual and augmented reality.

 The company is well-versed in facility management, offering this service as a key part of the portfolio. Without ongoing contracts to manage facilities from the ground up, it would quickly become difficult to apply digital solutions to problems and train staff to keep up to date.

 “With facilities maintenance management, it’s good to rather revamp facilities than build from new, but it is equally important to ensure that they are properly equipped and maintained. We have competence in that area, and we are going to be expanding that across our customer base. In the facility management space, there is room to tap into the digital space and looking at things like remote monitoring of facilities, remote monitoring of equipment, and remote monitoring of plant,” details Mphake.

 The company’s FM expertise was demonstrated in the early stages of the pandemic where SAKHIWO was called upon to assist in the supply of desperately required professional resources.

 “We have had to work with different departments to set the guidelines around how we ensure that facilities have extra capacity, so we have had to go into facilities and asses from a mechanical and electrical point of view, and from an oxygen supply point of view. Right in the middle of the pandemic, it was discovered that high-flow oxygen is a whole lot more effective compared to other forms of ventilation in most cases.

 “The health department engaged us on a Rapid Intervention Programmes because cases were rising so rapidly that we had to investigate how surge capacity can be created in existing facilities. We went into hospitals and wards to find additional spaces that could be converted and made available for Covid cases. That is a part of the role we have found ourselves playing during the pandemic,” explains Mphake. 

 HEALTHY PIPELINE

 In the early part of 2021, SAKHIWO has been busy solidifying relationships and ensuring that existing contracts are being serviced effectively while the healthcare industry remains under pressure. But, looking to the future, SAKHIWO remains typically ambitious.

 “Amongst other opportunities in South and Southern Africa, we are working with a client in Angola to deliver a private hospital. There are some private hospitals in Angola, but our studies show that they are not of the required standard for a private hospital. We are in the planning phase and developing a bankable business case following our pre-feasibility studies,” says Mphake.

 Healthcare as an industry, beyond its obvious human benefits, has the potential to deliver so much. Job creation, industry expansion, technological innovation, knowledge growth, and FDI all come as a result of developing the industry. SAKHIWO is perfectly positioned to drive funding and infrastructure development in South Africa and beyond.

 “Healthcare systems have been exposed and what we already knew about the state of these systems has been brought to the fore. One area that we will be putting focus on, from the perspective of our responsibility as a corporate citizen, is to look at skills upliftment in the healthcare sector,” emphasises Mphake. “Together with our partners, we are looking at a programme through which we can take young, unemployed matriculants or graduates on a project which will skill them in facilities management. We will be providing them with training and they will gain a certification. During the programme, they will be placed in hospitals under the guidance of qualified technicians and they will receive theoretical and practical training.”

 ‘Let’s build health’ is the call from SAKHIWO. In a time where healthcare and its efficiencies have been under the spotlight like never before, this is a company that has thrived and continues to work towards improving systems. By offering turnkey solutions, SAKHIWO has become the partner of choice and, even through the pandemic, continues to deliver.