I am researching on the feasibility of establishing a Healthcare center in Nigeria. I am leaning towards an out-patient
facility that will provide: Imaging / Radiological services, such as CT scan, MRI, Bone scan, X-rays, etc.
Laboratory services, Physical Therapy/ Physiotherapy and Medical Rehabilitation services (stroke, brain/ spinal cord injuries and orthopedic injuries rehabilitation, and basic Nursing services). Pharmacy service may be included as well.

What are the pros and cons of an out-patient facility in Nigeria? How many centers have MRI, CT scan and other imaging services?
What are the needs in various communities/ cities, and the country in general?
What are the challenges, govt regulations, and the current operating climate?

Its a good idea.Dough d nigerian environment presents a lot of challenges,a centre dt provides a total package,partcularly in d area of specialised investigations,sil bein a growing area is much desired.Gotta run,may com bac wen av more time,

@ doctokwus,
Thanks for your input!
Please keep adding more info. Let's debate all the pros and cons in every possible scenarios we can imagine!
All suggestions welcome!

Got little break,posted dis earlier,but jst got lost s/where,gosh eforts lost,anyways here go again 1st consideration in settin up a practice in nigeria is finance,considerin d fact dt d kind of equipments u av in mind don't come cheap.For any medical setup to meet d mark it must b up to date in having d basic latest in terms of imaging tools and lab equipments,as d society bcomes mor sophisticated and smaller,nigerians too ar dmandin for d best in terms of investigations for dem to engage dere medical handlers in decisions pertainin to dere health,dey want d 2sides to put all results on d table and arive at a treatment option(sometimes not d best for d patnt dough).However,a modest but modern set up can also b started if some key critical areas can b identified and added on frm dere.In nigeria d ke area I seem to identify are in dose of obs/gynae;surgery including cardivascular and paediatric surgery and EMERGENCY CARE,wt d relevant tools and well trained personel.Oda fields can b incorporated as time goes and demand determines.I wil try to explore d challenges and prospects as time,energy and brain permits,got to run again.sticated and smaller,nigerians too ar dmandin for d best in terms of investigations for dem to engage dere medical handlers in decisions pertainin to dere health,dey want d 2sides to put all results on d table and arive at a treatment option(sometimes not d best for d patnt dough).However,a modest but modern set up can also b started if some key critical areas can b identified and added on frm dere.In nigeria d ke area I seem to identify are in dose of obs/gynae;surgery including cardivascular and paediatric surgery and EMERGENCY CARE,wt d relevant tools and well trained personel.Oda fields can b incorporated as time goes and demand determines.I wil try to explore d challenges and prospects as time,energy and brain permits,got to run again.

Good points!
What are the challenges and opportunities in setting up Emergency care services including life saving surgeries in rural Vs urban areas of
the country?
How about cultural belief systems and how they influence healthy choices and use of health care services?

It is a very good idea. But before I make any comment I would ask for your motive for such a venture. Is it for profit or as a humanitarian gesture?

It is going to be run like a business after thorough needs assessment and evaluation. The business model of health care service will ensure that the facility can continue to survive financially and meet the needs and demands of Nigerians, and at the same time create
employment. It is a big vision. Even if it will be established to make profit, but at an affordable level and possibly
expand to rural areas.

Just my thoughts,is it profit oriented or humanitarian or none,none in d sense dt if d facility breaks evn,u ar ok.Anyway,unles its for charity,whc I doubt and whc sincerely speaking is not advisable if any private medical facility is to b topmost;ur best best is a facility in d city or close to d major city centre!why,bc u ave d people able to bear d financial cost to some extent and also dose who wi best benefit frm d modern tools d hosp wil ave.Of course dose in d rural areas wi also benefit if d msg gets acros s/how of d standards of practice available,but d facility jst has to b adequately funded s/howwi also benefit if d msg gets acros s/how of d standards of practice available,but d facility jst has to b adequately funded s/how

Whatever you do, stay away from emergency medicine. Or else, you'll end up treating every sick baby or injured okada man in your area for free. Nigerians never want to pay for emergency care but will be happy to break your head if their relative dies in your hands.

My advice to you is to start small and don't call attention to yourself. Develop relationships with other doctors. If won't hurt if you work for one of the bigger private hospitals for a few years to build up a reputation with patients before setting up your own place. Definitely don't put a big HOSPITAL sign in front of your building. That'll only attract emergencies that can't pay.

If you provide good services, you'll get patients through word of mouth and through referrals from other doctors.

@ Evil Brain and doctowus,

I have noted your points! All ideas welcome. It is an open public debate, so feel free to contribute.
For any avoidance of doubts, it will be a profit- making facility. I am trying to use the USA business
health care model and tailored it to the Nigerian environment.
I have worked in Nigerian hospitals, but that was a long time ago (late 1990s).
The world has changed and technology can actually help reduce cost and make services more affordable.

We Nigerians prefer dying in our own home than in a Nigerian health facility.

I dont agree with you Ileke, Nigerians are wiser now and the health insurance scheme which is mandatory for all workers to be signed up to is making a lot of people prevent and indeed treat ailments.
Hospitals are springing up just like churches but most do not have these equipments you mention matter of fact, they dnt even have provision for specialist consultations. Its a good idea,if you can foot it, go ahead wherever it is (urban or rural) people would visit because its equipped

Any chance of a clinical research facility also?

To start off the business, i think you should first of all get acquainted with a lot of the private clinics in an urban area such as Lagos, PH or Abuja (if you are going to be located in either of them). This will ensure you get good referrals from them and of course, prompt payment. If your services are good and up to speed, you can be sure that your news will travel far and wide by word of mouth and/or from the recommendations of the private clinics you have worked with.

I think that once you have a nice stream of revenue coming in and you weigh your options very well, you can then begin to think about engaging in any kind of community work - where the income you are collecting from the private 'high payers' may begin to subsidize what you get from the (not so rich) communities

Again, you have to think about things like fuel for Generators/electricity to run your machines, employment, continuous training and retention of competent staff, renting of adequate facilities, phone lines, IT equipment, maintenance of your equipment (and believe me, this is a very difficult one unless you are in partnership and/or sign some kind of agreement with your eqpt providers).

Other things to watch out for:

Like so many have said, a lot of people may want to use your services and 'pay you later', dont go there, otherwise you will end up with lots of debtors.

If you are not going to be on ground 24/7, esp in the initial phase of the business, who is going to run it for you?

Think about how much of your profits you will re-invest in the business to carry out things like periodic overhail of equipment/services etc because for some reason our operating environment 's needs more renovation (paint beging to peel off your walls, equipment parts need frequent changing, people just dont handle things that do not belong to them, etc etc.

If i think of anymore stuff, will write on here.

PS: I once worked for RADMED Centre, a centre on Ligali Ayorinde (VI) that provides such services. I dont know if they are still there, because then, they used to be in very high demand

Naija business atmosphere is quite challenging.
The initial capital outlay will be huge and so you have to consider ROI. Except of course you have lots of money stashed away.  Maintaining CT, MRI scan can be expensive especially if you are buying used tired ones.
Are there capable  medical engineers?

My Mrs talked about how much they had to forfeit because many patients could not pay their bills. Even some men would abandon their women post-natally.

You can surely begin pharmacy, physio/physical theray with swimming pool/rehab especially for amputees and neuro problems etc and see how it goes from there. Having a white guy, even a Lebanese might help. We unfortunately like to believe Europeans/whites can do things better.

Of course O &G will give you steady income too if become a specialist centre for it and get good referrals.
Obviously don't go and invest $7m without first going to do market research and spend quite some time in local hospitals.
Bonne chance!

@ op are you a medical personnel ie a medical radiographer/radiologist to be precise eady to offer QUALITY health care services to naija masses or u want to open anoda MECURE DIAGNOSTIC owned by one indian man which is proliferatin to diff states wt non professional indian.worst is dt dy partenered wt state govt set at umuahia,ondo ,lagos and kano etc yet ds gov never cared to ask how pro dy are.dy just employ few naija to cover up and those just kept snce d authority wudnt take action even when dy reportd , doin mammography instead of scan nd oda sharp practice wt radiation. BAD GOVT

am just sayn dt is a nice idea if u hav been into d practise and not just investing in it wt bizness mind.in some hosp/diagnostic clinic, d masses ar patient while in some eg MECURE and oda d masses are called customer/ cient where d Dr. that av no respect for oath of practise administered to dm send their customer to quack pro so they can collect commission each one dy sent and ds are ready to do CT scan for pregnant woman just to milk naija knwin radiation effect on growing baby in d womb.

Bros pls go get a business plan or feasibility report together. You can get all your questions answered therefrom.

You idea is a good one but I would advise you to start with the investigatory aspect of the business as this is a proven revenue generator. You should also have a time frame for the roll out of operations. Regarding the addition of other specialties,I would advice you keep it to the barest minimum,unless your intention is to become a general hospital (wouldn't advice that). WHAT IS YOUR TARGET MARKET This is probably the most important aspect of your business plan cos they determine a whole lot.
Nigerians are very savvy these days and have access to info via the internet. I should know,cos a lot of my patients ask me questions that surprise the hell outta me. Nigerians are also very class conscious, believe me, we are, for whatever misguided reasons we actually can be very snotty, but that"s digressing, the point I'm trying to make here is, decide ur immediate target market and design ur business model to cater to their needs.U'd be surprised what a little pampering can do.
The other most important aspect is your team.They better be well trained and not just clinically but relating to patients and potential patients as well.
I can't possibly run u thru it all but know ur research has got to be thorough.
Hope this helps a bit

Good idea, let me know I can write your business plan for you with scenario models,


Just to add to what a few have said, you have to identify who are your target clients. Also, I say invest in IT communication that way you can liaise with Nigerian Insurance Corps. and accepts electronic Insurance payments. As for electricity, solve the problem "personally". There's a whole lot of risk and advantages you have to identify in your business plan (research and findings) before you venture.

Hi,
I am a Medical Imaging Scientist aka Radiographer by profession. I currently work in a Medical Diagnostic outfit in Lekki. I basically practice X-rays, Ultrasound scan,CT Scan and MRI Scan.
Let me first of all concur that your vision is a laudable one. But you must know that it is a multi million Naira venture with a great return of investment.Some sale for N100Million.

If you are ready to get more info and clearification, pls do not hesitate to call me on 07037676951.

Funding could be a great problem after the facility has been built. Do investigate the medical insurance thing in Nigeria.I dont think it is fully functional. I do not see the possibility of running such a place without medical insurance. there is too much poverty in Nigeria and basic utilities like electricity and pipe borne water are mostly unavailable. but anything is possible. God luck in your venture.

@ All,
Thanks for all your contributions. I am aware of some of the challenges in Nigeria.
I was born in Nigeria, and worked in Eko Hospitals PLC, Ikeja in the 1990s prior to traveling abroad.
Most of you made very interesting points.
I have a business development consultant working on the business plan / proposal.
I will post some major issues he will raise in this forum in the near future.
Meanwhile, I want to use this forum to hear from fellow Nigerians generally to feel the "pulse" of the people.
Eko Hospitals PLC business model is closely aligned to the system in the USA.
Every business has risks and that's why all your contributions matter. Keep them coming!

Hi Sage,
Quite a laudable project indeed. and I am optimistic that it will, in the long term, be rewarding.
I am working on a similar project and would appreciate your views.
I would like to communicate with you off-NL (if you dont mind). You can reach me on +234 8052 190 305 or silvasurfa365@gmail.com
My best wishes in your project.

@ Silvasurfa,

OK, I will send you email. That's really cool to know that someone out there share similar vision.
My email is sagewood@yahoo.com

Evil Brain:

Whatever you do, stay away from emergency medicine. Or else, you'll end up treating every sick baby or injured okada man in your area for free. Nigerians never want to pay for emergency care but will be happy to break your head if their relative dies in your hands.

My advice to you is to start small and don't call attention to yourself. Develop relationships with other doctors. If won't hurt if you work for one of the bigger private hospitals for a few years to build up a reputation with patients before setting up your own place. Definitely don't put a big HOSPITAL sign in front of your building. That'll only attract emergencies that can't pay.

If you provide good services, you'll get patients through word of mouth and through referrals from other doctors.

Lie? Many Nigerians cant AFFORD to pay for healthcare, quite different from not wanting to pay for it!!

Get referral direct from hospital and make your payment policies clear!

I think the op has an eko hospital model in mind ie catering to high end clientele.

Such a venture will be capital intensive and only suitable for a certain demographic.

I personally think starting small and getting some experience in underpriviledged areas cant be emphasized enough, but i know not everyone is comfortable in those types of situations.

@ All,

I understand your various points. I have been brainstorming about all the above issues and several others.
Like most of you stated it will be an expensive venture.
Even in the US, only the middle class and above can afford to pay for expensive tests/ procedures, except the poor people have insurance provided or subsidized by the govt.
I am exploring all options. I know Nigeria is a developing country, I will see if a middle ground or some sort of balancing
act can be achieved.
All contributions welcome! We may learn and be better in planning for such capital intensive projects.

most people did not read your initial message and as a result do not understand your project.Instead,they concluded that you wanted to set up a hospital.I must say,your idea is very laudable and a money spiner.Do not be discouarged at all.You can do this at 3 levels depending on your budget.Health services is not all about treatment,so I clearly understand your vission and the business model.Nigeria is a very viable market for healthcare because every man pays for his healthcare.Forget all the talks about people owning.IT IS A LIE.This does not apply to diagnostic centers and laboratories.Nobody does X-trays or scans on credit.People pay,get their tickets/recipts and go to collection centers wt the tickets and receipts.A viable well managed service of such,which also adds contracts,on site testing (corporate health)for staffs of govt and corpoarate organizations, have a proven annual profit of 80million or more,not turn over,but profit.Conviniently with a good business plan,your monthly profit will be in the region of 5m,this is when you do contracts,working for organisationstarget oil companies,good organizations and do ur maket research to beat compititors.Without contracts,you can go home with 2m ,not less after staff,and all bills paid.The local test and scan centers sometime make even more than this.Go ask around from pregnant women and all.Goodluck.

Please i am an anatomist, graduated from unilorin, currrently
at the final stage of my masters program in Anatomy.
I need a place where i can learn how to use x-ray machine,
CT scan MRI, ECG etc.
i believe my knowledge in human structure, functions and
radiographic anatomy will make me learn fast.
Please i really want to learn this, any advice where this can
be done, please let me know. i have not being able to get
any medical diagnostic centre where i stay.
anywhere in lagos, Ibadan or ilorin will be ok.
Thanks

Please I will like to know the necessary requirment for opening a mmedical laboratory in lagos. Thanks