A) Active Projects in Progress
1) Liyana Digital Pharmaceuticals and Medical Supplies Import
This unit was established to address the current and future need of healthcare products
(drugs, medical equipment, and supplies) of the company, its sister companies, and the
country as a whole. The company has registered a long list of products from reputable
manufacturers from around the world as their first and sole agent, and many more are in
the process of being registered. This business unit is designed to help the company grow
financially and address the dire shortage of specific drugs and medical equipment that
would have a significant impact on healthcare delivery in Ethiopia.
2) Dream-Liyana Healthcare PLC (Addis Ababa)
This company was established in collaboration with five seasoned specialist and
subspecialist orthopedic,neuro and spine surgeons with the goal of addressing the
significant gap in high-end orthopedic, trauma, and neurosurgery care. The senior
physicians, in this unit, have rare subspecialties, a large pool of patients in Addis Ababa
and the regions, as well as in Somaliland, Eritrea, and other neighboring countries.
The acquisition of a premise (hospital facility) in Addis Ababa, Lideta sub city, near the
Africa Union headquarters, has already been completed. Renovation and furnishing are
already underway.
Dream Orthopedic and Trauma Specialty Center is expected to be operational by the first
week of August 2015.
3) Cheliyan Healthcare PLC (Addis Ababa)
CHC is a joint venture initiative between LDHCS (with a larger share) and Chechella
Medical Services PLC, which is under formation in Addis Ababa with a capital of 200
million ETB. This initiative is expected to address the challenge of hundreds of patients
who daily travel around the city in search of diagnostic, therapeutic, and pharmacy services
that are not available at public hospitals.
This multispecialty tertiary care center will provide high-end medical, surgical, and trauma
services, as well as state-of-the-art and latest imaging and laboratory services. The Plc.
owns an 8-story facility, which is currently undergoing renovation. The procurement of
diagnostic and therapeutic equipment is underway. The facility is expected to be
operational by the end of July 2015 E.C.
4) MAAL Healthcare PLC (Addis Ababa)
This company was established in collaboration with three renowned and experienced
obstetrician-gynecologists and surgeons who are focusing on significant unmet need for
high-end obstetric, gynecological, pediatric, and surgical services.
An eight-story building located in Bole sub city, in the vicinity of Jacros village, which
was built for hospital services, has been leased for 10 years. Renovation is underway, and
the import of the necessary equipment and furniture has been completed.
The MCH and Surgery Specialty Center is expected to be operational by the first week of
September 2015.
5) Liyana-Addis HC Share Company (Gondar)
This share company is the first regional initiative of LDHCS (with the largest share) and
was established in collaboration with Addis Gize Share Company and a group of senior
specialists who practice at Gondar Comprehensive Specialized Referral Hospital. This
initiative is expected to address the acute shortage of advanced diagnostic and tertiary care
services in Gondar, in particular, and in the northern part of Ethiopia, in general. The
facility is located in Gondar, Chechella, just in front of Gondar Specialized Referral
Hospital.
Liyana-Addis Healthcare (Yanet Multispecialty Center-Gondar) will provide advanced
medical and surgical services, as well as state-of-the-art imaging services, including high-
resolution CT scanning and advanced laboratory services. The facility renovation is
nearing completion, some of the required equipment has been delivered, and the rest is
being imported.
The facility is expected to be operational by mid-August 2015 E.C.
6) Gambella Advanced Diagnostic Center (Gambella)
The Gambella Advanced Diagnostic Center (GADC) initiative was launched in response
to a request from regional officials to collaborate in addressing the diagnostic and
therapeutic challenges in the region. A multispecialty center project is planned to follow
once the diagnostic center is operational.
A facility close to Gambella General Hospital has been leased for 10 years. Renovation of
the facility and importation of high-end diagnostic equipment are already underway. The
GADC is expected to be operational by the end of September 2016.
The GADC will provide a range of diagnostic services, including: X-rays, CT scans, MRIs,
Ultrasounds, Endoscopy, and Pathology. The GADC will also provide training and support
to local healthcare professionals. The GADC is expected to have a significant impact on
the health of the people of Gambella. It will provide much-needed diagnostic services to
people who have no adequate access to these services. The GADC will also help to reduce
the number of people who travel to other places for diagnostic tests.
7) Juba Kidney Hospital and Diagnostic Services (South Sudan)
The Juba Kidney Hospital and Diagnostic Services project was initiated in response to an
invitation from the Ministry of Health of the Republic of South Sudan, Honorable Minister
Yolanda Awel, and with the facilitation of the respective embassies in Addis Ababa and
Juba. The project is a public-private partnership (PPP) between LDHCS and the MOH of
the Republic of South Sudan.
The hospital will provide high-quality kidney care and other related services. The hospital
will also provide advanced diagnostic services. The project is expected to benefit a large
number of people in South Sudan who are living with kidney disease. The project will also
help to improve the quality of healthcare in South Sudan.
The project is expected to be launched by October 2016.
B) FUTURE INITIATIVES (2024 and Beyond/ 2016 E.C and
beyond)
1) SI-Liyana Manufacturing PLC (Addis Ababa Industrial Zone)
LDHCS is in the process of incorporating a joint venture company with SI Surgical LLC, a
reputable Indian manufacturing firm. SI Surgical LLC is a well-known brand in India, Africa,
Europe, and the United States for its hospital furniture, critical care devices, turnkey operating
theater devices, and modular OTs.
The joint venture company will address the immense gap in the supply of these products in
Ethiopia and supply them to other African countries from the Ethiopian hub.
The incorporation process is underway.
2) Liyana - OMCC Oncology Center (Sidama Region, Hawassa)
The Liyana - OMCC Oncology Center project is a joint venture between LDHCS and OMCC,
a multinational company from Luxembourg that specializes in providing comprehensive
oncology diagnostic and treatment services, including radiation therapy. OMCC has a
significant presence in Europe, South America, and Africa, including South Africa, Ghana,
Togo, Uganda, and Ethiopia.
This initiative aims to address the significant gap in the availability of world-class cancer
radiation therapy centers in Ethiopia. The project is expected to play a pivotal role in reducing
the need for cancer diagnosis and treatment abroad, as well as generating foreign exchange
from international patients.
The company incorporation process is underway. Adequate land has been secured, and site
clearance for construction is underway. Bunker construction is expected to begin in October
2016 E.C.
3) Regional Service Expansion
LDHCS currently has a presence in 5 geographies (four domestic and one foreign: Addis
Ababa, Hawassa, Gondar, Gambella, and South Sudan). Five more regional capital cities have
been identified for expansion of diagnostic and tertiary care therapeutic services in the coming
Ethiopian New Year, 2016.
The expansion is fairly distributed across the nation, taking into account the high impact of
setting up the facilities in the regional cities and the feasibility of the project. Land acquisition
as an investment project has already been initiated in some of these cities. Different business
models (acquisition, joint venture, rental, merger, franchise, etc.) will be utilized in the regional
expansion initiatives.
4) Health (Medical) Insurance Project
LDHCS has been working on the establishment of a medical insurance project for the past 5
years. The project was not able to materialize earlier due to the lack of an enabling policy and
regulatory framework for medical insurance.
However, with the current positive developments in the national financial policy and
regulations regarding the insurance landscape, coupled with LDHCS's aggressive regional
expansion of facilities, the company is now stepping into the medical insurance project in
collaboration with a few selected promoters.
5) Healthcare City Project (Hawassa and Shaggar)
The time is now for LDHCS to step into the healthcare city project and harness the potential
of wellness and medical tourism.
The national wellness and medical tourism roadmap is already in place, and it has become one
of the top national strategic initiatives. LDHCS is already positioning itself in this national
initiative. A multi-billion birr project proposal has been submitted to the Hawassa and Shaggar
city administrations following in-depth consultation and agreement with the leadership of the
cities.
The domestic and foreign finance mobilization process has already been initiated. Engagement
with a well-known global sustainable hospital design and development company is already
underway.
Retaining domestic clients who are traveling abroad for better medical checkups, diagnosis,
and treatment of medical conditions, and serving as the East African hub of medical tourism
generating foreign exchange from international patients will have a remarkable social,
environmental, and economic impact.
6) Pharmaceuticals Manufacturing
Local pharmaceutical manufacturing and revolutionizing the supply chain management is one
of the priority agendas of the Ethiopian government. To date, local pharmaceutical products
have a market share of less than 10%.
LDHCS is already onboarding trusted pharmaceutical manufacturers from India in a form of
domestic and foreign joint venture projects. This will help to increase the availability of high-
quality, affordable pharmaceuticals in Ethiopia, and to reduce the country's reliance on
imported drugs.
7) Liyana Boarding School Systems
Yanet-Liyana College of Health Sciences, a sister company of LDHCS, has developed a strong
track record in the higher education system, both in undergraduate and postgraduate studies.
LDHCS envisions duplicating this experience down to the pre-school, primary, and secondary
school levels. The school system expansion follows the geographic expansion of LDHS’
healthcare facilities across the regions.
The purpose of the boarding school systems is to create an ecosystem where the next generation
of great minds in the nation will be nurtured to international standards. Pilot projects will be
initiated next year, with plans for scaling up in the future.
C) Enabling factors for the realization of the projects
Internal factors
Brand image: LHC, sister company of LDHCS, has built a strong brand image in the minds
and hearts of customers, stakeholders, and employees over the past 10 years through its Yanet
chain of hospitals, pharmaceuticals, health sciences college, and Yali manufacturing. This
existing brand image and brand equity will be a great stepping stone for the initiatives at hand
and in the pipeline to excel in business performance in a short while.
Governance: LHC and LDHCS are proud of their visionary, innovative, and agile leadership.
LHC has been exercising corporate governance over the past several years, perfectly executing
multiple initiatives with great efficiency and effectiveness. The executive board of directors of
LDHCS SC are seasoned healthcare professionals with an immense domain-expertise in
academia, private business practice, and high-level leadership positions in the public sector.
The fact that Dr. Girma Ababi, the current CEO and board member, has been serving as
president and vice president of the regional as well as national private health facilities
association and federation, and is a member of the East African and All Africa Healthcare
Federation, will place the company in a strategic position to understand the national and
continental healthcare landscape, emerging trends, and opportunities ahead. Some of the board
members and the current CEO have been trained and coached by Stanford University faculty,
global executive coaches, and consultants, and have earned international certification on
innovation in developing economies. The current CEO and board member has been trained on
national health systems by world-renowned professors from Harvard, Oxford, and Stanford
University through the initiatives of the World Bank and Global Financial Facility (GFF).
The immense exposure to global leadership training and coaching coupled with the golden
leadership experience gained in leading healthcare businesses over the past 10 years puts
LDHCS in an unparalleled advantage to take all the initiatives forward.
Strategic partnership: Strategic partnership is one of the key pillars of LHC/LDHCS's
strategy to realize its vision of becoming the most preferred integrated healthcare solution
provider in the Horn of Africa by 2027 G.C. LHC and LDHCS have built a great reputation in
their entire engagement with diverse domestic and foreign stakeholders, be they regulators,
financiers, suppliers, joint venture partners, etc. The strong partnership is a key leverage for
LDHS to materialize its initiatives and bring its vision to reality.
Leveraging Technology and Innovation: LDHCS is the first Ethiopian company to establish
telehealth (digital healthcare) in the nation. All Liyana facilities have been using a paperless
electronic medical record (EMR) system for the past 8 years, and Digitization has helped the
facilities a lot in improving quality of care and process optimization.
Coupling the facility-based care with the virtual care is revolutionizing healthcare both in terms
of accessibility, quality, and affordability. This directly translates into strategic positioning in
business performance and societal impact by reducing both the direct and indirect costs of
healthcare.
Integration: LDHCS is aggressively expanding in tertiary healthcare services, product
manufacturing, distribution and retail, health workforce training, and financing (insurance).
The integration plays a key role in maximizing quality of care at an affordable cost, which
reflects directly on business profitability and social impact.
Quality, Systems, and Processes: LHC has been quality conscious from the very beginning
and has demonstrated consistent improvement over time. The company has been competing
for the Ethiopian Quality Award, the Excellence Model of International Standards, for the past
three years and has won a trophy for its quality service. ISO 9001.2015 accreditation in total
quality management has been underway for the past year and is nearing completion. The
company is also heavily investing in building a very strong system and process for both core
and support processes.
Workforce Development (Human Capital): LDHCS is embarking on developing and
retaining futuristic health workforce at different levels of its system. The company is
implementing an employee experience and talent management initiative aimed at becoming an
employer of choice.
Workforce development is given due attention due to the fact that the stakes are high in
providing world-class quality care. Yanet Liyana College of Health Sciences primarily trains
high-potential trainees who are carefully recruited and trained in selected undergraduate and
postgraduate programs relevant to its operation. This ensures that the trainees are trained and
graduate with the right knowledge,attitude and skills that position the company on the right
track in terms of quality of care.
The Yanet-Liyana nationally accredited CPD center provides continuous theoretical and skill
training so that the staff is up-to-date with the new developments in the healthcare ecosystem.
LDHCS is also heavily investing in sub-specialty training in medical fields where there are
few or no talented professionals available in Ethiopia. Accordingly, four sub-specialization
trainees are leaving for a year-long training at Indian super-specialty hospitals in a few weeks.
Six more will follow in the European New Year.
External factors
Government’s Policy and regulatory landscape: The revised National Health Policy and the
3-year Healthcare Investment and Development Plan (HIDP) both take into account the role
of the private sector in healthcare. This direction will create an enabling environment for
private sector investment, either alone or in collaboration with the public sector through public-
private partnerships. LDHCS has already positioned itself to collaborate and play a key role
through its aggressive regional expansion and conducive relationships with the respective
regional leadership.
Further, the Ethiopian government is committed to improving the healthcare system in the
country. This includes investing in infrastructure, training healthcare workers, and providing
access to affordable healthcare. These government policies are supportive of LDHCS's
initiatives and will help the company to achieve its goals
National Wellness and Medical Tourism Initiative: The Ethiopian government is heavily
investing in tourist destinations, taking into account the economic and other benefits of such
initiatives. The wellness and medical tourism roadmap encourages the private sector to invest
heavily in tertiary care services and building healthcare cities. LDHCS has already aligned
itself with this initiative and is pioneering the development of a healthcare city in Hawassa and
Shaggar. Given the unmet domestic need and the potential to serve as a medical tourism hub
for Eastern Africa, the company is already strategically positioning itself.
Capital market: Healthcare financing has been a major challenge in Ethiopia for many years
due to the lack of strong financial institutions in the country and poor access to foreign
financing. The emergence of a capital market (to be launched soon) will alleviate this chronic
challenge and improve the company's access to finance, enabling it to execute its initiatives.
Economic growth: Despite recent setbacks, Ethiopia is still one of the fastest-growing
economies in Africa. This economic growth is creating a growing middle class with an
increasing demand for healthcare services. This demand is supportive of LDHCS's initiatives
and will help the company to grow its business.
Demographics: Ethiopia has a young and growing population. This demographic trend is
supportive of LDHCS's initiatives as the company will be able to target a large and growing
market.
D) Potential Challenges and Mitigation Strategies
LDHCS may face some challenges in its effort to realize its initiatives. These challenges
include:
Political instability: The current political situation in Ethiopia is unpredictable. However,
LDHCS believes that the situation will improve over time. The company has thrived in
turbulent political situations in the past, and it is confident that it can do so again. To mitigate
this risk, LDHCS will focus on building ownership by the local community and leadership.
The company will also implement an enterprise risk management strategy to identify and
mitigate potential risks.
Financing and foreign exchange (Forex): Financing and Forex will be major challenges for
LDHCS in the short run. The company is planning to expand rapidly, and this will require
significant investment. To mitigate this risk, LDHCS is pursuing a number of strategies,
including:
Raising additional capital from investors.
Taking advantage of the opening of the Ethiopian banking system to foreign banks.
Listing on the capital market.
Expanding into neighboring countries and exporting medical devices.
E) Conclusion
LDHCS is confident that it can overcome these challenges and that it is well-positioned to
realize its initiatives, and achieve its goals.
The company has a strong brand image, visionary leadership, strategic partnerships, a team of
experienced professionals, political clout, and a supportive environment. With these factors in
place and with careful planning and execution, LDHCS is well-positioned to achieve its goals
and become the most preferred and a leading integrated healthcare solution provider in
Ethiopia and the Horn of Africa.