Dec. 20, 2016

Sulaiman Shahabuddin,


Sulaiman Shahabuddin,

Regional CEO , Aga Khan Health Service, East Africa

TBY talks to Sulaiman Shahabuddin, Regional CEO of Aga Khan Health Service, East Africa, on providing quality rural healthcare, developing constructive PPPs, and how to manage a vast healthcare network.


Sulaiman Shahabuddin is the regional chief executive officer of Aga Khan Health Services, East Africa, and chief executive officer of the Aga Khan Health Services, Tanzania. Shahabuddin has held executive and leadership positions within the Aga Khan Development Network institutions in Pakistan, Kenya, and Tanzania. He holds an MBA from the University of Karachi and an MSc in sustainable development from Imperial College, University of London.

Aga Khan is a major healthcare player around the world and in the region. What is the importance of East Africa to your overall operations?

The Aga Khan Development Network operates 15 hospitals around the world and more than 300 other healthcare facilities, so it is quite a large network. We see almost 5 million patients. Three of our hospitals, in Karachi, Nairobi, and Dar es Salam, are not only teaching hospitals but also Joint Commission certified hospitals, the highest level of quality in patient safety a healthcare facility can have. The other health facilities, which we call primary medical centers, are all connected in our hub and support model. Looking at East Africa, there are 70 healthcare facilities in addition to the four hospitals that we have. The objective is to provide access by partnering with the public center and improve it by having a robust patient welfare program.

How do you fit into the health matrix in Tanzania?

Within Tanzania we have the Aga Khan hospital, which is a tertiary level hospital with a major and underway expansion plan, which will see the hospital expand to a 170-bed tertiary and academic medical center by 2018. We are already tertiary in some sense and academic in some sense; however, the current in-patient capacity limits us from expanding in those areas. It is a USD80 million expansion project, and the purpose is to create the scale that will allow us to train more physicians and nursing leaders and provide tertiary level medical care. In addition to the hospital, we have 14 other healthcare facilities in Tanzania and will have 35 by 2019. We are opening an outreach health facility every two months so it is quite an aggressive plan. However it is not only about opening facilities but about programmatically linking the same with the hospital and our other centers to create a continuum of care.

What is your cost management procedure in a market that does not have a great deal of purchasing power but a great need for healthcare?

Affordability is a huge challenge, as majority of the Tanzanians are unable to pay for health care services. Within our system we manage to do the best by firstly haveinga robust patient welfare program with contributions coming from corporate donors, individuals, as well as from the hospital that contributes from its revenue lines. We have also been fairly successful in implementing the concept of differential pricing and cross subsidization. If a pregnant woman comes to this hospital in Dar es Salam then for example delivery would be say between USD400- 500 however if she went to our centers in Mwanza or Mbeya, the delivery cost is only USD70, so a portion of the cost that is paid in Dar es Salaam goes to subsidizing care in those centers. If a patient goes to an outreach center in Masaki, which is an affluent area he or she would probably pay USD20 for a consultant, but if they go to Tandika, which is a disadvantaged area, patients would pay USD1.5, and hence the principle of differential pricing and cost subsidization. This allows us to provide the same level of care irrespective of the affordability status of the community.

What do you see as barriers to the areas for improvement?

Unless there is a financing structure that pays for healthcare at the appropriate level, it will be always be a challenge as affordability is very low. The second area is human resources for health. While there are good medical schools that graduated about 1,000-1,200 doctors each year. The third area is making the whole process of obtaining approvals for various activities one stop and much quicker. als. To open a clinic takes six months. It has to move much quicker, and the Ministry of Health is focused on that.