LA PAZ COMMUNITY HOSPITAL

The Lapaz Community Hospital (LCH) Limited was incorporated in September 2003 under the companies Act 1963 (Act 179) as a private clinic and it commenced health service delivery on 2nd May, 2004. The main facility is located at Abeka Lapaz along the Anorhuma Street near Lapaz new market. LCH expanded from the threshold of a clinic to become a fully-fledged hospital in 2006.

On 29th November 2008, the hospital Annex Opened at Christian Village junction in response to calls and demands by residents, traditional and opinion leaders at Kisseiman and Christian Village near Achimota, and business leaders within the

community.

Both branches, the Main and the Annex have grown steadily to become 62 and 22 bed capacity facilities respectively.

Vision

To strive to become the leading Private hospital in Ghana and West Africa.

Mission

To provide high quality medical services to its valued customers at the least possible cost without compromising on quality.

The mission of the hospital has been designed to provide high quality medical services to its valued clients at the least possible cost without compromising on quality and this is anchored on a vision that progressively seeks to become one of the leading hospitals in Ghana.

Invariably, the vision and mission are driven by the following strategic goals;

The application of sound managerial practice

The deployment of competent and highly motivated workforce

The total commitment to excellent customer care

The utilization of efficient and reliable hospital information and communication systems

The regular use of state-of-the-art medical technology

To sustain a consistently well maintained infrastructure

And to leverage on results oriented clinical service modules to promote a favourable hospital

corporate image.

Strategy Statement

The strategy consist of carefully coordinated business activities such as: application of sound managerial practices, deployment of competent and highly motivated workforce, total

commitment to excellent customer care, utilisation of efficient and reliable hospital information and communication system, regular use of state-of-the-art medical technology, sustenance of consistently well-maintained infrastructure and leveraging on results-oriented clinical service modules to promote favourable hospital corporate image. The hospital is steered by a four-member Board of Directors and supported by a resilient management team.

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Services Rendered

The services the hospital renders include pharmaceuticals, imaging/radiography, medical laboratory, dental, optical, surgical and anaesthesia. Others are ENT, physician specialist, obstetrics/gynaecology, maternity, neo-natal paediatrics and dietary therapy. The rest are orthopaedic, physiotherapy, urology, neurology, clinical psychology, dermatology, IVF (Test Tube Babies) and emergency/ambulance services.

The branches are both equipped with modern laboratory, computerised pharmacy, modern x ray, maternity and theatre facilities with a staff strength of 250 operating at various workstations. Indeed, the hospital offers a wide range of general and specialist services tailored to present resilient health benefits.

The hospital treats 400 cases daily on the average and attends to private individuals, subscribers

of the national health insurance scheme, private health insurance schemes as well as international health insurance organisations such as Next Care, Cigna and AETNA International.

Quality has increasingly become a hallmark of the hospital and as technology is notably a catalyst aiding effectiveness and efficiency, the hospital has largely digitised operations and services and leveraged on the systems to maintain established standards. It also harnesses the expertise of qualified practitioners and leverages technology to achieve remarkable results.

The track record of the hospital has been remarkable, thereby attracting various prestigious national and international awards as testament to its outstanding performance.

Achievement awards received include; Gold Award in Medical Health Services, (October 2013); Glico Quality Healthcare Services Provider Award, (November 2015); International Quality Crown Award London, (November 2016); Excellence Award Ghana Medical Association, Greater Accra Division, (January 2017); West African Clinical Alliance Award (2018); Spirited African Private Clinician Award, (September 2018); International Achievement Award for Quality and Business Excellence by Association Management and Consulting Paris, awarded in Lisbon Portugal, (February, 2019), International Star for Quality Award, Platinum Category - Geneva, (May 2019) and CIMG Private Health Facility of the year Award (2021).

THE LABORATORY DEPARTMENT

The Laboratory Department of LCH is responsible for testing various samples for medical diagnosis, treatment, monitoring, management, and screening in the hospital. The department also plays a major role in the facilitys scientific and public health related issues. The laboratory

department is currently made up of four (4) main testing centers namely: - The Main Laboratory at the Main Lapaz Community Hospital - Paradise Diagnostic Centre - Annex laboratory at Lapaz Community Hospital Annex - Molecular Diagnostic Center.

The Laboratory Department currently has a total number of twenty-seven (27) technical and non- technical staff led by a Medical Laboratory Consultant. The staff, distributed in the four (4) main testing centers of the laboratory as follows; - Main laboratory: three (3) Medical Laboratory Scientists, seven (7) Medical Laboratory Technicians, and four (4) non-technical staff. - Annex

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Laboratory: Two (2) Medical Laboratory Scientists, two (2) Medical Laboratory Technicians, and one (1) non-technical staff. - Paradise Diagnostic Centre: Three (3) Medical Laboratory Scientists, two (2) Medical Laboratory Technicians, and one (1) non-technical staff. - Molecular Diagnostic Centre: One (1) Medical Laboratory Scientist and one (1) Technician.

The Molecular Diagnostic Centre continues to offer new molecular diagnostic services such as Hepatitis C viral load, respiratory viruses, etc.

Training

The Laboratory Department is well organised and requires regular training to keep the technical staff up to date on modern trends in the laboratory technician profession. Training program for the staff has been very regular. A recent training covered patient preparation, sample taking, analysis, and reporting on lipid profile.

Equipment

A chemiluminescent hormonal and immunoassay analyser was acquired to improve on the quality of hormonal and immunoassay analysis. The chemiluminescent method is the latest, most reliable, and best method for immunoassays.

On the 14th of December 2022, the laboratory had a meeting for all laboratory staff at the Main Laboratory. The meeting which was chaired by the Laboratory Manager, Dr. Iddrisu Mohammed saw deliberations among staff to look at ways to improve laboratory services and also enhance the quality of work. Key among the deliberations were:

1. Issuing of patient reports staff were mandated to continue to send patients laboratory reports through the HAMS system to the Doctors. This was done to improve the accuracy and precision of the lab results.

2. Turnaround time laboratory staff were admonished to communicate efficiently and well with patients regarding the duration of their tests. Should there be a delay in a patients results, staff were asked to address it appropriately and in an articulated manner to the patient.

3. Continuing Professional Development - staff were also encouraged to always seek to acquire new knowledge and expand on their professional know-how. Staff were asked to read widely and take short courses to improve themselves and learn new fields in laboratory technology.

4. Customer care - staff were also asked to take customer issues more seriously and always seek to deliver the best service to all clients or users of the laboratory.

5. Communication strategies among the Laboratory Staff, the Patients, and the Doctors was also discussed.

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GROWTH AND PROSPECTS

To ensure steady progress and growth, LCH has given prominence to equipping the hospital with modern trends and best practices in quality health care delivery.

LCH has also committed to building the capacity of a dynamic workforce consistently, to enhance their potentials to contribute more meaningful for optimum therapeutic outcomes towards world- class patient care.

Besides, the hospital has expanded the emergency unit and provided robust modern technology to facilitate unparalleled rapid response to medical emergencies as emergency care is notably critical to the delivery of quality care. Finally, the hospital has considered rolling out a process for the creation of access to medical advisory services online as a strategic standpoint.

As a service business, customer satisfaction is key. LCH is in the process of linking their competitive strategy to their operations, to ensure that the Hospital achieve its strategic objectives. Performance management systems have an important role, because they can show how well or how badly the LCH has performed in achieving its strategic objectives, and identify where improvements are needed.

BOARD MEMBERS

Dr. Kingsley Neequaye Kweku Tettey

Dr. Kingsley Neequaye Kweku Tettey is the Chairman of the 4-member board of LCH. He is a medical practitioner with over 25 years of experience in medical practice. He started his practice at the Korle Bu Teaching Hospital and then to the Ridge Hospital.

After working in the public sector for close to 7 years, he went into private practice by starting Lapaz Community Clinic in 2004, which over the years was upgraded to a hospital. He has led the hospital to receive various awards both locally and internationally. He holds a certificate in sonography. He is a product of Peoples Friendship University of Russia and he speaks English, Twi, Ga, Ewe and Russian languages.

Dr Kingsley Tettey is also the CEO of Paradise Diagnostic Centre and Sogakope Beach Resort in the Volta Region.

Dr. Joy Thelma Tettey

Dr. Joy Thelma Tettey is the Medical Director of LCH. Dr Joy Tettey is a medical practitioner of over 26 years experience of medical practice. She started her practice at the Komfo Anokye Teaching Hospital in Kumasi, then to the Ridge hospital and later to the La General Hospital. She finally went into full private practice after 10 years in the public sector.

She undertook a course in health care administration at GIMPA in 1998. In 2016, she undertook another course in health care systems at the Galilee Institute in Israel. She holds a certificate in sonography from the department of imaging in Korle Bu.

She speaks English; Ga; Twi and Russian languages. She is a product of Kharkov Medical University, in the Ukraine.

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Dr. Kwabena Agyekumhene

Dr. Kwabena Agyekumhene is an accomplished marketing professional. His is a national and international asset so far as Marketing is concerned. He is an expert marketing professional with over 20 years of executive experience. Skilled at creating campaigns centered around consumer education on product use, he is also a persuasive communicator who is confident in presenting marketing objectives to corporate stakeholders and potential investors. As a passionate leader he is able to motivate teams and departmental members to collaborate around common goals.

He is confident in using research and analysis to understand how trends, competitors, consumer requirements, and seasonal market volatility will affect campaign efforts. He also has a proficient understanding of social media and its role in building brand awareness and garnering positive media publicity.

He is a fellow member of the Chartered Institute of Marketing, Ghana.

Dr. Kwaku Adjei Gyimah

Dr. Kwaku Adjei Gyimah is an experienced Chartered Accountant with over 25 years professional experience. He is passionate about steering businesses in the right strategic direction, solving problems, and implementing change along with reporting on financial performance of a company or firm, which impacts greatly on the decision-making process. He is a trusted advisor, and provide services to other businesses either as a consultant, or as a practicing partner. Auditing, taxation, accounting, financial analysis, risk management and advising on financial structures, are just some of the wide-ranging services provided by Dr. Kwaku Adjei Gyimah.

He is a fellow member of the Institute of Chartered Accountants, Ghana.

Management and Services Staff work in good harmony and they encourage each other to put up a good ethical behaviour. The clients or patients of LCH are at the centre of any policy direction from the Board. These directives are geared towards patient satisfaction and there is the belief that ethics and customer service go hand in hand. The Financial Accountant and the Internal Auditor have therefore, been designated Ethics Focal Persons (EFP) to raise awareness of good ethical behaviour.

Board members of LCH have deliberated on putting in place an organisational structure that is most effective taking into consideration their size, complexity and strategies. The preferred organisation structure should reflect the culture and scheme of work. Currently, the Medical Director with the support of the Hospital Administrator issues directives for compliance.

THE HEALTH SECTOR IN GHANA

The Government of Ghana continues to expand access to healthcare coverage and the scope of benefits it makes available to its citizens. Ghanas 2021 census results report 68.6 % of the population is covered by either the National Health Insurance Scheme (NHIS) or Private Health Insurance Schemes (PHIS). There is a higher rate of health insurance coverage for females (72.6%) than males (64.5%). Health insurance coverage ranges from a low of 51.9% in the Oti Region to a high of 86.2 % in the Upper East Region. Ghana has moved away from a pay as you go system,

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where individual health expenditures were paid in cash prior to treatment and covered entirely by patients. The NHIS now provides wide coverage for a limited scope of health issues, primarily insuring for treatment against the most prevalent diseases, such as malaria.

The healthcare sector in Ghana is organised at three different levels: national, regional, and district. Health interventions are packaged for each level and are delivered at the respective clinics and hospitals.

Healthcare is variable throughout Ghana. Urban centers are well served, and are where most hospitals, clinics, and pharmacies in the country can be found. Rural areas often have no modern healthcare services. Patients in these areas either rely on traditional African medicine or travel great distances for healthcare. Most healthcare is provided by the government and is largely administered by the Ministry of Health and the Ghana Health Services. The healthcare system has five levels of providers: 1) health posts, the first level of primary care in rural areas; 2) health centers and clinics; 3) district hospitals; 4) regional hospitals; and 5) tertiary hospitals.

Ghana spends on average about six percent of its GDP on healthcare infrastructure. The Covid 19 pandemic has exposed large gaps in the health sector, including the need to construct more district- level hospitals.

SUB-SECTOR BEST PROSPECTS

Ghana has very limited local production of pharmaceuticals and even less manufacturing of medical equipment and devices. The country relies on imports for approximately 85 percent of its total healthcare consumption.

Private health facilities complement the public sector. Ghana has sought to introduce more private- sector participation in the healthcare sector. The most dynamic growth and most exciting opportunities will be found in privately funded hospitals and clinics and in the non-state-controlled portion of the pharmaceutical sector. Clients value the quality and convenience of private facilities. There is a growing middle class that prefers to use private health facilities and can afford the expense.

Below are areas of potential commercial opportunity:

Construction of hospitals and clinics

Diagnostic and laboratory facilities and referrals (histopathology)

Drug procurement and pharmaceutical supplies management

Medical equipment

Digital hospital equipment

ICT hospital management

Hospital waste management

Diagnostic imaging and digital imaging

Advanced laboratory equipment

Advanced life support and monitoring systems

Emergency response and ambulance services

Rehabilitation and physiotherapy

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Other opportunities meriting further exploration:

Commercial health insurance

Public hospitals and clinics

Elderly and residential care

Occupational health and rehabilitation/physiotherapy

Dialysis centers

Multidisciplinary cancer treatment centers

First aid and air ambulance services

Diagnostic services such as X-ray, MRI, CT, advanced laboratory services including

histopathology

Services for the maintenance and repair of medical equipment

Mortuary services/Funeral homes

HEALTH CARE INTERVENTION - AGENDA 111

The objective of this project as envisioned by the President of the Republic of Ghana is to ensure that Ghanaians in every district and region in the country have access to quality healthcare services.

The proposed project will boost the provision of healthcare infrastructure in line with the governments commitment to ensuring universal health care to all citizens and attainment of United Nations Sustainable Development Goal 3 (SDG3).

It will further be a fulfillment of the governments policy of a hospital in each district and region and improve the geographical coverage of healthcare delivery in the country, as well as offer improved access to healthcare for all Ghanaians. In the process, the outcome will also come with a model of accelerated construction of health facilities developed for future health projects.

The scope of the Agenda 111(Hospital Infrastructure) project will cover the following deliverables:

Design, procure, construct, equip and commission 101 District Hospitals, 6 Regional Hospitals in newly created regions, 1 Regional Hospital in the Western Region, 2 Psychiatric Hospitals in Kumasi and Tamale, Rehabilitation of Effia Nkwanta Regional Hospital-Sekondi and the redevelopment of the Accra Psychiatric Hospital. All hospitals shall have a compliment of staff accommodation.

On completion, this venture will be the largest investment in healthcare infrastructure in the country since independence. Never before in the annals of this countrys health infrastructure development has universal access to good and affordable healthcare been so strategically envisioned. (Source: Home - Agenda 111 (agenda111gh.com))

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HEALTHCARE MARKET SIZE IN GHANA

Ghana is the 8th largest economy in Africa, with an estimated GDP of $75 billion in 2021 and a population of 30.8 million in 2021. Ghana had a healthcare market size of $2.4 billion in 2021 with a total of 2,857 health facilities, 500 diagnostic centers and 337 ambulances, making the ambulance to population ratio 1: 84,000. Ghana had a pharmaceutical market size of $0.44 billion in 2021 with over 1,000 pharmacies and 30 pharmaceutical manufacturing companies. There are about 12 licensed private health insurance schemes in Ghana, with 7 being private commercial health schemes. Medical devices and supplies had a market size of $71.2 million in 2021, with consumables having the largest share of $23.8 million. Ghana also had the following health market prospects in 2021: $15.3 million Diagnostic Imaging, $1.2 million Dental Products and $0.8 million Orthopedics & Prosthetics.

The following statistics were sourced from the Ministry of Health, Fitch Solutions, The World Bank and World Health Organization: GH10.9 billion Healthcare budget for 2022, $75 Healthcare spend per capital (2021), 11,079 Number of public health facilities (2022), 0.10 Doctor per 1,000 (2020), 0.58 Hospital beds per 1,000 (2020), 1.2 Nurses per 1,000 (2020).

It is estimated that health expenditure reached $2.3 billion in 2020, representing 3.0% of GDP. Health expenditure has fallen, with a Combined Average Growth Rate (CAGR) of -3.4%, since 2015. It is estimated that per capita health expenditure reached $61.4 in 2020. Around 58% of expenditure is met by the private sector. Private health insurance only accounts for less than 1% of private spending. Total healthcare spent in Ghana accounted for about 3.2% of Ghanas GDP in 2021. 4,254 Registered Physicians, 194 Private Hospitals, 91 Public Hospitals, 516 Surgical procedures/Year per 1,000.

NATIONAL HEALTH INSURANCE

The government launched the NHIS in 2003 to focus on treatments for malaria, respiratory diseases, diarrhoea, diabetes, hypertension, and other local needs. Ghanas 2021 census results report 68.8 % of the population is covered by either the NHIS or PHIS. Public hospitals in Ghana are typically funded by the government. Additionally, religious groups play a key role in providing medical assistance to the local population. Expatriates living in Ghana typically opt for private healthcare facilities. Private clinics and hospitals in the country often provide a higher standard of treatment and have more modern equipment than public alternatives. While the standard of facilities varies even among private hospitals in Ghana, the ones found in large expat communities are well-equipped. Waiting times are also significantly shorter at private facilities and English- speaking doctors and medical staff are available.

More than half of all services utilised by Ghanaian customers are offered by private providers, and the share of services provided by the private sector appears to be increasing. Self-Financed Private (SFP) providers account for the majority of privately offered services. Users of all types, regardless of financial level, geography, or sex, pick private providers for a significant amount of their health- care needs, roughly 50% of the time. Coverage under the NHIS appears to promote customers to use Ghana Health Services (GHS) services over privately offered care, however, this could be due to SFP providers' inadequate accreditation. Despite NHIS coverage, consumers continue to spend money out of pocket at GHS, Christian Health Association of Ghana (CHAG), and SFP providers.

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Because of NHIS coverage, customers are now paying nothing at all more frequently. However, the amount of out-of-pocket spending in those circumstances where it is still required has remained unchanged. SFP providers are preferred for quality services, customer service, and fast wait times; GHS providers are preferred for quality services, reasonable pricing, and doctor availability; and CHAG providers are preferred for quality services, courteous service, and doctor availability

Urban centres are well served and are where most hospitals, clinics, and pharmacies in the country can be found. Rural areas often have no modern healthcare services. Patients in these areas either rely on traditional African medicine or travel great distances for healthcare. The CHAG and chemical dealers are concentrated in rural and urban-poor areas, whereas SFP and GHS providers are concentrated in metropolitan areas. Chemical dealers or pharmacies tend to be the largest and most accessible provider of services in rural and urban-impoverished communities, based on their number and geographic distribution. In both SFP and GHS hospitals, human resources for health are concentrated in urban areas, particularly in government hospitals. In 2020, nurses were the highest number of health personnel available in the country with a count of 66,097 whereas physicians came in second with a number of 4,254. Dentists however were the lowest with only 642 in the country.

COMPETITIVE FACTORS

LCH has enjoyed competitive advantage for being the first Community Hospital in Lapaz and its environ. However, AMPC International Health Consultants, an independent consultancy firm offering a wide range of services in the healthcare sector, between 2018 and 2019, developed a business plan for the establishment of St Michaels Specialist Hospital (SMSH). This 90-bed private hospital in Lapaz, has been completed and has a potential to compete with LCH. This competitor is offering general inpatient and outpatient services as well as specialist services such as cardiac care, day surgery, haemodialysis and IVF. AMPC supported DAP Motors, the local partner, in securing Dutch export credit financing for the project and was contracted in 2020 as the turnkey contractor for the design, construction and equipping of the new hospital.

In October 2021, Ghana's President Nana Akufo-Addo attended the sod cutting ceremony at the EU55. million Obuasi trauma and accident hospital. The initiative, which is being funded by Deutsche Bank, will increase the hospital's capacity by around 100 beds and will be used to redesign and renovate three other public hospitals in the country. This also has the potential to compete with LCH if it decides to expand to the middle belt of Ghana.

Agenda 111 Hospital Project is another potential competitor to LCH. However, due to financial constraints, it is not likely that the deadline would be met by the Government of Ghana.

Foods and Drugs Authority has also set up a Centre for Laboratory Services and Research and a Centre for Import and Export Control as part of strengthening its regulatory function to deliver improved services to support the implementation of the African Continental Free Trade (AfCFTA) regime. This is a potential competitor to LCHs bid to maximise its Laboratory services and develop it as a cash cow.

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OTHER DEVELOPMENTS

The Ghana National Chamber of Pharmacy (GNCP) signed a Memorandum of Understanding with construction firm LMI Holdings Ltd for the building of a pharmaceutical industrial park in Ghana's Dawa industrial zone, in line with Ghanaian government backing for a more developed pharmaceutical industry.

Atlantic Lifesciences, a pharmaceutical company, has inaugurated a large scale plant for the production of intravenous (IV) fluids, antiserums and vaccines for the West African market. The $35 million specialised factory, with a sterile pharmaceutical plant for producing infusions, eye drops, vaccines, serums, injections and general anaesthesia drugs, was financed by the Ghana Export Import (EXIM) Bank and the Standard Chartered Bank and from the companys own resources.

The African Medicines Agency (AMA) officially began operating in November 2021, to coordinate and strengthen ongoing initiatives on the harmonisation of medical products regulation and enforce Good Manufacturing Practices (GMP). This will improve the overall registration process of new medicines for member states, by facilitating a much quicker process. The treaty for the establishment of the AMA has been ratified by 17 member states of the African Union, including Ghana.

Technical Advisor to the Board of LCH, Professor Ahumah Dake, has advised that it is about time the Board of LCH give meaning to its vision, mission and strategic statement and venture in Telemedicine to neutralise the emerging competitive forces. He explained that Telemedicine is the exchange of medical information from one location to another using electronic communication, which improves patient health status. Telemedicine, he further explained has multiple applications and can be used for different services, which includes wireless tools, email, two-way video, smartphones, and other methods of telecommunications technology.

Dr. Kwabena Agyekumhene supported the advice from the Technical Director and has come out with healthcare marketing strategies to attract clients and patients in view of the competitive environment that LCH operates.

He reasoned that as more healthcare professionals provide accessible online services and shorten the red tape between physician-patient communications, consumers no longer feel the need to visit the closest option. Instead, theyre empowered to choose a healthcare business offering a consumer experience that meets or exceeds their expectations.

In one of the board meetings, he made the following statements: Even if you're happy with your current patient volumes, healthcare marketing can't happen without a planned medical marketing strategy to keep your healthcare brand at the forefront of people's minds. Think of all the reasons someone might decide to switch healthcare providers:

Relocation.

Providers are no longer accepting their healthcare insurance.

Higher costs for the same service.

Limited or no access to same-day appointments.

Limited or no access to direct communication with their physician.

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Limited or no access to virtual care appointments (e.g., telehealth).

Limited or no access to secure online appointment scheduling, bill pay, or medical records.

Dissatisfaction with wait times.

A negative consumer experience.

No access to remote patient monitoring capabilities.

Thats why its so important to have a planned, budgeted healthcare marketing plan to reach new and returning consumers in your area at the right moment.

HEALTH SECTOR PORTERS FIVE COMPETITIVE FORCES

a. The major competitors in the health sector, are Korle-Bu Teaching Hospital, 37 Military Hospital and others. They have high demand for their services, and this can be attributed to the fact that they have been operating for a long time in the country, thus they have gained goodwill and trust from their clients over the years.

b. It is important that other smaller hospitals develop an effective strategy that differentiates their services from that of their competitors to give them a competitive advantage in the market.

c. The market of healthcare in Ghana is not as diverse as other markets. Thus, the threat of substitutes will be based on the differentiating characteristics associated with each competitor that provides the same service.

d. The market has been dominated by the biggest teaching hospitals in the country over the years. A patient deciding between these hospitals could be based on the price range of receiving such services, the relationship established between the service provider and that of the client and based on how long the service provider has been operating.

e. Suppliers have very little power in the pharmaceutical industry. The raw materials for manufacturing drugs are commodity products in the chemical industry, which are available from numerous sources.

f. Most of the equipment used in manufacturing and research is available from multiple manufacturers. Suppliers usually offer multiple products to the manufacturer, which moderates pricing on rarer materials and unique equipment.

g. Buyers in Ghana's health-care sector have limited bargaining power. Customers may have some power due to the presence of other well-known health-care establishments. However, there is a cost associated with receiving treatment. Private hospitals would be the best alternative for higher- quality healthcare in Ghana, but they are out of reach for the typical Ghanaian.

h. In terms of pricing, public health care facilities would be the preferred option; however, clients may choose to pay a lower price for lower-quality treatments by purchasing a Health Insurance Scheme.

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i. Since this sector is dominated by a small number of enterprises, the threat of new companies entering the market is minimal. These large corporations have been in business for a long time and are well-known in the market. The Ghanaian health sector must prioritise policies that can lower costs with a more efficient system while simultaneously maximising value for customers in order for other firms to survive and compete.

SITUATIONAL ANALYSIS OF THE HEALTH SECTOR

The Government of Ghana supports the local manufacturing sector with financial incentives and the NHIS provides a basic care to majority of the population. The launch of the revised National Health Policy to provide a clear policy direction to Government in the provision of improved healthcare is another pillar of strength in the health delivery services in Ghana. Pharmaceutical manufacturing has been in place in the country for 75 years. This sector is being regulated by a well-equipped Food and Drugs Authority (FDA) to enhance drug surveillance.

Ghana is open to foreign direct investment. Investment in healthcare infrastructure, supported by international funding. Foreign Direct Investment in 2021 amounted to $1.3 billion. Therefore, there is an investment opportunity in the health sector. Domestic drug makers are also moving towards achieving World Health Organisation (WHO) qualification and GMP certification, supported by the government's policies. Ghana's evolving demographic and epidemiological profile will provide increased revenue earning opportunities for pharmaceuticals. The Government is willing to support indigenous drug manufacturers attain WHO qualification and GMP certification.

These favourable factors have been moderated by low incomes and limited out-of-pocket spending power. The Pharmaceutical market is also dominated by sometimes high-priced branded generics from India. The country is still highly dependent on pharmaceutical imports. The healthcare sector is also underdeveloped with low per capita health expenditure. In 2021 per capita expenditure was $75. The sector is also lacking a universal health insurance and limited expertise within the pharmaceutical sector resulting in high reliance on foreign imports. There is also no WHO nor GMP certified manufacturer. Worse of all there is either lax or no legal framework.

The sectors sustainability is impaired by the following factors; financial sustainability of the NHIS, prevalence of counterfeit drugs, mainly from abroad, which threaten to undermine sales from genuine pharmaceuticals, corruption remains a concern in all aspects of governance, recurrent bouts of currency weakness could erode consumer purchasing power and immigration

Summary of the competitive nature of the industry: is it an attractive industry? why? 1) identify the Driving forces - the 5 most significant ones (explain by providing 3 reasons for each force ) 2) Macro environmental Model problems/issue statement 1) describe - Describe the three most important/critical issues or problems facing the organization (be specific to the co.) 1)Describe the corporate governance problems of the above case study 2) Suggestions on any financial management questions that can be derive from the lapze community hospital case study. Summary of the competitive nature of the industry: is it an attractive industry? why? 1) identify the Driving forces - the 5 most significant ones ( explain by providing 3 reasons for each force ) 2) Macro environmental Model problems/issue statement 1) describe - Describe the three most important/critical issues or problems facing the organization ( be specific to the co.) 1)Describe the corporate governance problems of the above case study 2) Suggestions on any financial management questions that can be derive from the lapze community hospital case study