Field notes from inside Kenyan healthcare facilities.
What we're seeing across feasibility studies, builds, claims reviews and turnarounds — written for people who have to decide, not just read.
FINANCEWhy most hospital business plans don't survive a lender's first read.
The plans that fail aren't badly written — they're built on catchment, tariff and payer-mix assumptions nobody stress-tested. What a bank actually checks first.
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BUILDThe three things that push a hospital build past its licence date.
It's rarely the contractor. It's a clinical brief and an architectural drawing that quietly stopped agreeing with each other months before anyone noticed.
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GROWWhy SHA dependence is actually costing your facility.
A single-payer facility looks busy and still doesn't make money. The fix is rarely more patients — it's a payer mix and a claims process built for one payer instead of several.
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LAUNCHOpening day is not the finish line — it's a staffing problem in disguise.
Facilities that struggle in month one usually staffed to the building, not to the patient volumes they actually projected. What a realistic opening-readiness check looks like.
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SCALESecond branch, same mistakes: what expansion actually requires.
A working first facility is not proof the model repeats. A site selection method, a data room and an operating playbook are what actually make a second branch faster than the first.
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FINANCEReading a term sheet like a lender, not like a founder.
Covenants, drawdown conditions and security packages decide more about a facility's future than the headline interest rate does. What to compare before you sign.
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