Most business plans that come across a lender's desk read well. The problem is never the prose — it's that nobody stress-tested the three assumptions the whole model actually depends on: how many people live within reach of the facility, what they can realistically pay, and which payers will actually settle those claims on time.
A catchment study copied from a template rarely survives contact with a credit committee. Lenders in Kenya's healthcare space have seen enough failed facilities to know the questions to ask: where did the population figure come from, has it been checked against county health data, and does the tariff assumption match what comparable facilities in that catchment actually collect — not what they list on a rate card.
Payer mix is the other place plans fall apart. A model that assumes even a modest share of SHA, private insurance and cash patients needs to show how each one is won, not just totalled up as a percentage. Claims turnaround time belongs in the cash flow projection, not left out because it's inconvenient.
None of this requires a more sophisticated spreadsheet. It requires someone who has sat across the table from a bank before, and knows which three numbers they will pull on first. That's the difference between a plan that gets a second meeting and one that doesn't.