PROPOSAL
Business Start Up – School & Hospital
Project Name: A Nurse-Led Medical Training School and Hospital
Empowering Ugandan Nurses and Midwives through Education, Employment, and Sustainable Healthcare
Prepared For:
Nurses Revision
Midwives Revision
Table of Contents
1. Executive Summary 2. Introduction 3. Company Overview 4. Market Analysis 5. Project Description 6. Financial Plan 7. Operational Plan 8. Risk Analysis 9. Exit Strategy 10. Appendices1. Executive Summary
VISION
To create Uganda’s first nurse-owned medical school and hospital, integrating education, employment, and community healthcare.
MISSION
Train skilled nurses, provide affordable care, and generate sustainable revenue for stakeholders.
Key Highlights
- Facilities: 200-bed hospital + accredited nursing school with paid internships.
- Ownership Model: Nurses contribute shares (UGX 500k–1m) for dividends.
- Phased Approach: School development first, followed by the hospital.
Funding Requirement
UGX 10 billion (USD ~2.7 million) required over a 5-year period.
ROI for Investors
Profit-sharing model based on revenue streams including:
- Tuition fees: Projected annual revenue of UGX 600 million by Year 3 (based on UGX 1.5M/semester).
- Revenue generated from hospital services (Projected UGX 1.4 billion annually by Year 5).
- Potential government partnerships and contracts.
This initiative offers a unique blend of social impact and financial return by empowering healthcare professionals and improving healthcare access in Uganda.
2. Introduction
Problem Statement
Uganda’s healthcare and nursing education systems face critical gaps:
1. Nursing Unemployment:
Over 3,000 qualified nurses and midwives are unemployed annually, despite a national shortage of 15,000 healthcare workers (Ministry of Health, 2022).
2. Lack of Practical Training:
70% of nursing graduates report inadequate hands-on experience, leading to underprepared professionals (Uganda Nurses and Midwives Council, 2023).
3. Healthcare Access Crisis:
In Kampala alone, there is only 1 hospital bed per 1,500 people, far below the WHO recommendation of 1 bed per 300. Maternal mortality rates remain high at 336 deaths per 100,000 live births (UBOS, 2023).
Solutions
Our integrated model directly addresses these challenges:
1. Education-to-Employment Pipeline
A nursing school offering accredited diplomas paired with 1-year paid internships at our affiliated hospital, ensuring practical competence.
2. Scale-Driven Healthcare
A 200-bed hospital providing affordable care in underserved regions, generating sustainable revenue to fund dividends for nurse shareholders.
3. Cooperative Ownership Model
Nurses collectively own and govern the institution, ensuring alignment with workforce needs and community health priorities.
3. Company Overview
Who We Are
This is a nurse-led initiative founded by Nurses Revision, a Ugandan collective comprising over 5,000+ nurses and midwives. We are dedicated to advancing the nursing profession and improving healthcare outcomes in Uganda.
Our Leadership Includes:
(Note: Specific leadership details to be updated as per the document.)
Leadership Role 1
[Details to be updated]
Leadership Role 2
[Details to be updated]
4. Market Analysis
Nursing Education Demand
Key Statistics:
- Kampala has 32 accredited nursing schools training ~5,000 students annually.
- However, 15,000+ applicants compete for these slots each year (UNMC, 2023).
- Only 30% of graduates receive adequate hands-on internships, leaving 70% underprepared for clinical work.
Competitive Pricing (Average Annual Tuition):
| Institution Type | Average Annual Tuition (UGX) |
|---|---|
| Public Nursing School | 3,000,000 |
| Private Nursing School | 2,500,000 |
| Nurses Revision School (Proposed) | 3,000,000 |
Our proposed annual tuition (UGX 1.5M per semester) positions us competitively alongside public institutions and slightly above private schools. However, our unique value proposition lies in the fully integrated paid clinical internships and direct pathway to employment within our own hospital system, offering unparalleled practical experience that justifies the comparable cost.
Healthcare Demand
Current Facilities & Needs (Focus Area):
- Population: Target area population approx. 4,051,000 people (e.g., Kampala and surrounding).
- Hospital Beds: Critical shortage, exemplified by Kampala’s 1 bed per 1,500 people vs. WHO’s 1:300 recommendation. ICU capacity is extremely limited (e.g., 55 total ICU beds, translating to 1.3 per million).
- Maternal Mortality Rate: High at 336 deaths/100,000 live births (UBOS, 2023), indicating a strong need for improved maternal care.
Projected Impact of 200-Bed Hospital:
- Serve 50,000+ annual outpatient visits and 10,000+ inpatient admissions.
- Aim to reduce maternal mortality by 40% in the catchment area through dedicated prenatal and delivery care.
5. Project Description
A. Nursing School Financials
Initial Cost Breakdown (Years 1-2):
- Land (2 acres): Government Grant anticipated
- Classrooms/Labs Construction: UGX 500,000,000
- Accreditation Fees: UGX 50,000,000
- Estimated Total (Years 1-2): UGX 550,000,000
Revenue Projections (Annual Tuition @ UGX 3m/student):
| Year | Students | Total Revenue (UGX) |
|---|---|---|
| 1 | 100 | 300,000,000 |
| 2 | 150 | 450,000,000 |
| 3 | 200 | 600,000,000 |
*Based on UGX 1.5m per semester, 2 semesters per year. Assumes capped enrollment at 200 from Year 3 onwards.
B. Hospital Financials
Phased Construction Costs:
| Phase | Description | Cost (UGX) | Timeline |
|---|---|---|---|
| 1 | 50-bed maternal ward + outpatient clinic | 3,000,000,000 | Year 1-3 |
| 2 | 150-bed expansion (surgical/pediatric) | 4,500,000,000 | Year 4-5 |
| Total | 200-Bed Hospital | 7,500,000,000 | 5 Years |
Projected Annual Hospital Revenue Streams (at maturity):
| Service | Price (UGX) | Annual Volume | Revenue (UGX) |
|---|---|---|---|
| Outpatient Consults | 20,000 | 30,000 | 600,000,000 |
| Deliveries | 150,000 | 2,000 | 300,000,000 |
| Surgical Procedures | 500,000 | 1,000 | 500,000,000 |
| Total Annual Revenue | 1,400,000,000 |
6. Financial Plan
5-Year Projections (UGX)
| Year | School Rev. | Hospital Rev. | Total Exp. | Net Profit/(Loss) |
|---|---|---|---|---|
| 1 | 300M | 0 | 1,750M | (1,450M) |
| 2 | 450M | 0 | 500M | (50M) |
| 3 | 600M | 600M | 3,000M | (1,800M) |
| 4 | 600M | 1,200M | 2,000M | (200M) |
| 5 | 600M | 1,400M | 1,000M | 1,000M |
*Note: M = Million. Expenses are higher in initial years due to construction/startup. Hospital revenue commences Year 3. School revenue assumes cap at 200 students from Year 3.
Funding Sources (Initial Phase – Example UGX 2B)
| Source | Amount (UGX) | % of Total |
|---|---|---|
| Nurse Shareholders | 1,000,000,000 | 50% |
| Government Grants | 400,000,000 | 20% |
| Development Bank Loan | 600,000,000 | 30% |
| Total | 2,000,000,000 | 100% |
*Note: Illustrative initial funding mix. Total project funding needed is UGX 10B over 5 years.
Key Assumptions
- School enrollment grows by 50 students/year initially, stabilizing at 200 by Year 3.
- Tuition is UGX 1.5 million per semester per student (UGX 3 million annually).
- Hospital reaches 60% occupancy by Year 5.
- Loan repayment (e.g., Development Bank Loan) begins Year 4 at assumed 10% annual interest.
- Government land grant is secured.
- Operational costs managed efficiently.
7. Operational Plan
Management Structure
Board of Directors (Elected):
- Chairperson: Strategic oversight.
- Finance Director: Budgets, loans, investor relations.
- Medical Director: Hospital compliance (MoH standards).
- Education Director: School curriculum & accreditation.
- Community Liaison: Local leader/NGO engagement.
Hospital & School Leadership (Appointed):
- Hospital CEO: Daily operations, staffing, patient care.
- School Principal: Admissions, faculty, internships.
Advisory Board:
- Retired nurses (2), Public health expert (1), Legal advisor (1).
Staffing Plan
Recruitment Strategy:
- Faculty: Hire 10 experienced nurses initially (target 50% from Nurses Revision alumni).
- Hospital Staff: Prioritize hiring our own graduates (target 70% of entry-level roles).
- Training: Structured 3-month hospital mentorship programs for new grads.
Staff Projections:
| Year | Nursing School Faculty | Hospital Staff |
|---|---|---|
| 1 | 10 | 20 (Initial) |
| 3 | 15 | 100 (Phase 1) |
| 5 | 20 | 200 (Full) |
Timeline (Gantt Chart)
Key Milestones:
Month 1–6: Foundation
Land secured, feasibility study, initial fundraising.
Month 7–18: School Development
Construction, curriculum, accreditation.
Month 19–36: Hospital Phase 1
Build 50-bed maternal/outpatient, initial staff.
Month 37–60: Hospital Phase 2
Expand to 200 beds, full operation.
Simplified Gantt Chart Overview (5 Years):
*Gantt chart illustrative of timeline.
8. Risk Analysis
Risk Matrix
9. Exit Strategy
Investor Returns
- Dividends: Target 40% of annual profits to shareholders starting Year 5.
Example (Year 5): UGX 1B profit → UGX 400M distributed. - Share Buyback: Option after 5 years to sell shares back to cooperative at 120% of initial value (subject to financial health/approval).
Long-Term Sustainability
- Reinvestment: Allocate 30% of profits for expansions/improvements.
- Succession Plan: Train alumni/staff for future leadership roles.
Sale or Merger Option
After 10+ years, members may vote on sale/merger to ensure care continuity and potentially provide final liquidity.
10. Appendices
Appendix 1: Feasibility Study Summary
- Location ([Town X]): Confirmed 0 accredited nursing schools within 50 km.
- Demand: 80% of surveyed nurses interested in share contribution.
- ROI: Profitability projected by Year 5; break-even point analysis pending final reviews.
Appendix 2: Legal Docs (Samples)
- Cooperative Agreement Clauses: Shareholder voting on major decisions; Proportional dividend distribution.
- Land Title: Ref. to govt. grant copy for 2 acres in [District Y].
Appendix 3: Letters of Support (Examples)
- Nurse Commitment: “Nurses Revision commits 500 alumni to pre-purchase shares…”
- Govt. Endorsement: “Letter from UIA confirming potential tax holiday eligibility…”
Appendix 4: Financial Projection Snippet
Illustrative 5-Yr Balance Sheet Summary (UGX Billions):
| Yr | Assets | Liab. | Equity |
|---|---|---|---|
| 1 | 2.5B | 1.5B | 1.0B |
| 5 | 12.0B | 4.0B | 8.0B |
*Illustrative, detailed BS available.
Appendix 5: Architectural Plans Overview
- School Blueprint: Classrooms, skills labs, library, offices.
- Hospital Layout: 200-beds (maternity, surgical, pediatric wings), outpatient, emergency.
Renderings available separately.
Appendix 6: Final Notes
- Glossary: Definitions for “tax holiday,” “PPP,” “Cooperative Society.”
- References: Citations for UBOS, MoH, WHO, UNMC.
- Contact Sheet: Board/Lead contact details.
Project Status & Next Steps
This document represents the initial draft proposal, incorporating recent clarifications on tuition structure. We welcome feedback from members and stakeholders to refine the plan.
Amendments will be incorporated into a revised version.
For feedback or inquiries:
WhatsApp: 0726113908