Unihealth Consultancy Ltd Management Discussions

Global Economy

The global economy is projected to grow at 3.0% in 2025 and 3.1% in 2026 as per IMF World Economic Outlook, reflecting resilience amid persistent uncertainty. Growth remains below the pre-pandemic average as global trade distortions, elevated tariff risks, and geopolitical tensions continue to weigh on activity. At the same time, moderating inflation and improved financial conditions are expected to provide some support to recovery.

While risks remain tilted to the downside, progress in trade negotiations and structural reforms could enhance predictability and confidence. The overall outlook suggests a steady but moderate pace of expansion, with sustained global cooperation and policy stability being critical for ensuring long-term growth momentum.

Indian Economic Overview

Backed by improving economic fundamentals and a strong policy push to boost consumption spending through tax exemptions and easing monetary policy, India is expected to grow between 6.4% and 6.7% in FY2025–26 under the baseline scenario, according to Deloittes

India Outlook. Easing inflation is set to bolster consumer confidence and purchasing power, while range-bound oil prices are likely to keep inflation in check and improve the current account balance. Strong domestic demand, led by private spending and supported by private investments, is projected to lift GDP beyond its pre-COVID trend. Indias growth will also be tied to global trends, with rising geopolitical uncertainties and trade disruptions likely to affect exports. Domestically, the focus must be on raising per capita income, employment generation, and upskilling, with broader access to AI and digital skills essential to sustain future momentum.

Industry Overview

Global Healthcare Industry

The global healthcare industry in 2025 is at an inflection point, balancing constrained budgets, workforce shortages, and clinician burnout with the need for efficiency, productivity, and patient-centric care. As highlighted in Deloittes global healthcare outlook, more than 70% of C-suite executives across developed markets identify improving operational efficiency as their top priority for the year. Digital transformation is expected to be the most significant driver of change. Nearly 90% of global executives anticipate faster adoption of digital platforms in 2025, with strong focus on electronic medical records, enterprise systems, and emerging technologies such as AI, machine learning, and predictive analytics. Generative AI and autonomous "agentic AI" solutions are poised to automate administrative tasks, enhance productivity, and lower costs, while AI-enabled imaging is already reshaping diagnostics.

Challenges remain around workforce gaps, data integrity, and patient trust in AI-driven care. However, with rising investment, stronger collaboration, and rapid innovation, the industry is steadily shifting toward efficient, digital-first, and consumer-focused models.

Market Snapshot

• Global healthcare services market: US$ 8.77 trillion (2024); projected US$ 11.22 trillion by 2029 (CAGR 4.9%).

• Employment: 48+ million people globally, with over 2 million jobs added in 2024.

• Innovation: 1.9 million+ patents, growing at 2.6% annually.

• Investment: Average funding round value exceeds US$ 43 million, backed by 76,000+ active investors.

African Healthcare Industry

The healthcare landscape in Africa is poised for significant transformation. Despite ongoing challenges, there are numerous opportunities for innovation and improvement. Despite holding nearly 18% of the global population, Africa accounts for less than 1% of global health expenditure and just 3% of the worlds healthcare workforce, while carrying 24% of the global disease burden.

Healthcare Providers sector revenue is expected to hit US $82.9 billion in 2025, with growth continuing at 5.7% CAGR through 2029, reaching around US $103.6 billion.

Key Structural Challenges include:

• Demographics & Disease Burden, a youthful population that faces a dual disease burden, wherein while infectious diseases remain significant, the non-communicable diseases (NCDs) like diabetes, hypertension, and cancer now account for 37% of deaths in sub-Saharan Africa.

• Workforce and Infrastructure Constraints: Many countries fall far short of the WHOs recommended threshold of 4.45 health workers per 1,000 people.

• Financing Gaps: The Abuja Declarations 15% health budget target continues to elude many nations. Infrastructure remains underdeveloped, with only ~1.5 hospital beds per 1,000 people and fewer than 5 CT scanners per million—far below global averages.

• Out-of-Pocket Costs: In many countries, over 30% of health expenses come directly from patients—well above the recommended threshold of 15–20%

Key Trends:

Efforts to expand health insurance coverage will gain momentum, aiming to reduce out-of-pocket expenses and improve access to essential health services. Countries like Morocco, Ghana, and Kenya are making strides with their National Health Insurance Schemes, which are expected to cover a larger portion of the population by 2025. Successful UHC initiatives will lead to better health outcomes and reduced poverty levels due to healthcare costs.

Focus on non-communicable diseases (NCDs): Public health initiatives play a crucial role in combating non-communicable diseases (NCDs) such as diabetes, hypertension, and cardiovascular diseases. The WHOs Global Action Plan for the Prevention and Control of NCDs aims to reduce premature deaths from NCDs by 25% by 2025. This includes promoting healthy lifestyles, improving access to essential medicines, and integrating NCD care into primary health services.

Expansion of digital health technologies: Digital health technologies are set to revolutionize healthcare delivery across Africa. From telemedicine to mobile health apps, these technologies are enhancing access to healthcare services, especially in remote areas. For instance, the use of telemedicine platforms like Babyl in Rwanda has already shown promising results in providing remote consultations and reducing the burden on physical healthcare facilities. The integration of electronic health records and AI-driven diagnostic tools will further streamline healthcare delivery and improve patient outcomes. The healthcare landscape in Africa is on the brink of a transformative era. To achieve progress, it is essential for governments, private sector players, and international organizations to collaborate and invest in sustainable healthcare solutions.

Indian Healthcare Industry

The healthcare sector is one of Indias largest and fastest-growing industries, both in terms of revenue and employment. It spans hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance, and medical equipment. Growth is being propelled by expanding coverage, improved service delivery, and rising public as well as private investments. According to IBEF, the sector is not only a critical pillar of the economy but also one of the most dynamic in terms of innovation and employment generation.

Market Landscape and Growth Drivers

• Employment Backbone: The sector employs over 7.5 million people and is expected to generate more than 6 million additional jobs by 2030, particularly in health-tech and digital care.

• Government Push: Public healthcare spending is projected to reach nearly 2% of GDP, supported by flagship schemes like Ayushman Bharat and expanding digital health infrastructure. More than 70 crore digital health accounts have already been created.

• Technology Integration: Telemedicine and digital health are transforming care delivery. The telemedicine market is expected to touch over US$5 billion soon, while the digital health market is projected to grow at high double-digit rates through the next decade.

• Health Insurance Expansion: Health insurance continues to deepen its share, contributing one-third of overall general insurance premiums, reflecting rising awareness and adoption.

• Medical Tourism Growth: India attracted over 600,000 foreign medical tourists in recent years, making it one of the top global destinations for affordable, high-quality treatment.

• Pharmaceutical Strength: Pharmaceuticals remain a cornerstone, with India supplying affordable medicines worldwide. Export growth potential is immense, with a multi-fold expansion projected over the next two decades.

Alignment with Industry Trends

UniHealth has been able to leverage favorable industry dynamics across its operating geographies. The rising global emphasis on digital transformation in healthcare aligns with the Companys ongoing investments in advanced medical technologies, electronic health systems, and AI-driven care solutions. In Africa, where health financing challenges and dependence on imported pharmaceuticals persist, UniHealths integrated model of hospitals, consultancy, and pharmaceutical distribution enables it to bridge critical gaps while offering cost-efficient solutions. In India, expanding digital health infrastructure, and strong growth in medical tourism and insurance adoption provide significant tailwinds to UniHealths expansion strategy in Navi Mumbai, Nashik, and Pune. Together, these macro and sectoral trends reinforce the Companys ability to scale sustainably while delivering accessible, patient-first healthcare across India and Africa.

Review of Operations

Over the past several years, the Company has consistently outpaced market growth by focusing on its ‘Patients First initiatives and strengthening its position through collaborations with leading medical professionals, expanding its geographic reach, investing in advanced technologies aimed at upgrading its infrastructure and taking steps aimed at excelling in the delivery of clinical care to its patients. The Company, over the years has and continues to partner with leading manufacturers of medical consumable and pharmaceutical products, aimed at increasing the portfolio of its export and distribution vertical with the dual aim of reducing the cost of inventory for its captive consumption and providing supplies to other healthcare facilities in the markets of its presence. As part of its ongoing business review, the Company has exited operations at UMC Zhahir Hospital, Kano, Nigeria, which had been established in 2017.

Business Performance

Hospitals & Medical Centers

UniHealth is a leading healthcare provider in Africa., Operating its network of hospitals and medical centres under the brand ‘UMC

Hospitals, the company continues to strengthen its footprint across Africa and India. The Group currently owns and operates the 120-bedded UMC Victoria Hospital in Kampala, Uganda and is set to commission facilities in Mwanza (Tanzania), Navi Mumbai

& Nashik (India) during FY 2025-26, adding nearly 300 beds to its commissioned strength. In addition, addition of another 100 beds in Tanzania is presently under consideration.

Outlook – Africa:

UMC Victoria Hospital in Kampala remains the flagship private tertiary care hospital, with recent upgrades in orthopedics, spine, IVF, and planned ophthalmology services. UniHealth is expanding its presence with 8–10 spoke clinics in Uganda and a 20-bedded secondary facility in Mwanza, Tanzania. Advanced discussions are underway for a 100-bedded tertiary hospital in Dar es Salaam, supported by a 40,000 sq. ft. expansion. By FY25-end, 125–150 new beds are expected to be added across Africa.

Outlook – India:

UniHealth is entering the domestic healthcare delivery space through Maharashtras golden triangle (Mumbai–Pune–Nashik). The 50-bedded Navi Mumbai hospital is scheduled to be commissioned in September 2025, followed by a 175–200 bed facility in Nashik in Q4 of the ongoing FY. Two hospitals in Pune, with a combined bed strength of 250–300 beds are being planned for FY 2026-27. By FY28, India is expected to contribute over half of UniHealths targeted 1,000-bed capacity, driven by advanced medical technology and patient-centric care.

Healthcare Consultancy

UniHealth provides consultancy for healthcare projects, leveraging expertise in hospital planning, management, and infrastructure development. The Company has delivered end-to-end solutions across

India, Africa, and the Middle East and is presently extending services to projects with a combined bed capacity of nearly 1,300 beds across multiple projects.

Outlook:

The consultancy division is positioned to deliver integrated solutions from concept to commissioning across India and Africa. Current projects include the development of PHRC Health City as a Deemed-to-be-University, having a 650-bedded tertiary care hospital along with a medical teaching facility in Pune, India, and multiple African assignments. Long-term Operations & Management contracts are expected to further strengthen recurring revenues.

Pharmaceutical & Medical Consumables

UniHealth serves as an authorized distributor for medical consumables and pharmaceuticals, exporting from India to multiple African countries.

Outlook:

Through partnerships with an increasing number of India-based manufacturers, UniHealth supplies pharmaceuticals and consumables across Africa. The division is focused on expanding distribution rights, strengthening partnerships, and diversifying its product mix to support both internal hospitals and external healthcare providers.

Medical Value Travel (MVT)

UniHealth facilitates medical travel for international patients seeking specialized treatments in India.

Outlook:

MVT facilitates cross-border patient referrals from Africa to India, providing end-to-end services from consultation to post-travel care. This division complements Unihealths broader healthcare operations by enhancing patient trust and reinforcing its integrated healthcare ecosystem.

Financial Highlights

In FY25, Unihealth Hospitals Limited sustained its growth trajectory, delivering solid financial results across key performance metrics.

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Particulars	FY24 ( Cr)	FY25 ( Cr)	YoY Growth
			(%)
Total Income	48.75	55.59	14.0%
Other Income	1.60	2.82	76.3%
Total Income	50.35	58.41	16.0%
Total Expenditure	31.07	37.10	19.4%
EBITDA	19.28	21.32	10.6%
PAT	10.31	15.14	46.9%

Geographically, the companys revenue in FY25 was dominated by Uganda, contributing 74.45% of total revenue. India accounted for

15.81%, followed by Nigeria at 7.71%. The UAE contributed 0.73%,

Tanzania 1.10%, and Mauritius 0.20%. This distribution underscores the companys strong market position in Uganda while maintaining a diversified international presence across multiple regions.

In FY25, , Unihealth Hospitals Limiteds revenue composition was led by the Medical Centres & Hospitals segment, contributing

82.19% to total revenue. Export & Distribution of Pharmaceuticals &

Medical Consumables followed at 8.67%, while Consultancy Services accounted for 4.31%. Medical Value Travel contributed 4.83%, with Other Income forming a minimal share. This distribution reflects the companys continued dominance in core healthcare operations, while also maintaining steady contributions from its diversified service verticals

Ratio Analysis
Particular	FY24	FY25
Net Profit Margin (%)	20.47	25.92
Debt to Equity (Times)	0.18	0.13
Interest Coverage Ratio (Times)	5.04	12.09

• Conservative Capital Structure: Debt-to-equity improved to

0.13x from 0.18x; interest coverage rose to 12.09x from 5.04x, indicating strong debt servicing ability.

• Healthy Return Metrics: ROE stood at 16.03% and ROCE at

16.61%, reflecting efficient capital deployment amid expansion.

• Efficient Collections: The Companys disciplined collection cycle remains low, ensuring faster receivable turnover and reduced credit risk despite higher institutional business.

• Robust Liquidity: Cash and bank balances stood at 14.64 crore at year-end, with sufficient buffers to support growth plans.

• Working Capital Discipline: While trade receivables increased with revenue growth, strong collection practices and a short cycle continue to support cash flow stability.

While receivables increased in line with revenue growth, liquidity remained comfortable with 14.64 crore in cash and bank balances. Overall, prudent leverage, consistent profitability, and disciplined working capital management position Unihealth well to fund its growth while maintaining financial flexibility

Risks and Concerns

The Company operates in multiple geographies, exposing it to diverse regulatory regimes across India and Africa, which increases compliance costs and adds to operational complexity. A significant dependence on imported consumables and medical equipment also makes operations vulnerable to foreign exchange volatility, supply chain disruptions, and tariff-related risks. Fiscal constraints in several African countries, along with declining donor aid and limited healthcare budgets, may further impact patient affordability and demand. Additionally, a high revenue concentration in Uganda continues to be a structural risk, as any economic or regulatory disruption in this market could materially affect overall earnings.

Execution risks also remain relevant for ongoing and upcoming projects across India and Africa, with potential delays, cost overruns, and shortages of skilled manpower posing challenges. Dependence on the availability and retention of qualified doctors, nurses, and other healthcare professionals is a critical factor in talent-scarce and highly competitive markets. Rising receivables and increasing working capital requirements could exert pressure on liquidity, despite the Companys low debt-to-equity position. Furthermore, global macroeconomic and geopolitical uncertainties—such as inflationary pressures, currency depreciation, and trade disruptions—may affect patient flows, cost structures, and investment sentiment, underscoring the need for prudent financial and operational risk management.

Human Resource Development

Human Resource Development (HRD) remains a critical enabler of UniHealths expansion strategy across Africa and India. The Company recognizes that the success of its healthcare delivery model is rooted in the skills, commitment, and engagement of its workforce. Accordingly, UniHealth continues to strengthen its human capital framework by investing in local talent development, capacity-building programs, and employee engagement initiatives that align with its long-term growth objectives.

Key HR Initiatives in FY25

1. Capacity Building and Structured Training Programs

UniHealth invests in specialized training modules across hospitals in Africa and India in intensive care, diagnostic imaging, surgical support, and CME with regional and international institutions. In

FY25, structured leadership and management training has been introduced to develop future healthcare leaders.

2 Job Creation and Local Employment Opportunities

• Africa: Expansion projects to generate 600+ jobs across medical, technical, and administrative functions, with priority on local recruitment.

• India: With the upcoming 50-bedded flagship facility in

Navi Mumbai and 200-bedded facility in Nashik in FY25-26, recruitment is underway. Planned expansions over 24 months to create 500+ new positions.

3. Cross-Border Talent Development

Knowledge transfer initiatives between Africa and India promote collaboration, technical expertise, and best practices in patient care.

4. Employee Retention and Career Development

Engagement and retention strategies include career progression plans, professional development, and competitive compensation to strengthen UniHealth as an employer of choice.

Future Plans for Human Resource Development

1. Strategic Workforce Planning

• Africa: Workforce pipeline aligned through structured recruitment, skill-gap mapping, and local hiring.

• India: Expansion in Navi Mumbai and Nashik supported by AI-driven HR platforms for recruitment, training, and performance management.

2. Leadership Development & Succession Planning

• Africa: Regional Leadership Hubs to groom middle managers and reduce reliance on expatriates.

• India: Senior management to continue programs at ISB, IIMs, and premier institutions.

3. Cross-Border Knowledge Exchange

India–Africa training and staff exchange programs for best practices in care, technology, and hospital administration.

4. Diversity, Inclusion & Well-being

Aligned with ESG goals, UniHealth is enhancing womens leadership roles, wellness programs, and inclusivity.

5. Career Progression & Retention

Career roadmaps with global certifications, professional development, and retention policies to position UniHealth as a long-term career partner.

Challenges and Opportunities

1. Challenges

• Talent Retention: Retaining top talent remains a critical challenge, especially in competitive Indian markets and high-demand African regions. With new facilities coming online, ensuring long-term engagement requires continuous investment in employee experience, professional growth opportunities, and retention-linked rewards.

• Cultural & Regional Diversity: Managing a geographically dispersed workforce across India and Africa presents challenges in maintaining consistent HR practices. UniHealth continues to strengthen cross-cultural training and integrated HR policies while fostering inclusivity across all levels.

• Resource & Skill Gaps: In several African regions, shortages of trained professionals and limited training infrastructure persist. UniHealth is addressing this by scaling digital learning platforms, simulation-based training, and academic partnerships to build specialized local capabilities.

• Technology Adoption: While HR digitization is a priority, challenges around integration, adaptability, and digital literacy exist. Ensuring smooth adoption of AI-driven HR platforms and e-learning solutions remains a focus area.

2. Opportunities

• Strong growth prospects in Indias healthcare market, projected to expand from US$372 billion in 2023 to US$638 billion by 2025, supported by insurance penetration, medical tourism, and digital health adoption.

• Significant potential in Africas US$259 billion healthcare market, with demand for over three million new hospital beds by 2030 and heavy dependence on imported pharmaceuticals.

• Integrated business model spanning hospitals, consultancy, distribution, and medical value travel creates synergies and diversifies revenue streams.

• Expansion in India through new facilities in Navi Mumbai,

Nashik, and Pune, targeting over 500 beds by FY27, which will reduce geographic concentration and strengthen domestic presence.

• Asset-light growth strategy under the Design–Build–Operate and leased-hospital model allows for scalable capacity addition with lower upfront capital investment.

• Strategic partnerships with an increasing number of medical consumable and pharmaceutical manufacturers and tie-ups with international airlines enhance supply chain reliability and patient referral networks.

• Medical value travel poised to grow in line with Indias medical tourism market, expected to reach US$14.3 billion by 2029.

• ESG-led initiatives such as solar energy adoption, comprehensive waste management, and 95%+ local employment in Africa reinforce sustainability and brand goodwill.

Internal Control System & Its Adequacy

The Company has established a comprehensive internal control system that is commensurate with its size, scale, and growing complexity of operations. These controls are designed to ensure operational efficiency, compliance with applicable laws, reliability of financial reporting, and safeguarding of assets. The framework integrates documented policies, SOPs, process guidelines, and segregation of duties, supported by both manual oversight and increasing reliance on automation and digital monitoring tools.

During FY 2024–25, the Company further enhanced its control environment by strengthening technology-enabled processes, expanding audit coverage, and refining compliance monitoring mechanisms. Senior Management conducts periodic reviews of the systems adequacy, with key findings discussed with Internal and Statutory Auditors, ensuring that corrective measures are implemented promptly.

Internal audits are carried out by an independent firm of Chartered Accountants under a risk-based audit plan, formulated in consultation with operating divisions. These audits assess the design and effectiveness of controls and recommend improvements wherever required. Audit findings are reviewed by Management and presented quarterly to the Audit Committee of the Board, which includes independent directors. The Audit Committee actively evaluates significant observations, monitors action plans, and ensures accountability across business functions.

For the year ended March 31, 2025, Management has evaluated the adequacy and effectiveness of internal controls over financial reporting. Based on this review, the internal controls were found to be robust and operating effectively. The Statutory Auditors have also confirmed the adequacy and operating effectiveness of these systems, reaffirming the Companys commitment to strong governance, risk management, and compliance practices.

Cautionary Statement

The Companys objectives, projections, outlook, expectations, estimates, and other information expressed in the Management Discussion and Analysis may be considered forward-looking statements under applicable securities laws and regulations. These statements are based on certain assumptions that the Company cannot guarantee. Several circumstances, some of which the Company may not have direct control over, could have a substantial impact on the Companys operations. As a result, actual results may differ materially from such projections, whether expressed or implied, because it would be beyond the Companys ability to successfully implement its growth strategy. The Company assumes no obligation or responsibility to update forward-looking statements or to publicly amend, modify, or revise them to reflect events or circumstances that occur after the date of the statement on the basis of subsequent development, information, or events. The Management of Unihealth presents below an analysis of its performance during the year under review, i.e., accounting year ended March 31, 2025 (for the period April 1, 2024 up to March 31, 2025).