how to enhance private sector participation in achieving public health goals: what we can learn from...
TRANSCRIPT
How to Enhance Private Sector Participation in Achieving Public Health Goals: What We Can Learn from India
Suneeta Sharma, PhD, MHAAugust 26, 2010
Outline• Context: challenges and
opportunities
• Building public private partnerships: a policy approach
• Three examples
• Voucher system
• Mobile health clinic
• ASHA Plus scheme
• Equitable policy reform
Photo by Suneeta Sharma
Challenges• High maternal mortality, infant
mortality, and total fertility rates
• Use of FP methods and institutional facilities for deliveries is the lowest among poor
• Out-of-pocket expenditure on reproductive and child health (RCH) services in both government and private facilities is high
• Enormous access barriers to the poor
• Health expenditure – major cause of poverty
• Staff vacancies, lack of trained staff
• Difficult geographic terrain, remote populations
Photo by Michael Foley
Opportunities• Enabling environment under
National Rural Health Mission
• Emphasis on reducing inequities and improving access to MH and FP services
• Capitalize on private sector market presence
• Private sector is preferred provider of choice in both urban and rural areas
• Increased demand for high-quality healthcare services
Photos by Suneeta Sharma (top) and Meena Kadri (bottom)
Both Public and Private Sectors Have Important Roles to Play
Public-private partnerships provide opportunities for:
Creating Competition Achieving
Economies of Scale
Using Existing Capacity
Expanding ServiceDelivery Network
Targeting The Poor
Capitalizing on Strengths
Mobilizing Resources
Building Public-Private Partnerships: A Policy Framework
Balance public-private sector roles
Create an enabling environment
Share information, foster dialogue, and develop a common understanding of
health system goals
Understand the market and
policy environment
Build public-private partnerships
Using a Systematic Process of Building PPP Models
Develop strategicoptions
Develop strategicoptions
Ensure sustainablefinancing
Ensure sustainablefinancing
Establish links withpolicy framework
Establish links withpolicy framework
Develop costed scale up strategy
Develop costed scale up strategy
Evaluate impactEvaluate impact
GovernmentLeadership and
Ownership
Design and testappropriate
models
Design and testappropriate
models
Prioritize needsPrioritize needs
Determine shared goals
Determine shared goals
Engage right partners
Engage right partners
Effective Public-Private Models to Achieve Health Equity Goals
• Voucher system
• Social marketing
• Social franchising
• Mobile health vans
• ASHA Plus program
• Contracting out
Photo by Suneeta Sharma