Partnerships

This report summarizes the findings from research examining the role of the private sector in health systems in developing countries and emphasizes the importance of effective stewardship by governments of their country’s health system, especially given the reality that the private (nonstate) part of the system is large and complex, with major challenges and significant opportunities. [adapted from author]

The report is the culmination of a work group tasked with exploring practical and feasible ways for donors and technical agencies to support improvements in public-private interaction in developing countries as a means to accelerate the achievement of widely agreed-upon social objectives: reduced mortality and expanded and more equitable access to health services and essential medicines and products. [from author]

This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model for health services to private providers that has been in place for almost 10 years in Mexico. [adapted from abstract]

This brief provides a retrospective view of the Project’s contributions and recommendations in the area of global partnering. [from author]

This report provides a short summary of the key discussion points from a meeting in Addis Ababa, Ethiopia on the 10th and 11th of January 2008. The meeting followed on from the launch of the WHO Guidelines on Task-Shifting and was attended by participants who are actively involved in addressing HRH. [adapted from author]

In response to the critical HRH shortages in Africa, the UK Department for International Development (DFID) and Office of the US Global Aids Coordinator (OGAC) have been in discussion with a number of African countries to develop strategies and country level actions. The aim is to demonstrate the maximum flexibility of disease specific programmes to support broad based primary care in line with countries’ health plans. This report presents a summary of the main findings from the country visit to Kenya. [from introduction]

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]

In this paper, we describe the design, development and implementation of a public-private partnership for managing urban health services in Ahmedabad city, Gujarat. Our model has succeeded in bringing together compatible public and private partners to plan and deliver quality healthcare services to meet the community needs of Vasna ward, in Ahmedabad. [from abstract]

This article describes issues raised by the deployment of civil servants through the public-private partnership for health to work in private-not-for-profit health facilities in Kibaale region of Uganda. [adapted from abstract]

This presentation describes the issues faced and the measures employed by the Provincial Government Western Cape Department of Health regarding nursing shortages. It describes the issue of contracting with private agencies for nurses and details how the PGWC Department of Health managed this challenge.

Contracts can be used to govern the relationship between the public and the private sectors where the private sector delivers services on behalf of the state. On occasion, this allows the state to offer services such as basic medical provision where public sector provision does not reach. Researchers examine the case of primary care in South Africa where such contracts are being utilised. [from author]

This toolkit provides practical advice to anyone involved in, or who is interested in becoming involved in, performance-based contracting of health services with nonstate providers in the context of developing countries. It addresses many of the issues that may be encountered and provides input from experienced contracting professionals, many of whom contributed to the development of this toolkit. [adapted from introduction]

This presentation discusses the current climate and prospects for health partnerships between the private and public sectors in Africa. [from presentation]

Contracting out public services is a way for governments to complement their own delivery of services. It is particularly effective for high risk or hard-to-reach populations that can be more effectively served by private groups. It can also contribute to more efficient delivery of primary health care. [from introduction]

Contracting NGOs to manage the primary health care system was found to be an effective means to increase service coverage and achieve a more pro-poor distribution of services in rural areas of Cambodia. The Ministry of Health (MOH) proposed contracting NGOs to manage the public health care system at the district level using a results-based contract to monitor progress.

This case study looks at the contribution of the Observatório and its members to the development of the public health sector in Brazil. [from introduction]

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

This report describes opportunities for engaging and supporting a well managed and effectively regulated private sector to improve the region’s health. This report highlights the critical role the private sector can play in meeting health care needs in Sub-Saharan Africa. It also identifies policy changes that governments and international donors can make to enable the private sector to take on an ever more meaningful role in closing Africa’s health care gap. [adapted from publisher]

This guide offers policymakers and researchers the latest evidence on private-provider networks and franchises, lessons learned in the field, and policy recommendations on how to mobilize private-provider networks and health franchises to help address reproductive health care needs in developing countries. [adapted from publisher]

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

This edition focuses on the role of the private sector, a part of the health system that has not previously been accorded extensive coverage in the SAHR. The contrast between the public and private sectors remains stark in many facets and the deepening inequity is cause for profound concern. The significance of the private sector cannot be underestimated both with regard to its potential contribution to the health and well-being of this country’s people, as well as its role in drawing resources (financial and human) from the public sector. [from foreword] Chapter 6 provides an overview of health information systens in the private health sector from a legilateive and operational perspective.

In responding to the goal of rapidly increasing access to antiretroviral treatment (ART), the government of Botswana undertook a major review of its health systems options to increase access to human resources, one of the major bottlenecks preventing people from receiving treatment. In mid-2004, a team of government and World Health Organization (WHO) staff reviewed the situation and identified a number of public sector scale up options. The team also reviewed the capacity of private practitioners to participate in the provision of ART. Subsequently, the government created a mechanism to include private practitioners in rolling out ART.

This presentation reviews the global experience of contracting and discusses two spedific examples of contracting in Cambodia and Bangladesh.

The report, in its first part, destroys three common myths regarding the private health care sector in Africa and discusses how to engage the private sector effectively. It provides examples of successful public-private partnerships and highlights some of the trends in these types of partnerships. [adapated from executive summary]

The World Bank commissioned the Center for Development Communication (CDC) to develop a communication strategy to help boost public-private partnerships in the African continent. CDC consulted with key informants and stakeholders identified by the World Bank’s Public-Private Partnerships (PPP) working group in order to develop a stakeholder analysis to help inform the larger communication strategy. This report summarizes the results of that consultation. [from executive summary]

The Argentine Maternal-Child Health Insurance Program uses an interesting approach of combining output-based contracting with an output-based funding mechanism. Particularly innovative is the combination of enrollment numbers and performance indicators as a way to address the trade off between quantity and quality.

In Asia the majority of tuberculosis (TB) patients get their diagnosis and treatment from private medical practitioners - yet private doctors are notoriously bad at providing adequate TB services. At the same time, public services find it difficult to provide services that are easily accessible to patients. Surprisingly, one approach - public-private partnerships - may address both of these problems. [author’s description]

At the inception of Uganda’s second 5-year Health Sector Strategic Plan (HSSP II), this paper traces the history of the public - private partnership for health (PPPH) in Uganda, giving its justification and mandate. It also gives its current state of the art, outlining the successes scored, the challenges still faced in its implementation and current efforts being made to make it comprehensively institutionalized. [abstract]

Before the project began, 300,000 remote rural inhabitants in the Mayan highlands lacked basic primary care, the NGO civil society in health lacked cohesion, and the MOH NGO granting program needed revising. From 2000 to 2004, the NGO Networks Project implemented a grants program that helped form networks of NGOs, strengthening health services and testing innovations in service delivery, and improved monitoring and evaluation.

This is a guideline to replicate and scale-up a human resources promising practice documented by the Capacity Project for outsourcing human resources services (HRS) to obtain a rapid increase and deployment of the health workforce, making HIV services available in a short period of time, especially in underserved areas.