public private partnership

1. PUBLIC PRIVATE PARTNERSHIP
SUBMITTED TO: MS. SEEMA RANI,
ASSOCIATE PROFESSOR, RCON, JH
SUBMITTED BY : ARUSHI NEGI, M.SC . NURSING I YEAR

2. INTRODUCTION
 In today’s world of complexity and rapid pace it is almost
impossible to do anything alone.
 Due to rising price, changing disease pattern and increasing use
of sophisticated technology for diagnosis and treatment.

3. DEFINITION
 Public: It generally refers to government or organizations
functioning under state budget.
 Private: It refers to the profit/ non- governmental / voluntary
sector.
 Partnership : Its a an agreement between two or more parties. It
reflects the mutual responsibilities of shared interests

4. PUBLIC PRIVATE PARTNERSHIP IN HEALTH CARE.
 It is an approaches to addressing public health problems
through the combined efforts of public private and development
organizations complimenting each other by contributing or
sharing their core competency.
 These are collaborative efforts, between private and public
sectors, with identified partnership structures, shared objectives,
and specified performance indicators for delivery of health
services

5. COMPONENTS OF PPP
 Shared interest or objectives
 Mutual responsibility
1. Shared goals
2. Shared resources (time, money, expertise, people).
3. Shared risks and benefits

6. NEED OF PPP
 Because existing services fails to reach all people
 Government on its own cannot always fully address the most needy
population.
 To set minimum standard for quality of services and legal regulation.
 For mutual benefits(cost,manpower and financial resources.)
 To improve Consumer’s involvement in planning and monitoring of
services
 To commitment for public good
 To avoid duplication

7. PRINCIPLES OF PPP
• Set up common goals and objectives
• Joint decision-making process
• Relative equality between partners
• Accountability and responsibility set out for each partner
• Understanding the strengths and weakness of the partners among themselves
• A high level of trust and confidence
• Benefits to both the stakeholders
• Monitoring and evaluation:
by government departments authorized to do so, based on a standardized scale
by independent agencies/regulators based on a standardized scale
by department or independent agencies, based on the simple criteria of pass and fail
by department

8. OBJECTIVES
 Universal coverage and equity
 Improving quality, accessibility, acceptance and efficiency of
health services.
 Exchange of skills and expertise between the public and private
sector
 Mobilizations of additional services
 Community ownership.

9. OBJECTIVES CONT....
 Improve the efficiency in allocation of resources and additional
resource generation
 Strengthening the existing health infrastructure.
 Widening the range of services.
 Clearly defined sharing of risks.

10. MODELS
Contracting:
 Contracting out : government pays outside individual to
mange a specific function
 Contracting in : government hires individual on a
temporary basis to provide services Eg. Human
resources.

11. MODELS CONT..
Franchising
 Arrangement where one party (the franchiser) grants another party
•Partial franchising
•Full franchising
•Branded clinic
Eg. Butterfly clinic, Titli clinic in bihar,
Social marketing
 A promotional business idea applied to increase awareness about a social welfare
campaign.

12. MODELS CONT...
Joint venture
 It is a business arrangement in which two or more parties agree to pool
their resources for the purpose of accomplishing a specific task. This task
can be a new project or any other business activity.
Voucher scheme
 It is a ticket or piece of paper that can be used instead of money to pay for
something

13. MODELS CONT..
Hospital autonomy
 It is the quality or state of being self- governing, existing or capable of
existing independently.
Partnership with corporate sector/ industrial houses,
 •Eg. CII(Confederation of Indian Industry) , FICCI(Federation of Indian
Chambers of Commerce and Industry)
Involving professional association
 •Eg. IAPSM (Indian Association of Preventive and Social Medicine)

14. OTHERS....
 Donation and philanthropic contributions
 Involvement of social groups and clubs rotary club, lions club
 Partnership with cooperative societies
 Partnership with nonprofit community based organizations
 Running mobile health units
 Community based health insurance

15. EXISTING SCENARIO OF PPP
 Tenth five year plan, national health policy 2002 and other national health
program like RNTCP, NPCB, NLEP, RCH and NRHM initiated under
five basic mechanisms:
 Contacting-in
 Contacting –out
 Subsidies
 Leasing or rental
 Privatization

16. SOME EXAMPLES:
 Partnership between the government and the profit sector
 • Government of Andhra Pradesh has initiated ArogyaRaksha Scheme in collaboration
with New India Assurance Company and with private clinics.
 • It is an insurance scheme fully funded by government.
 • It provides hospitalization benefits and personal accident benefits to citizens below
the poverty line
 • The government paid an insurance premium of Rs. 75 per family to insurance
company

17. PARTNERSHIP BETWEEN THE GOVERNMENT AND THE NON
PROFIT SECTOR
 • Public/private DOTS modelestablished on pilot basis in Hyderabad at Mahavir Trust
Hospital
 • Mahavir Trust Hospital acts as a coordinator and intermediary between govt. and
private medical practitioners
 • PMPs refer TB suspected patient to hospital
 • Govt. benefit as DOTS medicine are not wasted
 • Mahavir Trust Hospital also benefited as their service cure patient

18. CASE STUDIES:
CHIRANJEEVI YOJNA SCHEME
• Launched in Gujarat 2005
• Aim: Improve access of poor families (BPL) to institutional delivery
• Form of partnership: Voucher scheme to involve private providers in delivering maternity care
• Reasons for contracting: High maternal mortality, low institutional delivery, involving large groups of private practitioners
• Financing: NRHM and state budget
• Implementation problems:
 Inadequate awareness among private providers about the scheme benefits
 Shortage of specialists
 Uniform service package impedes handling of high-risk cases
 Monitoring quality of Care
• Challenges:
 With no system of cross checking BPL, the scheme now runs the risk of processing bogus and fraudulent claims.
 According to facility survey conducted under RCH II, at least two of the districts do not have essential obstetric care services.
 None of the private providers were aware of the fact that one pre-delivery visit and an investigation is part of the Chiranjeevi package.

19. ANTICIPATED OUTCOMES
 Cost effectiveness
 Higher productivity
 Accelerated delivery of goods
 Client focused

20. CHALLENGES
• True partnerships in sense of equality amongst partners, mutual commitment to goals,
shared decision making and risk taking are rare affecting quality.
• Absence of representation of the beneficiary in the process
• Lack of effective governance mechanisms for accountability
• Non transparent mechanisms
• Lack of Institutional Capacity to design, contract, monitor PPPs
• Payment Delay
• Local political interference

21. RECOMMENDATION TO ENSURE SUCCESSFUL PPP
• Adequately synchronize the public and private sectors by plugging
existing gaps in health systems policy documents
• Enable government functionaries to structure, regulate and monitor PPPs
• Adherence of PPPs to national health programme protocols

22. SUMMARY
 Through this topic we came to know about public
privat partnership, its objectives, models, existing
scenario.

23. CONCLUSION
 Public and private partnership have a critical role in improving
the performance of health system worldwide, by bringing
together the best characteristic of public and private sectors to
improve efficiency , quality, Innovation and health impact of
both private and public system.

24. BIBLIOGRAPHY
 Kavya, Slideshare, Public private patnership, sep03, 2017
available at : https://www.slideshare.net/KavyaC8/public-private-
partnership-79381548
 gupta subodh, slideshare , public private patnership,
Available from: http://rsbygujarat.org/about_rsby.html