At the health policy dialogue organised by PharmAccess Foundation and Nigeria Health Watch on the 11th April 2019, Ibironke Dada discussed quality as a key element for public-private partnership in Nigeria.

1. Quality: a key element of
viable PPPs
Dr. Ibironke Dada
Director of Quality (Program Director, SafeCare)
PharmAccess Foundation

2. • Government plays a central role in the provision and regulation of
healthcare.
• Explore PPPs to expand access to quality health services by leveraging
capital, managerial capacity, and knowhow from the private sector.
• Well-structured PPPs can create platforms for the private sector to
deliver solutions to health challenges in developing countries.
• Improve quality and efficiency of public health services
• Strong M&E system – baselines and SMART KPIs
• Undergo post-transaction monitoring by government
Background

3. PPP project life cycle
• Procurement
process
• Investor
marketing
Quality

4. Health Service Delivery
Government ensures health care services provided are of
the appropriate quality
Issue
• Weak contract management and oversight by often weak government
institutions
• Often oversight post the award is weak and not a priority for government

5. Quality
Quality
The degree of excellence as measured
against standards
The extent to which an organisation meets
clients’ needs and exceeds their
expectations
Doing the right thing right, the first
time
‘Providing the right care for every
person, every time.’

6. Dimensions of Quality
Technical
Competence
Access To
Service
Effectiveness
Interpersonal
Relations
Efficiency Continuity
Safety Amenities Affordable
All Health PPP
projects must consider
the dimensions of
quality

7. Dimensions of Quality
▪ Client: Effectiveness, accessibility,
interpersonal relations, continuity, and
amenities
▪ Health Service Provider: Technical
competence, effectiveness and safety
▪ Healthcare Manager: Access,
effectiveness, technical competence, and
efficiency are the most important
dimensions of quality.

8. Conditions that Define PPPs
ARRANGEMENT
Between Public and
Private Partners
PROVISION
Of service for public
benefit, by private
sector
INVESTMENT
In and/or management
of public asset by
private sector
TIME PERIOD
For a clearly
defined tenor
RISK SHARING
Optimally between
contracting parties
PAYMENT
Linked to performance
STANDARDS
Focus on standards of
service and
performance
Quality

9. Making a case for a quality partner in PPP projects
Source: Paul vanOstenberg Joint Commission International Work with a
Technical Partner
Lack QI expertise,
what next?
Regulatory approaches to quality

10. Access to Finance Scheme
Fund Providers
(LASG, ETF, BOI)
LASHMAENROLEES
HCP
PAF
(Safecare)
Third Party
Admins
LAGOS STATE MINISTRY OF HEALTH |
HEFAMAA
HCP HCP HCP HCP
Banks
Loans
Capitations
RepaymentFunding
Health
Services
Support
QA/QC
Premiums
LAGOS STATE MINISTRY OF WEALTH
CREATION AND EMPLOYMENT
MCF
Partial guarantee

11. Medical Equipment Leasing Scheme
LAGOS STATE MINISTRY OF HEALTH
LAGOS STATE MINISTRY OF WEALTH CREATION
AND EMPLOYMENT
Beneficiaries: Healthcare Facilities
Equipment Supply, maintenance and
capacity development
Transaction Adviser
OEM Partner
Banking
Partner Technical Adviser

12. SafeCare, Established in 2011

13. SafeCare Service Elements
Management and Leadership
Human Resource Management
Patient & Family Rights & Access to Care
Management of Information
Risk Management
Management
Clinical
ClinicalSupport
Ancillary
In-patient Care
Operating Theater & Anesthetics
Primary Healthcare
Laboratory
Diagnostic Imaging
Medication Management
Support
Facility Management
Determined by scale & scope of
health care services provided

14. Quality is a
Journey, not a
Destination

15. Thank you!