A final Project for World Bank MOOC on PPPs

1. Final Project
Mrs. Geeta V. Poojary
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2. 1 : 650 Health Posts Project, Zambia
2 : Pan African e-Network Project
3 : Zambia : Public Private Partnership in
Telemedicine – A Way to Best
Healthcare Delivery to Remote Areas
The Target Audience : The Govt. of
Zambia
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3. 650 Health Posts Project,
Zambia
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4.  The Ministry of Health, Government of Zambia is
constructing 650 health posts throughout the rural
areas of the country.
 Building of these health posts is in line with
government’s vision of providing equitable access
to cost effective, quality healthcare to all citizens of
Zambia as close to the family as possible.
 The Health Posts will be modern health facilities
comprising of the Health Post itself, an incinerator,
solar power system, four toilets, one staff house,
equipment and furniture, hand pumps, medicines
and dressing materials, among others.
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5.  The Government of Zambia has plans to
upgrade all district hospitals into general
hospitals while Provincial hospitals would be
upgraded to Central and teaching hospitals.
 To correspond with the construction of these
health Posts, the Ministry will have to train
health professionals to work in these facilities,
thus the upgrading of all Provincial hospitals
into training institutions.
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6.  The project is expected to be completed in
April 2016.
 Under the project, 208 health posts will be
constructed in the Copperbelt and Eastern
Provinces, 195 health posts will be constructed
in the North-Western, Northern, Muchinga and
Luapula Provinces and 247 health posts will be
constructed in the Western, Southern and
Lusaka Provinces of Zambia.
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8. Pan African e-Network
Project
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9.  Pan-African e-Network Project is the project of distance
education and tele-medicine set up by the Government
of India in Africa.
 The basic objective of the Pan-African e-Network
project is to assist Africa in capacity building by way of
imparting quality education to students in various
disciplines from some of the best Indian Universities
/Educational Institutions.
 Besides, this would provide Tele-Medicine services by
way of on line medical consultation to the medical
practitioners at the Patient End Location in Africa by
Indian Medical specialists in various disciplines
/specialties selected by African Union for its Member
States.
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10.  The Pan African e-Network Project was conceived by
former President of India, Honorable Dr. A.P.J. Kalam.
 The Ministry of External Affairs, Government of India
is the nodal ministry for the project while
Telecommunications Consultants India Limited (TCIL)
is implementing the project on a turnkey basis.
 Tele-Medicine consultations are being conducted from
Super-Specialty Hospitals from India to the African
countries on need basis. Moreover, regular Continued
Medical Education (CME) sessions have been started
with effect from 22nd April, 2009 from 11 Indian
Super-Specialty Hospitals.
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12.  Second phase of the project was inaugurated on
16-08-2010 and included Zambia.
 Details of the project are available on Youtube at the
following link :
https://www.youtube.com/watch?v=eBUmdnab9io
 The project envisages connecting all African nations of
the African Union by a satellite and fiber optic network
that would provide effective communication for Tele-
education, Tele-medicine, Internet, Videoconferencing
notably diplomatic communications (VVIP) and VoIP
services and also support e-Governance, e-Commerce,
infotainment, resource mapping, meteorological
services etc.
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13. Zambia : Public Private
Partnership in Telemedicine –
A Way to Best Healthcare
Delivery to Remote Areas
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14.  The 650 health posts will be ready by April
2016.
 Now, let us consider extending the
telemedicine facility, which is at present being
extended to Zambian hospitals, to all these 650
health posts. A PPP Project? (Need)
 With this PPP Project, the telemedicine facility
will reach remote areas of Zambia. (Need)
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15.  The 650 health posts can be converted into 650
Telemedicine Posts with this PPP Project.
 The Ministry of Health, Government of Zambia
can examine this proposal. If not all 650 health
posts, even if half of them are converted into
Telemedicine Posts, lot of rural folks will be
benefitted.
 The basic infrastructure is already available which
is being put in place by way of 650 Health Posts
Project. Thus to that extent the PPP project
becomes economical as there is no need to spend
on these facilities which are being put up thorugh
health post project.
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16.  The current project of 650 Health Posts will serve
the basic needs of the people in the remote area of
Zambia.
 However, in case of complications in child birth or
any other complications, these Health Posts will
have to send the patients to District level hospitals.
 However, with a little upgradation in the facility
and telemedicine facilities, lives of many people
can be saved with the help of advice from doctors
from superspecialty hospitals from India. (Doing
things differently)
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17.  The Government of Zambia (GOZ) can invite
private companies and place the idea in front of
them and invite their responses.
 The private partners will critically examine the
proposal and come up with their suggestions.
 Based on the initial discussions, a consultant can
be commissioned to study the proposal and
prepare a detailed feasibility report.
 GOZ can then internally discuss in the Parliament
or at any other level about the support to the
Project from GOZ. (Political Champion)
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18.  Since this is a project which is for the rural
people from the remote area, definitely World
Bank can be approached for concessional loan
under IDA, as all beneficiaries of the project
will not be able to bear the cost initially.
(Economics)
 However, as the project would save lives,
create jobs which will result in upliftment of
rural people and their standard improves, they
will be able to pay for the telemedicine
services.
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19.  Once partial funding is decided, GOZ can invite
tenders from private partners, local as well as
international, for converting Health Posts into
Telemedicine Posts, covering all 650 health posts or
dividing them into different smaller lots. (transparent
bidding process.)
 Initially these projects need to be made concessional by
GOZ by extending subsidy as this project will be a
social upliftment project. (Responsibility of Public
Sector)
 This is similar to water supply project in Benin referred
to in the Video talks during Week 3 of World Bank PPP
Project course, where the Government of Benin chose
to put in a grant.
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20.  While execution risk may be taken care of by
involving reputed contractors with excellent
track record, the revenue risk will be a major
risk which can convert this project into a
failure. (identification, mitigation and
allocation of risks)
 GOZ will need to shoulder this risk. It may
market this project as corporate social
responsibility project for high end corporates.
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21.  As the health posts will be ready next year,
which means basic infrastructure facility will
be ready.
 The PPP Project will take care of network
connection to the Pan African e-Network.
 Zambia as also some of Zambian hospitals are
already connected to the Pan African e-
Network.
 The project will involve extension of the
connection to the remote areas of Zambia.
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22.  As basic facility will be available at each site,
installation of equipment for network connection is
required to be taken care of.
 The project will comprise less of basic construction
and more of installation of IT hardware
equipment and related software. (responsibilities
of private partner)
 The contracts can include all clauses pertaining to
execution, arbitration, force majeure, termination,
etc. as per international standards, which is the
case for existing Zambian contracts.
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23.  Zambian Ministry of Health can monitor the project
execution with the ICT Ministry. (Monitoring)
 After execution, the private partner can manage the
telemedicine posts.
 The posts can function as health posts for ordinary
health problems, by either charging low fees or no fees.
 Whenever special advice is required, the posts can act
as telemedicine posts by using the network
connectivity and seeking advice of the medical
professionals from Lusaka or India.
 For this facility, part of the fee may be borne by the
government by way of grant to make the project viable.
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24.  This may look like a unreal or fancy project.
One may call this a flight of imagination.
 However, the mileage which a project
authority can gain from this project will be
immense.
 The project will result in a very high class
medical assistance at the grassroot level!
 If really implemented, this project will be a
model for whole of Africa!
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25.  Video talks, Resources provided by the World Bank Group
 https://www.facebook.com/mohzambia/posts/169477889893543
 http://www.lusakatimes.com/2013/07/03/three-indian-firms-win-
tenders-to-construct-650-health-posts-in-zambia/
 http://www.moh.gov.zm/press/the-status-of-the-650-health-posts-
being-constructed-across-the-country/
 http://www.panafricanenetwork.com/
 https://www.youtube.com/watch?v=eBUmdnab9io
 http://pages.au.int/infosoc/pages/pan-african-e-network-paen-tele-
medicine-and-tele-education
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26. THANK YOU
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