PPP

2.  It is a joint ownership of a program/ proposal
by two or more parties to achieve a common
goal.
 It is a higher level of collaboration.
2

3. PPP in health is an approach 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
This synergy leads to better outcome of goals
3

4.  The term PPP was defined as voluntary and
collaborative relationships between various
parties, both state and non-state, in which all
participants agree to work together to achieve a
common purpose or to undertake a specific
task, and to share risks, responsibilities,
resources, competencies and benefits.
 Public-private partnerships are typically found
in transport infrastructure such as highways,
airports, railroads, bridges, and tunnels.
municipal and environmental infrastructure
include water and wastewater facilities.
4

5.  The term public-private partnerships covers a
wide variety of ventures involving a diversity
of arrangements, varying with regard to
participants, legal status, governance,
management, policy-setting prerogatives,
contributions and operational roles.
 They range from small, single-product
collaborations with industry to large entities
hosted in United Nations agencies or private
not-for-profit organizations (WHO).The
objectives of public-private partnerships
include: 5

6.  The objectives of public-private partnership includes: Developing
a product, e.g. the Medicines for Malaria Venture and the
International AIDS Vaccine Initiative.
 Distributing a donated or subsidized product, to control a specific
disease, e.g. initiatives to distribute leprosy medicines. Concerns
have been expressed about these initiatives as not tackling the
health problems of highest priority, as perceived locally.
 Strengthening health services, e.g. the Gates Foundation/Merck
Botswana Comprehensive HIV/AIDS partnership.
 Educating the public.
 Improving product quality or regulation.
6

7.  Some so-called public-private partnerships could be
more accurately described as public sector programs
with private sector participation. Collaborations in this
category include Roll Back Malaria, Safe Injection
Global Network, and Stop TB (all of which have
secretariats in WHO) and the Global Alliance for
Vaccines and Immunization, which has its secretariat at
UNICEF.
 There are also legally independent “public interest”
(but actually private sector) entities such as the Global
Fund to Fight HIV/AIDS, TB and Malaria.
7

8.  Develop strategies to utilize untapped
resources and strengths of the private sector
 Enhance the capacity to meet growing health
needs
 Reducing financial burden of government
expenditure on tertiary care
 Reducing geographical disparity in provision
of services and its access
 Reaching remote areas; target specific group
of populations
 Improving efficiency through evolving new
management structures 8

9. PUBLIC
SECTOR
PRIVATE
SECTOR

Free Provision of Products
and Services
Unsustainable for
Government &
&Donors
Unsustainable for
Consumers
Profit
Maximization
Break Even 




9

10.  Super-ordinate Goal
 High perceived pay-off to both
parties
 Equal power with both parties
 Mutual Trust
10

11.  Joint action at all stages
 from planning, follow up and termination
 Complimentary roles
 expectation of each other are clarified and
stabilized
 Creation of a temporary system
 task force with representatives from both
sides
 Continuous Communication
 lines of communication between partners to
be always kept open
11

12. PPP is Seeking collaboration with private
sector in the situations where the public
health system is not immediately able to
provide guarantee.
12

13.  Historically, governments have engaged the
private sector to deliver services
through healthcare PPPs to achieve one or
more of six functions:
 Finance – financing or co–financing of the
project
 Design – design of the project, including design
of the infrastructure and care delivery model
 Build – construction or renovation of facilities
included in the project 13

14.  Maintain – maintenance of hard infrastructure
(facilities as well as equipment as applicable)
 Operate – supply of applicable equipment, IT
and management/delivery of
nonclinical services
 Deliver – delivery and management of
specified clinical and clinical support services
14

15. The majority of facility–based PPPs bundle these
functions into three models:
 Infrastructure–based model – to build or
refurbish public healthcare infrastructure
 Discrete Clinical Services model – to add or
expand service delivery capacity
 Integrated PPP model – to provide a
comprehensive package of infrastructure
and service delivery
15

16. 16

17.  It has a desired health outcome.
 It means to achieve better community health
 It is a specific strategy to achieve better
community health.
17

18.  Global Alliance for Vaccine and
Immunization
 Global Polio Eradication Initiative
 European Partnership Project on Tobacco
Dependence
 UNAIDS/Industry Drug Access Initiative
 Stop TB Initiative
 Roll Back Malaria
18

19.  Cost containment
 Effective use of private resources
 Logical diversion of public resources
 Synergy to reduce duplication
 Resource mobilization
19

20.  Franchising
 Branded Clinics
 Contracting Out
 Contracting In
 Social Marketing
 Donations
 Social Club Partnerships
 Involvement of Corporate Sector
20

21. One time/short partnership Donation of land, money,
equipments etc
Participation in campaigns
Continuous long term
partnership
Social franchising of
service
Contracting in and out
Social marketing
Capacity building
21

22. Service oriented Social marketing
Social franchising
Contracting health care providers
Mobile vans
Information/advocacy oriented Contracting out IEC activities to
NGO’s
Category campaign with private
partners
Infrastructure oriented Construction of buildings
Repair of buildings
Donation of equipments
Vehicles etc
Capacity Building Training for skill enhancement and
counseling
Sponsoring conferences for
management capacity
22

23.  Capacity of Private Partner
 Advocacy
 Accreditation
 Regulation by the Government
23

24.  Clarity of Purpose
 Creation of value
 Congruency of Mission, Strategy and
Values
 Connection with purpose and people
 Communication between partners
 Continual learning
 Commitment to the partnership
24

25. Looking ahead, healthcare systems will be under
ongoing pressure to increase quality and
efficiency of care, and find new ways to use data,
systems and distributed networks of providers
focused more on wellness and disease prevention
rather than on the acutely ill. Health systems will
need to become more integrated, addressing care
needs across the continuum, while utilizing
technology to enhance delivery.
25

26.  PPP models are adapting to these changes.
Where early PPPs focused on building
and replacing critically-needed hospital
infrastructure, integrated PPPs were the next
evolution, adding clinical service delivery and
private sector management practices to
improve the quality of care delivered, as well
as access to specialty care.
26

27.  Conflicts of interest over the role of industry
partners.
 Donations in kind, such as drug donations,
which often require relatively high national
inputs, including costs associated with
guaranteeing distribution networks, storing
drugs at ports and airports, and training health
workers.
27

28.  The exclusion of poor countries with large
populations, unpopular governments or poor
infrastructure from public-private partnership
programmes.
 The circumvention of mechanisms designed to
ensure that developing countries have a say in
the policies that will affect their populations.
28

29.  Involving private providers in managing
various components of health sector
programmes
 Developing joint ventures or inviting private
capital to set up hospitals
 Contracting out services (Catering, Cleaning,
Security, Laboratory…..)
 Consumer Protection Act (Safeguarding the
interest of consumers)
 Regulation and Accreditation of private
providers by Government
29

30.  Public-Private partnerships in health are at
very early stages
 Will need significant institutional
development work in terms of financial
analysis capabilities, monitoring and
evaluations systems
 Appropriate regulations to check the
unintended outcomes of private sector growth
in health
30