Private Public Partnerships (PPPs) for Sustainability

Editor's Notes

1. The Private Health Sector includes: Private commercial or for-profit entities active in the health sector Non-profit entities active in the health sector, such as FBOs, NGOs, CSOs and community organizations Examples of private health sector actors: Private health facilities Private insurance providers Private pharmacies Private sector professional associations Private medical colleges Producers of e-health technologies
2. Let’s turn our attention to the different components of a health system and the range of private sector actors. This is diagram – which is on the wall as a reference as well as a handout in your packet – is based on the WHO six building blocks. The six building blocks are in the middle green circle. They include governance; information; financing; human resources and medicine and technology. The outer blue ring illustrates the breadth and scope of private sector providers. Private sector is a cross–cutting theme in each of health system building blocks LIST A FEW BY BUILDING BLOCK As you can note, there are a diverse range of private sector actors beyond private healthcare providers. As mentioned before, the diversity presents a challenge for public sector because the private health sector is often fragmented and not “organized”. The breadth of private sector actors also presents an opportunity, offering a greater range of PPP possibilities that can strengthen the health system. Another important observation is that many of the same private health sector actors are present in multiple building blocks. This signifies that when the public sector can effectively work with the private sector partners it not only helps strengthen one building block but in most cases, several health systems.
3. Clear Sector Strategy and Road Map The diagnostic assessment of the sector yields information to develop and inform targeted, specific, and realistic sector strategy and road map to achieve improvements, through PPPs and other interventions. The strategy and road map provide clarity and certainty about the operating environment to private sector operators—a prerequisite for sizable investments. Clear political commitment and champions The private sector will expect government to be a competent partner in discharging its obligations in terms of policy and reform planning, project development, and contract oversight. It will also expect that the government has established the appropriate legal and other frameworks to set targets, monitor progress, evaluate progress, report progress, enforce the contract provisions, and handle disputes. A detailed road map helps manage expectations in that regard, and allows the actual performance of the government to be monitored and measured. The government’s commitment to the strategy is demonstrated in several ways: through a public statement of the reform strategy and expectations of PPP; through stakeholder consultation and transparency of process; through the provision of adequate funding and support for the process; and through the appointment of a powerful champion, or driver, for the process. The champion is an individual or unit that is accountable for progress, is a focal point for public communication and information, ensures that appropriate attention is given to the main issues, works with various parties to achieve cooperation/ consensus, and leads the government toward decisions. The standing, credibility, and strength of mandate of the PPP champion are strong indications of the true commitment of the government to the PPP project. Political changes and powerful vested interests can all constrain the PPP process