Review Article
Year: 2018 | Month: October | Volume: 8 | Issue: 10 | Pages: 254-261
Achieving Universal Health Coverage through Public Private Partnerships: A Study of Trends in the Public Private Partnerships in India
Dr Utkarsh Shah1, Dr Harshad Thakur2
1Pursuing PhD in Health System Studies at Tata Institute of Social Sciences, Mumbai
2Professor, School of Health System Studies, Tata Institute of Social Sciences, Mumbai
Corresponding Author: Dr Utkarsh Shah
ABSTRACT
Background: Universal health coverage is very vital to propel and power a country’s economic and social development. The National Health Policy, 2017 has reiterated the need to increase public spending on healthcare, to achieve UHC. However, financial constraints and limited capabilities have led governments to engage the private sector, through the module of Public Private Partnership.
Aim: The paper aims to understand the preferred models of partnerships, thematic areas of interest and procurement patterns, based on historic trends across five states, with an objective to guide future strategies and decisions for Healthcare PPPs.
Methods: The information about the healthcare PPP projects was compiled from different publically available databases, as on 15thDecember 2017. These projects were reviewed, and tabulated based on the project type, segment and status, for further analysis.
Results: The result demonstrated that Healthcare PPP projects were smaller in terms of project value, compared to other infrastructure projects. A majority of the projects (more than 65%) were aimed at providing primary care, diagnostics and outreach services, with very few large scale medical college projects. More than 70% of the projects conceptualized by the governments were infrastructural projects, though about two thirds (65%) of the currently operational projects were non-infrastructural Operate and Manage (O&M) projects. The procurement principles used for the selection of private partners was vastly different across the 5 states for an enterprise of a similar type and design.
Conclusion: Low risk O&M projects are easily rolled out compared to large scale ‘risky’ infrastructural projects. In most cases, this reluctance can be attributed to poor pre-contracting transparency, post contract red tapism and no contract flexibility or scope of re-negotiations, based on business changes. There is a strong need for policy modifications and a necessity to reconsider our procurement strategies, to help boost private sector confidence and expand their participation in healthcare PPPs, thereby contributing to the achievement of the Universal Health dream.
Key words: Public Health, Public Private Partnerships, Universal Health Coverage, Health Management