At the inception of Uganda's second 5-year Health Sector Strategic Plan (HSSP II), this paper traces the history of the public - private partnership for health (PPPH) in Uganda, giving its justification and mandate. It also gives its current state of the art, outlining the successes scored, the challenges still faced in its implementation and current efforts being made to make it comprehensively institutionalized. The successes include the bilateral acceptance of the principle and need for partnership by both the public and private partners, the overt gestures by the public partner through direct funding of the private providers, the ceding of some responsibilities to private players and the acceptance by the private players to take on some public responsibilities using their own resources. The challenges include the slow formalization of the partnership, skepticism about autonomy, the stagnation of government funding, the poor understanding of the partnership at sub-national levels and poor sharing of information, among others. These challenges are now further compounded by the recent introduction of new policy reforms like fiscal decentralisation to the same local officials who do not fully appreciate the partnership and are therefore not likely to support it. The paper concludes with some useful suggestions on how these challenges may be tackled.
Public-Private Mix
The Health Sector Strategic Plan (HSSP) aims to ensure access to basic health care by the Ugandan population through the delivery of the National Minimum Health Care Package (NMHCP). This requires availability of well-trained health professionals. This study demonstrates that the Private-Not-For-Profit (PNFP) Health Training Institutions - the majority in Uganda - have remained grossly under-funded, which poses a threat to achievement of the HSSP. They are faced with decreasing income from fees, dwindling donor support and over-dependence on government grants which are both uncertain and erratic. Consequently, vital activities for students' training such as field trips, teaching and reading materials are left unsatisfied as a copying mechanism, but not without negative implications for quality. It is recommended that government increases and guarantees its support to these Health Training Institutions as a way of maintaining quality of health worker training. At the same time, the training institutions need to diversify their funding options to include designing short tailor-made courses, mobilizing alumni contributions, research and consultancies, self-help projects like farming, canteens and stationeries as well as fund-raising activities as a way of bridging their funding gap. This should be coupled with more efficiency mechanisms and prudent management to avoid wastage of the already scarce financial resources.
Corporations across the globe are capturing more and more of the public sphere, encroaching on all aspects of people’s lives. This publication compiles analyses of different country experiences on public-private partnerships that in themselves have become a powerful tool to achieve what the authors observe is starting to look like the privatisation of life itself. Feminist researchers from the Global South have spent a year researching this theme in their home countries, including in Kenya and Zimbabwe. Together they present an analysis and critique of the state of PPPs today, and the consequences for women’s lives, communities’ wellbeing, and public health and social services.
This paper, produced by Health Research Policy and Systems, outlines key challenges in public-private arrangements in health care and makes a Global Call to Action to address these challenges. The author establishes several ethical challenges in public-private partnerships. These include: a lack of global norms and principals, threatened impartiality of health care due to poorly designed partnerships, the risk of abandoning social safety nets for vulnerable groups, and conflict of interest due to ‘for-profit’ demands of the private sector. Other ethical issues consist of redirecting national health policies, fragmentation of the health system, contribution to common goals and objectives, and lack of contributions to improvements in quality and efficiency.
Universal access to contraceptives is a key goal of sexual and reproductive health programmes. But what is the best way to supply them? Donated or subsidised contraceptive supplies raise questions of sustainability whereas there are concerns that market-based distribution has negative impacts on equity and access.
Universal access to contraceptives is a key goal of sexual and reproductive health programmes. But what is the best way to supply them? Donated or subsidised contraceptive supplies raise questions of sustainability whereas there are concerns that market-based distribution has negative impacts on equity and access.
The need for public-private partnerships arose against the backdrop of inadequacies on the part of the public sector to provide public good on their own, in an efficient and effective manner, owing to lack of resources and management issues. Though such partnerships create a powerful mechanism for addressing difficult problems by leveraging on the strengths of different partners, they also package complex ethical and process-related challenges. Participation of international agencies warrants that they be set within a comprehensive policy and operational framework within the organizational mandate and involvement of countries requires legislative authorization, within the framework of which, procedural and process related guidelines need to be developed. This paper outlines key ethical and procedural issues inherent to different types of public-private arrangements and issues a Global Call to Action.
South Africa’s Health Minister Aaron Motsoaledi has signed a "social compact" with the private sector, describing it as a "historic" step towards closer collaboration between the government and private enterprise. Such collaboration was vital for the success of the government’s ambitions for introducing National Health Insurance (NHI), the minister said. The minister and the CEOs of 23 companies have agreed to meet at least twice a year to discuss issues that affect them, and have established the Public Health Enhancement Fund to address the skills shortages facing the healthcare sector. The fund pools donations from 23 companies from the pharmaceutical, private hospital and medical scheme administration industries, who have committed to providing financial support for the next three years. The money will be used to train more doctors, improve the skills of healthcare managers, and ensure more doctors get specialised training in HIV and AIDS. Forty million rand (US$4.5 million) has been committed for the first year.
When leaders of governments, international organisations, corporations, nongovernmental organisations and faith-based groups came together on 14 December 14 in Washington, they jump started an ambitious public-private effort to save lives from the preventable and treatable mosquito-borne disease of malaria.
The paper first discusses the concept of PuPs and proposes a two-dimensional typology for categorising the various forms of partnership so described. The range of types of PuPs is then discussed with reference to specific sectors (water and healthcare), international associations, and six case studies. The final section draws general conclusions and makes recommendations for future research into the subject.