Approach to improving health service delivery by promoting public-private partnerships in the health sector

Transcription

1 Approach to improving health service delivery by promoting public-private partnerships in the health sector Dr. Mariam K. Ongara NPPP COORDINATOR MOHSW 24/08/2015

2 PRESENTATION OUTLINE Background Policy, Legal frameworks and Strategies Rationale for Public Private Partnerships The Private Sector & Its contribution Public-Private models in use PPP -Achievements PPP -Challenges Way forward Conclusion 2

3 Background Public and Private Health sectors have been providing health services in Tanzania before and after independence. The public sector was the main provider The Government imposed restrictions on private health care services delivery in The Government re-introduced private Health Service practices in 1991

4 Policy, Legal and Sector Specific Framework for PPP in Tanzania The Government has developed enabling policies and environment as an effort to strengthen the delivery of health services in Tanzania Government regulates public-private partnerships in several sectors to ensure they serve national goals Public Private Partnership Policy, 2010 Public Private Partnerships Act; 2011 Public Private Partnership Regulations Ministry of Health and Social Welfare has guidelines for public-private partnerships since

5 Strategy 6: Public Private Partnership Objectives: 1) To ensure conducive policy and legal environment to facilitate PPP operations 2) To ensure effective management and operational framework for PPP development 3) To enhance PPP in the provision of health and nutrition

6 The Private Health Sector is Diverse Health Private-not-for-profit Faith-based organizations CSO-Non-governmental organizations Other Not-for-profit entities Private for-profit Non-health private sector Private employers, corporations, commercial banks

7 Health Facility by Ownership Year 2014 N = 6935 Private, 14.4 FBO, 12.3 Public, 73.3 Source: MOHSW/HMIS-DHIS2 Year 2014

8 The Private Sector Contributes at all Health Service Levels 8

9 Rationale for Public Private Partnerships in Health Demand for health services has increased, due to increased population growth New policies promote increased participation of the private sector in provision of health services. Inadequate public fund Only 10.3% (2012/13) of total govern budget is allocated to health sector Need to complement government efforts. Need to leverage private sector resources

10 Many Public-Private models being used effectively Contracting for service delivery (Specialist clinical services, Procurement contracts ect) Build and transfer Corporate sector clinics CSR Social Marketing (mosquito nets, condoms), Voucher systems- MNCH Accredited drug dispensing outlets Training Institutions, Professional Associations Health Insurance-Private

11 Achievements-PPP PPP implementation Framework in place Government support for staff salaries and bed grants Training public health workers within private facilities and training Institutions Private sector engaged in health planning, guidelines

12 Achievements ct district councils have entered into service agreements with the private health providers (88 SA Signed) More than 5,757 accredited drug dispensing outlets nationwide; an additional 1,658 outlets awaiting accreditation. In Urban Areas: > 50% of reproductive child health services and > 30% of HIV/AIDS services are delivered by the private health sector

13 Achievements ct... Established a broad and inclusive Public-Private policy dialogue health forum PPHF (National and 10 Regions) Developed a PPP Communication strategy in the health sector Public-Private Partnership Advocacy training done in all 25 Regions and being rolled out to Council level Social Welfare Assessment was conducted country wide jointly with SW department SA Template of 2007 reviewed awaits approval and printing Supportive supervision guideline of reviewed jointly with Quality Assurance Department Pipeline projects identified in the health sector

14 HEALTH SECTOR PPP GUIDELINE & REFERENCE BOOK IN KISWAHILI

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17 Big Results Now (BRN) INITIATIVE & PPP BRN is about Improved Prioritisation, focused planning, resource management; efficient and accountability implementation mode. All stakeholders (public and private) optimally use their comparative advantages to contribute to universally available, affordable, accessible, appropriate and effective health and social welfare services to atain universal coverage.

18 MoHSW prioritized 4 key areas Human Resources for Health (HRH) Distribution Health Commodities 100% balanced distribution of skilled health workers at primary level by 2017/18 Performance Management 80% of primary health facilities to be rated 3 Stars and above by 2017/2018 Mother and Neonatal Child Health (MNCH) 100% stock availability of essential medicines by 2016 / 2017 Special Focus 20% reduction in maternal mortality ratio and neonatal mortality rate in 5 regions by 2017/18 Big Results Now!

19 BRN & PPP CT. In all 4 BRN Priority areas and enablers private sector engagement is a priority Human Resource for Health Distribution Provide skilled HRH through PPP/Private sector engagement Health Facility Performance Implement Star Rating System (Public & Private) Health Commodities ICT Platform through Mobile Apps for tracking supply chain Private sector to complement MSD RNCH Introduce SMS for community reporting

20 Big Results Now (BRN) in Health- Private Sector Contribution Human Resources for Health (HRH) Distribution Health Commodities Mother and Neonatal Child Health (MNCH) 554 Dispensaries across the countries without Skilled Health Workers These facilities are manned by Medical Attendants who are not qualified to attend to patients PRIVATE SECTOR CONTRIBUTION Reduction in the number of Dispensaries without Skilled HRH Private health sector producing skilled health workers., employs and managing PHC facilities through Service Agreements. Private health sector participation in the manufacturing and supply of medical commodities Engage private sector on procurement as prime vendors Engagement of private sector as 3 rd Party Logistics for transportation & distribution Private sector offers leading edge technology including e-health and ICT platforms in supply chain management. Complement MSD with Procurement and Direct Delivery from zones to facilities Supporting Dispensaries and health centers in providing quality services that meets the BEmONC Expanding CEmONC services

21 Challenges Understanding of PPP as a new concept at all levels Transparency and Trust among partners (Public & Private Financial resources for the implementation of PPPs Effective management to enhance PPP in the provision of health and social welfare Concerted efforts and change of mindset among implementers are required in engaging the private sector in the provision of health services

22 Way forward for Health PPPs Increase understanding of advantages of PPPs through increased advocacy Institutionalization of PPHF at remaining 15 regions and councils Build capacity of public and private health providers to identify, negotiate and develop PPPs in health at all levels Strengthen PPP implementation to improve the provision of health and social welfare services

23 Conclusion Public Private Partnership is a cross-cutting issue and is a Government priority Private sector complements government efforts in the provision of health services PPP can help expand and retain the pool of human resources in health Private health sector can extend the reach of the public sector to underserved groups Allows public sector to focus on those most in need Private sector services and products require little donor or government support Private sector Participation/Involvement in the provision of health and social welfare services will facilitate the achievement of MOHSW s Vision Mission Health Policy s GOAL 23

24 THANK YOU FOR YOUR KIND ATTENTION