Public Private Partnerships for Health Service Delivery

Busulwa Ivan

Team Leader Public Private Partnerships

The USAID/Health Initiatives for the Private Sector (HIPS) Project implemented by Emerging Markets

Group Ltd.

May 29

• USAID funded, 2007-2012• Works with Ugandan businesses to find cost-

effective ways of improving access to and utilization of health services

• Based on a Public Private Partnership model• Builds capacity of Private Sector Employer

organizations• Supports Orphans and other Vulnerable

Children

Menu of services

HEALTH SERVICEHIV/AIDS TB MAL OVC

FP/RH

COST SHARE

Workplace Policy Formulation ✔ ✔ ✔

Peer Education ✔ ✔ ✔ ✔ ✔ ✔

Health Fairs ✔ ✔ ✔ ✔ ✔ ✔

Voluntary Counseling & Testing ✔ ✔ ✔ ✔

Low cost health commodities & IEC materials ✔ ✔ ✔ ✔ ✔ ✔

Lab. equipment & trainings ✔ ✔ ✔   ✔

Private clinic Accreditation ✔ ✔ ✔ ✔ ✔

Access to free ARV’s, TB & Malaria drugs ✔ ✔ ✔ ✔ ✔ ✔

A Partnership Model

The Dunavant Mobile Clinic

Why a mobile clinic?

• Previously ongoing conflict led to breakdown of social & economic infrastructure in the area

• Led to relocation of people to Refugee camps commonly as IDP’s

• Dunavant has up to 100,000 farmers whose productivity was being affected by ill health

The Public Private Partnership

PARTNER ROLES USAID/HIPS

DUNAVANT

• Selected target areas• Availed customized truck, fuel and a driver• Provided supply chain link

• Brokered partners’ roles• Provided equipment•Developed BCC education materials• Structured Pilot program

IAA-LIRA CLINIC

• Availed staff & supplies• Outpost for replenishment & referral• Provided link with district health teams

The Pilot• Assessed operational costs

• Established epidemiology of commonly occurring ailments

• Evaluated community perceptions

• Determined accessibility to remote sites

Kitgum, Lira & Pader

New Jersey

Washington, D.C.

Mobile clinic setup• Manned by 7 staff: 1 Clinical Officer, 1 Logistician,

1 Lab. technician, 1 nurse, 2 counselors and 1 driver

• Availed a variety of services:– BCC/IEC dissemination and awareness– Health commodities e.g. condoms & nets– Immunizations & mass Deworming– Diagnosis & Treatment of common ailments– Transportation of severe cases to IAA Lira clinic

Pilot Findings• Accessibility

– Smaller satellite camps were targeted– Average distance to any H/C is 10 miles. Mobile

clinic was stationed within 3 mile walking distance

• Acceptability– Consulted with existing private facilities and local

authorities to garner their support– Inclusive participation brought about a sense of

attachment

Pilot Findings

• Sustainability– We built capacity of health personnel to use

modern medical procedures to deal with the commonly occurring ailments

– We trained community volunteers & peer educators using a cascade of Training of Trainers

– Built referral mechanisms with local H/C’s

Advantages

• No stock outs are realized due to mobile clinic’s proximity to IAA Lira clinic

• Extends health services to people in remote, hard to reach places

• Brought expertise and technology that would otherwise have been unavailable

Challenges

• Clinic could not ensure clients followed up

• District Implementation Plans did not exist

• Mobile clinic team needed more specialist personnel (Dental, ENT, OBGYN)

• Clinic solely relied on sponsors since all services on board were provided for free

Possible solutions• Build stronger linkages with existing NGO’s/

service providers• Carry out supplemental needs assessment to

get more statistics• Identify private specialists and facilitate their

travel to offer these health services• Charge a nominal fee to recoup some costs

Conclusions

• Services to be offered and roles & responsibilities need to be clearly assigned

• Pre-implementation analysis important since it leads to targeted interventions

• Local capacity building leads to continuous service provision

Thank You