PUBLIC PRIVATE PARTNERSHIP IN HEALTH VHAIS EXPERIENCE OF ARUNACHAL PRADESH

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PUBLIC PRIVATE PARTNERSHIP IN HEALTH VHAIS
EXPERIENCE OF ARUNACHAL PRADESH

• Dr. P.C.Bhatnagar
• Director Community Health
• VHAI N.Delhi

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Voluntary Health Association of India

• VHAI
• aims to
• make health a reality for the people of India

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INTRODUCTION

• PPP in the context of the health sector is an
  instrument for improving the health of the
  population
• Public would define Government or organizations
  functioning under State budgets
• Private would be the Profit/Non-profit/Voluntary
  sector
• Partnership would mean a collaborative effort
  and reciprocal relationship between two parties
  with clear terms and conditions to achieve
  mutually understood and agreed upon objectives
  following certain mechanisms.

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ARUNACHAL MODEL

• Being implemented as a Pilot Project.
• One PHC in each district of Arunachal (total 16
  PHCs) handed over to NGOs.
• PARTNERS IN AP
• Karuna Trust 9 Districts
• VHAI 5 Districts
• JAC(Prayas) 1 District
• FGA, Itanagar 1 District

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Name location of PHCs.
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Modalities of Implementation

• The State Government has handed over the building
  and physical infrastructure of PHC to the Agency
  along with the available equipment, furniture,
  etc.
• The existing staff at PHC has been suitably
  redeployed by the State Government to other
  PHCs/health facilities centers.

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Modalities of Implementation

• The Agency is providing, the following services
• 24 hours Emergency Service.
• OPD service for Six days a week, as per the
  timings specified by the State Government.
• 5 to 10 Bed inpatient facility.
• Ensuring availability of essential medicines
• Minor Operation Theatre facility,
• 24 hr. labor room, and Essential Obstetric
  facility

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Modalities of Implementation

• 24 hr Ambulance services
• Participation and implementation of National
  Programmes of Health Family Welfare including
  NRHM, Outreach/IEC activities by conducting
  medical camps
• Training of ASHAs

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Staff deployment
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Staff Deployment

• The personnel engaged by the Agency possess the
  required qualifications as intimated by
  Government and are being paid at the rates
  envisaged in the funding pattern.

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Laboratory Test Facilities

• Blood routine examination (Hb, TLC, DLC, ESR)
• Blood Grouping and Rh typing
• MP test, Widal Test
• Stool Routine Microscopic Examination
• Urine Routine Microscopic Examination
• Pregnancy Test
• Sputum for AFB
• Blood Sugar
• VDRL

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FUNDING

• Medicines Consumables - 3,50,000
• Maintenance, Furniture - 5,50,000
• Equipments
• Administrative Charges - 1,00,000
• Personnel Cost - 19,37,172
• Total Maximum Fund - 29,37,000

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Audit Accounting

• Separate Books of Account for each PHC
• Accounts are being audited by a Chartered
  Accountant.
• SOE UC is being submitted as per the State
  Government/Govt. of India norms.
• Special audit
• CAG can as per their discretion conduct an audit

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Performance Monitoring Standard of Services

• Availability of services like OPD, IPD, MOT,
  Labor Room, Emergency services, Ambulance
  services, Lab services- No. of days functional
  Average Attendance and/or Usage
• Personnel Availability- Nos. Number of
  days/months
• Availability of Medicines Consumables
• Referrals
• Preventive/Promotive IndicatorsIMR, MMR,
  Immunization coverage individually for each
  vaccine, Institutional Delivery, Referral to FRU,
  ANC Coverage, PNC, Sterilization, Temporary
  Methods
• Outreach activities- No. of Camps, No. of Anchal
  Samities covered, No. of patients seen

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Review and Monitoring Structure

• PHC management committee
• Representatives of the Agency, District Medical
  Officer, DRCHO,DC or his nominee (not below the
  level of Circle Officer), and 3 representatives
  from the Anchal Samities of the area.
• Local MLA Permanent Special Invitee
• CDPO,PHE special Invitee
• Meet once every 2 Months
• Can also Function as RKS

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Review and Monitoring Structure

• State Level Steering Committee
• Chaired by the Commissioner Secretary (Health)
• Representation from all stake holders including
  the Agencies, Central Government and other State
  Government Departments
• Meet at least once in every three months.

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Purchase of drugs and consumables

• The Agency is allocated funds by the Government
  for procurement of drugs/consumables.
• Drugs procured in a transparent economical
  manner
• Only approved quality drugs of generic nature are
  procured.
• Normally the price of procurement for the Agency
  for any drug is not exceeding the price at which
  the same drug is procured by the State
  Government.

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National Programmes

• The Agency is a part of the Health Delivery
  System of the State.
• Various National Programmes being implemented in
  coordination with existing field staff of that
  programme
• Any drugs/vaccine/equipment made available by the
  central government under any National Programme
  for use at PHCs will also be given to the agency.

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Others

• Records Reporting
• Standard of hygiene and health safety
• Asset Creation
• Evaluation
• External evaluation after 6 months
• Concurrent Evaluation after First year

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Additional Support from VHAI

• 10 Financial Contribution
• Monitoring Supervision
• Capacity Building
• Mobilization of Additional Resources

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Challenges

• Making People Aware about The Concept
• Retaining Staff
• Fund Flow
• Community Empowerment
• Extrenious issues

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Some Achievements

• OPD Indoor Facility with 5 8 Beds
• Emergency Care on 24x7 basis
• Availability of Ambulance for Referral
• Fully functional Lab
• Availability of Essential Drugs in PHC Pharmacy
• Ten Sub Centers are functional
• VHAI-managed PHCs are gradually emerging as the
  centre of integrated development in locality. We
  do convergence of other health and non-health
  activities through PHCs.

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Some Achievements
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Some Glimpses
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Some Glimpses
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Woods are lovely dark and deep.But I have
promises to keep.And miles to go before I sleep.
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Thank You