Public Private Partnerships PPP

1
Public Private Partnerships (PPP)

• Dr Partha P Mandal
• India Resource Centre
• The Union, New Delhi
• ppmandal_at_iuatld.org

2
Objectives of PPP

• Increase case detection
• Improve treatment outcomes
• Enhance access and equity
• Reduce financial burden on patients

3
Key features of PPP

• Quality DOTS
• Strengthening Health System
• Building networks
• Resource pooling
• Monitoring and evaluation
• Addressing emerging challenges

4
Quality DOTS

• Early referral, Early diagnosis and Early
  treatment
• Less waiting time at diagnosis centre and DOT
  centre
• Quality control of sputum microscopy
• Standard recording and reporting
• Reducing opportunity cost
• Community ownership of DOT

5
Strengthening Health System

• Expansion of quality assured diagnostic and
  treatment services
• Improving coordination among diverse health care
  providers (NGOs, PP, corporate sector)
• Enhancing Health Management Information
  System-HMIS (quarterly meeting and feedback)
• Co-investment brings accountability and shared
  responsibility amongst different partners
• Increasing access to health care

6
Resource Pooling

• Health infrastructure
• Laboratory and diagnostic equipment
• Treatment facility
• Human resources
• Health workers
• Laboratory personnel
• Public health experts
• Access to increased pool of expertise
• Financial resources

7
Building networks

• Linking public health programmes with
• general practitioners, public and private
  facilities
• NGOs, community and patient networks
• traditional practitioners
• medical schools
• Professional associations
• Media

8
Monitoring and evaluation

• Builds accountability
• Improves health care services
• Measures programme performances
• Develops sustainable models

9
Address emerging challenges

• TB/HIV co-infection
• Drug resistance
• Special population (refugees, prisoners, Slum,
  migrants, marginalized etc)

10
Integrated HIV Care for TB patients (IHC) in
Myanmar- The Union Model

• Parties involved
• The Union of Myanmar, TOTAL Myanmar, The Union,
  World Health Organization, PLWHA, Local NGOs
• One million population of Mandalay district
• Provides access to comprehensive HIV care
  including VCCT, OI prophylaxis and treatment
  PMTCT, and ART to TB patients co-infected with
  HIV, their sexual partners and children
• NTP is the entry point for diagnosis and
  treatment of HIV infection in TB patients and
  their relatives.

11
A model PPP

• Demonstrated the capacity of the NTP, the NAP,
  physicians in teaching hospitals and PHC
  facilities in townships to collaborate and
  deliver accessible, acceptable and accountable
  diagnostic and treatment services for TB patients
  and their relatives living with HIV/AIDS
• Strong links have been established with the NAP
  to support and monitor HIV VCCT and treatment
  services including follow-up of patients after
  completion of TB treatment.
• Basic health staffs in township health centres
  manage TB treatment for co-infected patients and
  assist in the follow-up of HIV infected patients.
  
• Support groups in the community have joined hands
  with the national programmes to provide ongoing
  care and support.

12
Flow of Patients
Adult TB Patients registered 01/2005-08/2007
(5735)
No. of TB Patients HIV Tested 3940 (69)
HIV Positive 1308 (33)
HIV Negative 2632 (67)
Spouse/partner/children tested 205
HIV positive 123 (27 children, 96 spouses)
HIV Negative 82(49 children, 33 spouses)
Number enrolled788 (695 TB patients) (21
children, 72 spouses)
Total Positive1431
13
(No Transcript)