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PHC MANAGEMENT THROUGH PUBLIC PRIVATE PARTNERSHIP INITIATIVES

The major focus of Orissa Health Sector Reform is management of Primary Health Centre (PHC) through Public Private Partnership. The state government realized the need for collaborating with private sector. In order to strengthen the PPP arrangement in PHC, a guideline has been developed. The guideline identifies four options for management of PHC through PPP. The policy identifies NGOs as its partner for health service delivery at PHC. The NGOs shall be responsible for planning and delivering curative, preventive and promotive services at the PHC. And also the PHC shall undertake all other activities as per the guideline of the state government.

Options of Management of PHC through PPP

Option1:Government hands over physical Infrastucture,Equipments,Budget and personnel of a health unit to the selected agency

Option2:Government hands over the physical insfrastucture,Equipments,budget but gives freedom to the selected agency to recruit personnel as per their terms and conditions but following the government norms

Option3:Government hands over the physical insfrastucture,Equipments,budget but gives freedom to have their own service delivery model without following the fixed prescribed pattern

Option4:Government hands over the physical insfrastucture,Equipments,budget but gives freedom to the selected agency to have their own personnel, service delivery model, freedom to expand types of service provided and freedom to introduce user fee and recover some proportion of cost

The NGO enters into a Memorandum of Understanding with government, in order to manage the staff. The NGO-P3 Cell and RRC along with the DP3 Cell is responsible for providing technical support for PPP program, besides monitoring and capacity building support. The Hospital Management Committee or Rogiklyan Samitti at PHC level with Medical Officer of CHC, NGO representative, prominent local citizen, PRI Representatives as its members is responsible for day to day monitoring.

As per the policy framework the resource for management of PHC in PPP shall be shared both by NGO and government. The Government will provide Rs. 6 Lakhs per year to the NGO/Hospital Management Committee. The Amount may be spent for PHC renovation, personnel cost, outreach health activities, capacity building, equipments etc as per the proposal. Private NGOs has to contribute 10% of the budget in cash or kind. The monitoring cost would also be borne by NGOs. They can mobilize finance from other sources for the PHC management. The partnership shall be valid for three years and is renewable, thereafter as per the recommendation by Hospital management committee and district. If the NGO desires to sustain the partnership with its own fund, it is allowed.

The existing staff of the government will continue to work and will be responsible to HMC and NGO. Government can transfer staff as per recommendation by HMC. NGO can also appoint additional staff on its own fund, if required. All the existing equipments shall be provided to the NGO/HMC for the management. Additional equipments may be added by the NGO from its own fund. The government shall provide drugs and medicines as per the rule. Additional medicines can be supplied by the NGOs. The NGO is also allowed to establish a medicine store to provide low cost medicines, contraceptive and other health items.

For management of the Hospital a Hospital management committee is formed with Medical Officer of CHC, NGO representative, prominent local citizen, PRI Representatives, local teacher as its member. It is the responsibility of the PHC Management Committee to provide effective service to the people through quality treatment and linked referral services. Medical Office of the CHC will monitor the progress and CDMO will review the functioning quarterly.

Achievement Under the programme

  •    22 PHC (N) - Contracted out mostly in Tribal/SC dominated area
  •    State PPP Health Policy (draft) prepared.
  •    Existing staff of PHCs are being redeployed by the Government. Partnership established @ 90:10 ratio.
  •    Mobile Van is hired on contractual basis for transport communication and networking between PHC(N) and CHCs.

Following are the indicator wise achievement of the PHC (N) through PPP initiatives in Orissa

  •    Total no of OPD cases treated-78521
  •    Laboratory Test done for samples of population-7496
  •    Health Camp organized in the PHC(N) Catchment population-90
  •    Contraceptive Distributed among population of the PHC(N)-32540
  •    Ambulance Services available currently-15 locations
  •    Wall Paintings done at places to sensitise Population -189 locations