Public Private Partnership (PPP) Project for the improvement of the Health Delivery System in Arunachal Pradesh.

The Government of Arunachal Pradesh has approved a Public Private Partnership ( PPP ) Project, on a pilot basis, or the Primary Healthcare Services delivered through the Primary Health Centres (PHC) in the State. It is proposed that one PHC in each of the 16 Districts of the State would be hand over to a reputed NGO/Voluntary Agency/Non-commercial Hospital (collectively referred to as “Agency”) for, inter alia, providing clinical and preventive health services, implementation of the National Rural Health Mission (NRHM) and other National Health/Family Welfare Programmes, Health & Family Welfare related IEC activities, and for promoting community based disaster preparedness measures. The selection of the “Agency” will be on an “All India” basis after calling for “Expressions of Interest” (EOI). A Memorandum of Understanding (MoU) would be entered into between the State Government and the selected “Agency” wherein the different goals and parameters to monitor the performance of the “Agency” would be listed alongwith the respective obligations of the State Government and the “Agency”. The management of the PHC under the PPPP would be effected through a PHC Management Committee having representation from the “Agency”, the District Medical Officer, Circle Officer and the local Panchayat. Where the Member of Panchayat in the said committee is a Male, a lady Member of the Panchayat would also be co-opted in the Management Committee. At the State level, a Steering Committee under the chairmanship of the Commissioner & Secretary (Health & FW) with suitable representation to all stake holders would guide the PPP Project. As per the model envisaged, the “Agency” managing the PHC would deliver the required services through its own Doctors, Para-medical and other staff, medicines, consumables etc. A basic infrastructure of building and equipment would, however, be provided by the State Government. Depending on the actual field level situation existing in the different selected PHCs in the Districts, the nuts and bolts of the MoU and the detailed arrangements would be finalized. The initial project life is visualized to be three years.

The “Agency” selected may be expected to contribute in part towards the cost of the Project. User charges may also be levied from those persons who can afford to pay, to plough back the revenue into the project. However given the situation in rural areas of the State, collection of large amounts of funds by user charges may not be possible. In order to promote the adoption of this innovative model of Public Private Partnership for Primary Health Delivery, funding may also be considered through Central/State Government.

The PPP model envisages a service oriented and client friendly approach in providing health services to the masses. It is presumed that Doctors and para-medical staff working under the aegis of the “Agency” would be more committed and motivated. The choice of the PHC would normally be such that PPP Project is implemented initially in remote and far flung areas. Accordingly, it is hoped that this model will improve the health delivery system by reaching the inaccessible areas, will provide quality health services, and will serve as a reference point for the Government run health delivery system. The PPP Project has immense synergies with the goals and objectives of the National Rural Health Mission. Reputed “Agencies” would bring with them the expertise in running health institutions and the State and its people will gain in the process. The PPP Project will increase the Peoples’/ Community’s participation in the Community and Public Health management.

The Expression of Interest (EOI) from the Agencies has been requested by September 16, 2005. Thereafter a Consultation meeting will be held with the short listed Agencies. The details of financing, performance parameters, MoU, location of PHCs etc. would be discussed at that time. The final selection of Agencies is envisaged to be completed by mid October, 2005. We hope to commence the project latest by early December, 2005.