The Role of Public-Private Partnerships in Health Systems Strengthening Workshop Summary (2016) / Chapter Skim
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3 Multistakeholder Perspectives on PublicPrivate Partnerships for Health Systems Strengthening
3 Multistakeholder Perspectives on PublicPrivate Partnerships for Health Systems Strengthening
Pages 19-32
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From page 19... ...
developed to improve infrastructure, such as building roads, and he attributed the success, in part, to established incentives for all contributing partners. Yet, when it comes to developing PPPs for strengthening health systems, Gunn observed that such development can be incredibly challenging because the incentives are not well understood for all parties.
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From page 20... ...
Through this system, every citizen in Chile is insured. Citizens can opt-out and seek private insurance if they prefer or they can be insured by the Social National Health Insurance Agency, FONASA, which is responsible for all the revenue collection, pooling, and purchasing of health services for those insured, generally the lower- and middle-income people, while high-income workers and their families are usually insured by private insurers.
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From page 21... ...
The government, in partnership with a private company, has introduced telehealth services for chronic care of diabetic and hypertensive patients in the largest health system of the capital city Santiago that covers more than 1 million people. In brief, each primary public health care center in the area offers program enrollment to all patients seeking better control of their diabetes and hypertension.
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From page 22... ...
In Chile, forming partnerships with private businesses also proved to be challenging, Vega explained. Instead of contracting with large private companies that can offer health care more efficiently, the Chilean government is supplementing the income of private physicians by allowing them to use public facilities to provide care.
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From page 23... ...
Cohen explained that the traditional business models of sales people carrying bags and pushing their products into the market may not be effective; rather, business models that are based on building trust and partnering to address unmet needs will be more effective ways to expand in new markets. Although the term "public–private partnerships" is relatively new, and perhaps the definitions of such partnerships may differ, Cohen described several experiences over the past 20 years that changed his thinking on what can be accomplished when working together across sectors. To begin, he shared an experience from December 2003 when he
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From page 24... ...
The third category is called shared value creation, where intentionally and specifically, the partnership focuses on an unmet societal need in a manner that also provides a business opportunity. In January 2004, BD partnered with the Clinton Foundation to make CD4 monitoring widely accessible; CD4 monitoring measures the immune system of people living with HIV and AIDS, so clinicians know when to begin antiretroviral therapy.
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From page 25... ...
Intolerable working conditions and the high potential of contracting disease occupationally in the health care environment were also important indicators for this health worker emigration. In response, the ICN, BD, PEPFAR, and the Stephen Lewis Foundation entered into a partnership to establish wellness centers, safe havens where health workers and their families can go for discrete testing, counseling, and treatment.
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From page 26... ...
These efforts are helping to establish the next generation of finance models using blended finance and risk and providing an opportunity for shared value creation, with the aim of developing sustainable business models with high access in the highest-burden countries. In distilling some common principles that led to the success of BD's PPPs, Cohen listed establishing trust as extremely important, as well as identifying the right leaders and champions and aligning purpose and motivations.
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From page 27... ...
Historically, public opinion in the United Kingdom has been more supportive of providing financial assistance for development through local charities and projects rather than through governments and international organizations. As such, providing funds to support the delivery of global health care through large PPPs, global funds, or the international organizations does not always garner public support.
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From page 28... ...
Bland stated that a comparative review of this nature introduces competition and edge into the market to drive performance and efficiency, but it fails to assess the systemic issues of how the broader international system comes together to deliver health care and that the synergies and reliance between organizations are often ignored. To be effective and address the global health care delivery systems, Bland believes the needs of health systems must be communicated more effectively to donor governments, including how the health system is defined, why it is important, how to build and strengthen it, and how investing in it yields results and why, without this, the results achieved by Gavi and the Global Fund would suffer considerably.
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From page 29... ...
Collectively, there is a need to challenge this assumption, Bland suggested, and promote stronger private-sector investment in ways that support national development and free up public finance for the social sectors. Ambassador John Lange from the United Nations Foundation noted that Bland highlighted the vertical programs that have been successful, but suggested that the future is in the national and subnational levels for partnerships.
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From page 30... ...
Cohen experienced this successful model at BD, where significant investments have been made toward training, whether it is provided within laboratories or clinical practices, and he encourages the promotion of a sustainable business model that incorporates PPPs. He believes that if accomplished, it could add tremendous value in multiple ways toward strengthening a global health care system.
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From page 31... ...
One of the models that BD is implementing is around strengthening the health care delivery for maternal and newborn health. To do this, BD has requested private capital to limit the impact this work has on profit and loss for the year; instead, providing a solid return to the private investors.
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From page 32... ...
Health systems strengthening partnerships provide companies with the opportunity to move into new markets and to conduct business in a different way in places where they have not had access before. Also, companies are as affected by poor health and related impacts on productivity as governments are, as well as anyone else living in a society.
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