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Devising a robust, accountable and quality partnership mechanism(June - 2008)
Cyclone Nargis that lashed Myanmar killing a few thousands, and the earthquake that struck China taking a heavy toll of human lives cast a deep gloom over the globe. They are pointers to future climatic calamities.
Our country passes through a very unhealthy situation marked by blazing heat and acute water shortage, soaring inflation causing paucity of food materials, garbage crisis and political pollution. All these ultimately affect the nation’s health. People, especially cricket-loving Indians, can forget, though momentarily, the harshness of these through “cricketainment” afforded by the Indian Premier League.
“For a country crowing about its cracking growth rate, here is a fact that should make its head hang in shame. Over 53 per cent of children in India aged under 5 years – 67 million – live without basic health care facilities. (Times of India, 8, May 2008).” According to Water Aid Report, in a list of 120 countries rated on quality of potable water, India ranks a lowly 120. Of the 1.42 million villages in India 1,95,814 are affected by contaminated water. No wonder 37.7 million people – over 75 per cent whom are children — are affected by water-borne diseases.
According to the latest global report, “State of the World’s Mothers” brought out by Save the Children, India is seeing alarming inequities with regard to health services — 66 per cent of the poorest children receive no or minimal health care whereas the number stands at 31 % of well-off children who are not covered. Globally, more than 300 million children under age 5 do not get basic health care leading to nearly 10 million deaths from treatable diseases like diarrhoea and pneumonia.
Today, enormous amounts of money are swilling around. Stories of people indulging in various eccentric pursuits frittering billions abound. Recently, news of a businessman in Abu Dabhi paying Rs.52 crore to own No.1 car number plate appeared in the press. It is hard to explain such weird behaviour. And there are millions of starving raggedy sick persons scraping around for the odd crust. Let the rich and famous indulge in their pleasures. The point is most of our rich and famous choose to turn a blind eye to the suffering fellow brethren. A fraction of what they waste could have given a life to many.
Over the last years there have been many initiatives to improve the efficiency, effectiveness and equity of health care services. Public-Private Partership (PPP) is one such initiative. Various states have introduced the PPP concept. Bihar, Karnataka and Gujarat are examples. The Chiranjeevi programme launched by Gujarat and Vandemataram scheme launched by the union health ministry are familiar examples as they were launched with much fanfare.
PPP is not something new. It has always been there in some form or the other. Starting in the form of state subsidies or benefits to private sector to promote specific health activities, it has assumed the form of partnership today organized to do specific programmes, to market health and health care or even reduce the role of state. PPPs are possible in various forms and many ways. Franchising, branded clinics, contracting-in, and contracting-out, social marketing, partnering with CBOs and NGOs and mobile health vans, health insurance etc. There may not be dearth of funds, but still with the existing government infrastructure showing lack of managerial and technical ability, it may not be possible for the government machinery to cater to the mounting health needs of the people. Participation of the private sector under the new system will help in making health care services reach more people. PPPs have been seen as a new essential strategy to extend the scope of existing public health care system in the nationwide perspective. It has been identified as an important tool in National Rural Health Mission (NRHM) to provide people with total access to rational, appropriate and effective health care.
A robust, accountable and quality partnership mechanism should serve well. This issue offers well-researched and well-written write-ups on the topic by Prof C V Nagaraj, Mr William Joe, Dr H Sundarshan, Dr N Prashanth., Mr Denny John, and Mr Ravi Duggal.
Rev.Dr.Sebastian Ousepparampil
Director, CHAI
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CHAI at ……. |
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The Centre of Excellence, a partnering venture, is being set up to harmonize national, state and Church efforts in the care and control of HIV/AIDS. Activities include Out-patient and In-patient Services, Referral Linkages, and Training.
A Clinical Consultation Hotline is being put in place to provide physicians across the country with timely access to up-to-date HIV/AIDS clinical information, and individualized expert case-consultation.
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