Indian Journal of Public Health Research & Development

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Public-Private Partnership: a Revolution in Antenatal Health Management


Affiliations
1 U Mass, Boston, United States
2 Department of Physiology, Saraswathi Institute of Medical Sciences, Anwarpur, Hapur, India
     

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Maternal mortality remains one of the most daunting public health problems in resource-poor settings, and reduction in maternal mortality has been identified as a prominent component of Millennium Development Goals (MDG 5). The productivity of public health sector in meeting these goals has been rather low, and it is often considered one of the 'sick unit'. Public-Private Partnership seems to be a 'treatment' to this 'sickness'. It can play a significant role in determining whether success or failure is achieved in working towards goals for safe motherhood in many low- and middle-income settings. Though established private providers, especially nurses/midwives, have the potential to contribute to safe motherhood practices if they are involved in the care continuum, it is a subject of considerable debate that can or should private organizations provide public healthcare services? What is the scope for private finance in public healthcare services? Therefore this paper reviews some of the arguments for and against public or private ownership management and financing of public healthcare services in the field of antenatal care. It concentrates on health services, where non-economic values and ethical questions are as important as the efficiency considerations, and on health purchasing or funding organizations.

Keywords

Maternal Mortality, Public-Private Partnership, Antenatal Care, Emergency Obstetric Clinic (EmOC), Millennium Development Goals (MDG 5)
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  • Mavalankar D, Rosenfield A. Maternal Mortality in Resource-Poor Settings: Policy Barriers to Care. Am J of Public Health. Feb 2005; 95(2): 200-203.

  • Millenium Development Goals. Available at: www.developmentgoals.org Washington: World Bank; 2007.

  • Aggarwal AK.Strengthning Health Care System in India: Is Privatisation the Only Answer? Indian Journal of Community Medicine. Vol.33, Issue 2, April 2008; 69- 70.

  • Ovretveit J. Beyond the public-private debate: the mixed economy of health. Health Policy. 1996 Jan; 35(1): 75-93.

  • UNICEF India Statistics. http://www.unicef.org/ infobycountry/india_india_statistics.html

  • WHO Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF, and UNFPA http:// www.reliefweb.int/library/documents/2003/who-saf- 22oct.pdf [PubMed]

  • Mavalankar D, Vora K, Prakasamma M. Achieving Millennium Development Goal 5: is India serious? Bull World Health Organ. 2008;86:243–243A. doi: 10.2471/ BLT.07.048454. [PMC free article] [PubMed] [Cross Ref ]

  • Ministry of Health and Family Welfare Annual Report 2004. New Delhi: Government of India; 2004.

  • Acharya A, McNacmee P. Can Public-Private Partnership reduce Maternal Mortality? Assessing efforts made by the ‘Chiranjeevi’ scheme in Gujrat. Available at: www.esocialsciences.com/ Document113112009270.2739069.pdf

  • Makinen M, Waters H, Rauch M, Almagambetova N, Bitran R, Gilson L, McIntyre D, Pannarunothai S, Prieto AL, Ubilla G, Ram S. Inequalities in health care use and expenditures: empirical data from eight developing countries and countries in transition. Bull World Health Organ. 2000;78:55–65. [PMC free article] [PubMed]

  • Hotchkiss DR, Rous JJ, Karmacharya K, Sangraula P. Household health expenditures in Nepal: implications for health care financing reform. Health Policy Plan. 1998;13:371–383. doi: 10.1093/heapol/13.4.371. [PubMed] [Cross Ref]

  • Patouillard E, Goodman CA, Hanson KG, Mills AJ. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of literatyre. Int J Equity Health. 2007; 6:17.

  • Kikumbih N, Hanson K, Mills A, Mponda H, Schellenberg JA. The economics of social marketing: the case of mosquito nets in Tanzania. Soc Sci Med. 2005;60:369–381. doi: 10.1016/ j.socscimed.2004.05.005. [PubMed] [Cross Ref]

  • Mills A, Brugha R, Hanson K, McPake B. What can be done about the private health sector in low-income countries? Bull World Health Organ. 2002;80:325–330. [PMC free article] [PubMed]

  • Van Rossem R, Meekers D. An evaluation of the effectiveness of targeted social marketing to promote adolescent and young adult reproductive health in Cameroon. AIDS Educ Prev. 2000;12:383–404. [PubMed]

  • Paulino LS, Angeles-Agdeppa I, Etorma UM, Ramos AC, Cavalli-Sforza T. Weekly iron-folic acid supplementation to improve iron status and prevent pregnancy anemia in Filipino women of reproductive age: the Philippine experience through government and private partnership. Nutr Rev. 2005;63:109–115. doi: 10.1301/nr.2005.dec.S109-S115. [Cross Ref ]

  • Abdulla S, Schellenberg JA, Nathan R, Mukasa O, Marchant T, Smith T, Tanner M, Lengeler C. Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under 2 years in Tanzania: community cross sectional study. BMJ. 2001;322:270–273. doi: 10.1136/bmj.322.7281.270. [PMC free article] [PubMed] [Cross Ref ]

  • Marek T, O’Farrell C, Yamamoto C, Zable I. African Region Human Development Working Paper. Washington, DC , The World Bank ; 2005. Trends and Opportunities in Public-Private Partnerships to Improve Health Service Delivery in Africa.

  • Mushi AK, Schellenberg JR, Mponda H, Lengeler C. Targeted subsidy for malaria control with treated nets using a discount voucher system in Tanzania. Health Policy Plan. 2003;18:163–171. doi: 10.1093/heapol/ czg021. [PubMed] [Cross Ref]

  • Nathan R, Masanja H, Mshinda H, Schellenberg JA, de Savigny D, Lengeler C, Tanner M, Victora CG. Mosquito nets and the poor: can social marketing redress inequities in access? Trop Med Int Health. 2004;9:1121– 1126. doi: 10.1111/j.1365-3156.2004.01309.x. [PubMed] [Cross Ref]

  • Schellenberg JR, Abdulla S, Nathan R, Mukasa O, Marchant TJ, Kikumbih N, Mushi AK, Mponda H, Minja H, Mshinda H, Tanner M, Lengeler C. Effect of largescale social marketing of insecticide-treated nets on child survival in rural Tanzania. Lancet. 2001;357:1241– 1247. doi: 10.1016/S0140-6736(00)04404-4. [PubMed] [Cross Ref ] 22. SARA Toolkit to Improve Private Provider Contributions to Child Health. Washington, DC , USAID; 2005.

  • Jacobs B, Kambugu FS, Whitworth JA, Ochwo M, Pool R, Lwanga A, Tifft S, Lule J, Cutler JR. Social marketing of pre-packaged treatment for men with urethral discharge (Clear Seven) in Uganda. Int J STD AIDS. 2003;14:216–221. doi: 10.1258/095646203762869250. [PubMed] [Cross Ref]

  • Brieger WR, Salako LA, Umeh RE, Agomo PU, Afolabi BM, Adeneye AK. Promoting pre-packaged drugs for prompt and appropriate treatment of febrile illnesses in rural Nigerian communities. Int Q Community Health Educ. 2003;21:19–40. doi: 10.2190/0N5X-0NVDR0VB- 4QKF. [Cross Ref ]

  • Montagu D. Franchising of health services in lowincome countries. Health Policy Plan. 2002;17:121– 130. doi: 10.1093/heapol/17.2.121. [PubMed] [Cross Ref]

  • Agha S, Karim AM, Balal A, Sossler S. A quasiexperimental study to assess the performance of a reproductive health franchise in Nepal. Washington, DC , Commercial Market Strategies; 2003.

  • Plautz A, Meekers D, Neukom J. PSI Research Division Working Paper No 57. Washington, DC , PSI; 2003. The impact of the Madagascar TOP Réseau social marketing program on sexual behaviour and use of reproductive health services.

  • Smith E, Brugha R, Zwi A. Working with private sector providers for better health care: an introductory guide. London , Options and LSHTM; 2001.

  • Sigonda-Ndomondo M, Kowero O, Alphonce E, Mbwasi R, Shirima R, Frankiewicz C, Taylor M, Heltzer N, Clark M. Accredited Drug Dispensing Outlets: A Novel Public-Private Partnership: December; Dar es Salaam. Management Sciences for Health; 2003.

  • Adu-Sarkodie Y, Steiner MJ, Attafuah J, Tweedy K. Syndromic management of urethral discharge in Ghanaian pharmacies. Sex Transm Infect. 2000;76:439–442. doi: 10.1136/sti.76.6.439. [PMC free article] [PubMed] [Cross Ref ]

  • Conteh L, Hanson K. Methods for studying private sector supply of public health products in developing countries: a conceptual framework and review. Soc Sci Med. 2003;57:1147–1161. doi: 10.1016/S0277- 9536(02)00491-4. [PubMed] [Cross Ref]

  • Waters H, Hatt L, Peters D. Working with the private sector for child health. Health Policy Plan. 2003;18:127–137. doi: 10.1093/heapol/czg017. [PubMed] [Cross Ref]

  • Dange Chettri GB, Kafle KK, Karkee SB, Rajubhandari V, Humagain B. Proceedings of International Conferences on Improving Use of Medicines (ICIUM): 2004 March 30-April 2; Chiang Mai. Effect of regulatory intervention on drug availability in Nepal.

  • Marek T, Diallo I, Ndiaye B, Rakotosalama J. Successful contracting of prevention services: fighting malnutrition in Senegal and Madagascar. Health Policy Plan. 1999;14:382–389. doi: 10.1093/heapol/14.4.382. [PubMed] [Cross Ref]

  • Broomberg J, Masobe P, Mills A. To purchase or to provide? The relative efficiency of contracting out versus direct public provision of hospital services in South Africa. In: Bennett S, McPake B, Mills A, editor. Private health providers in developing countries:serving the public interest? London , Zed Books; 1997.

  • Anand S, Barnighausen T. Human resources and health outcomes: cross-country econometric study. Lancet. 2004;364:1603–1609. doi: 10.1016/S0140- 6736(04)17313-3. [PubMed] [Cross Ref]

  • Harrison KA. Tropical obstetrics and gynaecology. 2. Maternal mortality. Trans R Soc Trop Med Hyg. 1989;83:449–453. doi: 10.1016/0035-9203(89)90243- 5. [PubMed] [Cross Ref ]

  • Sundari TK. The untold story: how the health care systems in developing countries contribute to maternal mortality. Int J Health Serv. 1992;22:513–528. doi: 10.2190/91YH-A52T-AFBB-1LEA. [PubMed] [Cross Ref]

  • Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091–1110. doi: 10.1016/0277-9536(94)90226-7. [PubMed] [Cross Ref ]

  • World Health Organization Improving Maternal, Newborn and Child Health in the South-East Asia Region: India. Geneva: World Health Organization; 2005.

  • World Health Organization Country Health System Profile: India. Geneva: World Health Organization; 2008.

  • Staff Reporter Over 800 rural hospitals don’t have a single doctor. Thaindian News. New Delhi; 2008.

  • Gill Z, Carlough M. Do mission hospitals have a role in achieving Millennium Development Goal 5? Int J Gynaecol Obstet. 2008;102:198–202. doi: 10.1016/ j.ijgo.2008.04.003. [PubMed] [Cross Ref]

  • Strobino DM, Baldwin KM, Grason H, Misra DP, McDonnell KA, Liao M, Allston AA. The relation of FIMR programs and other perinatal systems initiatives with maternal and child health activities in the community. Matern Child Health J. 2004;8:239–249. doi: 10.1023/ B:MACI.0000047422.87300.f7. [PubMed] [Cross Ref ]

  • Satpathy SK, Venkatesh S. Human Resources for Health in India’s National Rural Health Mission: Dimension and Challenges. Regional Health Forum. 2006;10:29–37.

  • Kwast B. Reduction of maternal and perinatal mortality in rural and peri-urban settings: what works? Eur J Obstet Gynecol Reprod Biol. 1996;69:47–53. doi: 10.1016/0301-2115(95)02535-9. [PubMed] [Cross Ref]

  • Forum on engaging the private sector in child health 30 November 2005 — 2 December 2005; Munyonyo Hotel, Kampala, Uganda.

  • Travis P, Cassels A. Safe in their hands? Engaging private providers in the quest for public health goals. Bull World Health Organ. 2006;84:427. doi: 10.2471/ BLT.06.032755. [PMC free article] [PubMed] [Cross Ref ]

  • Montagu D, Prata N, Campbell MM, Walsh J, Orero S. HNP Discussion paper: Reaching The Poor Paper No 11. Washington, DC , The International Bank for Reconstruction and Development and the World Bank ; 2005. Kenya: Reaching the poor through the private sector - A network model for expanding access to reproductive health services.

  • Bennett S, Hanson K, Kadama P, Montagu D. Making Health Systems Work: Working Paper No 2. Geneva , World Health Organisation; 2005. Working with the non state sector to achieve public health goals.

  • Price M. The consequences of health service privatization for equality and equity in health care in South Africa. Soc Sci Med. 1998; 27(7): 703-16.

  • Palmer N, Mills A, Wadee H, Gilson l, Schneider H. A new face for private providers in developing countries: what implications for public health? Bull World Health Organ. 2003; 81(4): 292-7.

  • Singh A, Mavalankar D, Desai A, Patel S, Shah P. Human resources for comprehensive EmOC: an Innovative partnership with the private sector to provide delivery care to the Poor. Ahmedabad: Indian Institute of Management, Ahmedabad; 2007. http:// gujhealth.gov.in/Chiranjeevi Yojana/pdf/Chiranjeevi Yojana-A Journey to safe motherhood.pdf

  • Bhat R, Chandra P, S M. Involving Private Healthcare Providers to Reduce Maternal Mortality in India: A Simulation Study to Understand Implications on Provider Incentives. 2007. http://www.iimahd.ernet.in/ publications/data/2007-01-01_SMukherjee.pdf


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  • Public-Private Partnership: a Revolution in Antenatal Health Management

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Authors

Nidhi Gupta
U Mass, Boston, United States
Sonal Agarwal
Department of Physiology, Saraswathi Institute of Medical Sciences, Anwarpur, Hapur, India
J. L. Agarwal
Department of Physiology, Saraswathi Institute of Medical Sciences, Anwarpur, Hapur, India

Abstract


Maternal mortality remains one of the most daunting public health problems in resource-poor settings, and reduction in maternal mortality has been identified as a prominent component of Millennium Development Goals (MDG 5). The productivity of public health sector in meeting these goals has been rather low, and it is often considered one of the 'sick unit'. Public-Private Partnership seems to be a 'treatment' to this 'sickness'. It can play a significant role in determining whether success or failure is achieved in working towards goals for safe motherhood in many low- and middle-income settings. Though established private providers, especially nurses/midwives, have the potential to contribute to safe motherhood practices if they are involved in the care continuum, it is a subject of considerable debate that can or should private organizations provide public healthcare services? What is the scope for private finance in public healthcare services? Therefore this paper reviews some of the arguments for and against public or private ownership management and financing of public healthcare services in the field of antenatal care. It concentrates on health services, where non-economic values and ethical questions are as important as the efficiency considerations, and on health purchasing or funding organizations.

Keywords


Maternal Mortality, Public-Private Partnership, Antenatal Care, Emergency Obstetric Clinic (EmOC), Millennium Development Goals (MDG 5)

References