About the Project

Over the years the private health sector in India has grown markedly. As budgetary constraints erode the capability of the public health system, the poor are forced to spend out of pocket to seek health care services from the private sector. Though unregulated and inequitable, the private sector is easily accessible, better managed, and a potent sector for realising public health goals.  Public collaboration with the private sector in the form of Public-Private Partnership (PPP) would improve equity, efficiency, accountability, quality, and accessibility of the entire health system. While there are many innovative options available for PPP, there is little evidence to indicate the relative merits of one form of PPP over another that could help in developing a comprehensive policy towards the private sector. There is little evidence to suggest the institutional capacity of the government agencies to design, negotiate, implement and monitor such partnership, scope and coverage of the services for potential partnership with the private sector, required incentives and subsidies, transaction costs and savings, delegation and decentralisation of authority, performance and quality of services under existing arrangements, operational constraints, effect on the public health system, stakeholders’ perspective to this policy option, and whether PPP has been particularly designed to benefit the women, children, and elderly,  etc.

There can be no effective and sustainable policy options unless these issues are studied in depth, systematically analysed, and documented. This study will (a) review and evaluate the experiences, including stakeholders perspective, in five selected states of India and in the Netherlands, through case studies on various forms of PPP, (b) compile documented evidence from Europe and other developing countries, and (c) identify the policy options, institutional necessities, and future directions for an enhanced role of private sector participation in the provision of public health services, targeted to the poor, women, children and the elderly. Stakeholders from government, patients, the private sector, development organizations, community groups, and bilateral and multilateral agencies will be extensively consulted.

Unless innovative and radical changes are brought about in the health sector, the poor and socially marginalized groups will continue to bear the brunt of inefficient public health system and the unregulated, inequitable private health sector.  While PPP is considered to be an option for ensuring efficiency, quality and accountability of the health system, the task will be a big leap forward for government departments under the present circumstances. Therefore there is a need to find evidence-based ways to develop the capacity of the government institutions and systems towards this task. This study will provide insights into the experiences of PPP around the world and in India by highlighting the opportunities, challenges and policy options of decision makers, administrators, researchers, regulatory agencies and others in fostering private sector collaboration in the provision of affordable, and quality health care to the needy.