Public Private Partnership for Health Our Experience-Road Ahead

Transcription

1 Public Private Partnership for Health Our Experience-Road Ahead Dr. Anil J. Purty MD, DNB, MNAMS Associate Professor Department of Community Medicine PONDICHERRY INSTITUTE OF MEDICAL SCIENCES

2 What is Partnership? It is a joint ownership of a program/ proposal by two or more parties to achieve a common goal. It is a higher level of collaboration.

3 Prerequisites of Partnerships Super-ordinate Goal High perceived pay-off to both parties Equal power with both parties Mutual Trust

4 Principles for Partnership Joint action at all stages from planning, follow up and termination Complimentary roles expectation of each other are clarified and stabilized Creation of a temporary system task force with representatives from both sides Continuous Communication lines of communication between partners to be always kept open

5 Public Private Partnership in Health Care PPP is Seeking collaboration with private sector in the situations where the public health system is not immediately able to provide guarantee.

6 PPP at Global Level in Health Global Alliance for Vaccine and Immunization Global Polio Eradication Initiative European Partnership Project on Tobacco Dependence UNAIDS/Industry Drug Access Initiative Stop TB Initiative Roll Back Malaria

7 Issues in PPP in Health Care Capacity of Private Partner Advocacy Accreditation Regulation by the Government

8 Application of PPP in India Health System Development Projects National Rural Health Mission Blindness Control Diagnostic Support within Medical College Hospitals

9 MADRAS MEDICAL MISSION PIMS DIRECTOR Professor & HOD FACULTY Professor-1 Associate Prof-3 Asst. Prof-2 Lecturer (Biostat)-1 Tutors-4 HEALTH CENTRES RHC, Chunampet UHC, Muthialpet RHC, Anaichikuppam PHC, Kalapet, PHC, Katerrikupam Health Centre, Univ. Medical Officers Medical Social Workers Public Health Nurses Technicians Field Health workers Office Staff Supportive Staff Drivers Electrician Security Gardner Cook Safaikaramchari Total staff : 94

10 PONDICHERY INSTITUTE OF MEDICAL SCIENCES (A Unit of Madras Medical Mission) Dept of Community Medicine Reaching the Unreached RHC Chunampet Pop: 9,408 UHC Muthialpet Pop:12,026 State Govt. PHC Kalapet, Pop: 12,458 State Govt. PHC Katerrikuppam Pop:10,312 Hope Hospital Anaichikuppam Pop: 10,027 Health Centre Pondicherry University Pop: 2320 RNTCP,ADRA (India) TB Project in TN, RCH (FNGO), NACP,PUDA

11 ACTIVITIES o Teaching and Training o Primary Health Care to over 1,00,000 Population o Community Based Research o Health Education o School Health Programme o Liason with Govt. Departments for NHPs o Co-ordination with National and International NGOs for Public Health Practice

12 Teaching and Training MBBS Students Semester I-VII as per MCI and University guidelines Community Based postings/teaching ROME Scheme Training of allied health staff working with Govt. and NGOs

13 Community Postings

14 SCHOOL HEALTH PROGRAMME

15 Dental School Health Programme

16 Training of Field Health Workers

17 COMMUNITY EDUCATION

18 DEPT. OF COMMUNITY MEDICINE ANNUAL REPORT 2006 OPD-PATIENTS SL.NO CENTRES TOTAL NO.OF PATIENTS UHC-MUTHIALPET RHC- KOONIMEDU & HOPE HOSPITAL RHC-CHUNAMPET PHC-KALAPET PHC-KATTERIKUPPAM UNIVERSITY HEALTH CENTRE TOTAL 1,10,984

19 Dept. of Community Medicine Annual report-2006 Income from Centres Centres Total income 1. UHC- MUTHIALPET Rs. 10,94, RHC-CHUNAMPET Rs. 4,83,547 3.RHC- KOONIMEDU Rs. 2,46,653 & HOPE HOSPITAL 4.UNIVERSITY HEALTH CENTRE Rs. 2,02,234 Total Rs. 20,26,751

20 Dept. of Community Medicine Annual report-2006 Income from Centres Total Income from Centres - Rs. 20,26,751/- Total Income from Camps - Rs. 2,49,725/- Total Income of Dept. - Rs.22,76,476/- Estimated Expenditure: - Rs. 50,00,000!!

21 ANNUAL REPORT-06 PARTICULARS JAN-DEC-05 JAN-DEC-06 Total population Male Female No. of families URBAN HEALTH CENTRE- Hindu 1950(83.6%) 2299(85.9%) Muslim 105(4.5%) 95(3.5%) MUTHIALPET Christian 278(11.9%) 283(10.6%) Family Size ANNUAL REPORT-2007 No. of EC 1742(16.8%) 2020(16.8%) Family PS PERMANENT Tubectomy Vasectomy 2 5 TEMPORARY CC IUCD Pills 5 12 TOTAL FPC 58% 56.3% EFPC 57% 53.7% No. of death Total Live Birth M U T H I A L P E T UHC

22 MORBIDITY MORBIDITY REPORT OF MUTHIALPET-UHC GASTRO. INTESTINAL INFECTION 1876 ACUTE RESPIRATORY INFECTION 4133 TUBERCLOUSIS(PULMONARY & EXTRA PULMONARY) NUMBERS 17 EYE INFECTIONS 141 GENITO URINARY INFECTION 175 NUTRITIONAL DISORDERS 470 MUSCLO-SKELETAL DISORDERS 3613 SKIN INFECTION 466 ENDOCRINAL DISORDERS 08 CARDIOVASCULAR CONDITIONS 97 PSYCHIATRIC DISORDERS 07 FEBRILE CONDITIONS 821 CNS DISORDERS 43 MISCELLANEOUS 13,749 TOTAL 25,616

23 ANNUAL REPORT CHUNAMPET RHC PARTICULARS JAN-DEC-05 JAN-DEC-06 Total population male female No. of families hindu Muslim Christian 17 9 Family Size No. of EC 1263(15.9%) 1455(15.4) Family PS PERMANANT Tubectomy Vasectomy 2 2 TEMPORARY CC 5 15 IUCD 9 9 Pills 1 - TOTAL FPC 68.3% 74.1% EFPC 67.7% 73.5% No. of death Total Live Birth

24 MORBIDITY MORBIDITY REPORT OF CHUNAMPET-RHC GASTRO. INTESTINAL INFECTION 3628 ACUTE RESPIRATORY INFECTION 3587 TUBERCLOUSIS(PULMONARY & EXTRA PULMONARY) EYE INFECTIONS 504 GENITO URINARY INFECTION - NUTRITIONAL DISORDERS 925 MUSCLO-SKELETAL DISORDERS 2293 SKIN INFECTION 2606 ENDOCRINAL DISORDERS 1033 CARDIOVASCULAR CONDITIONS 512 PSYCHIATRIC DISORDERS 23 FEBRILE CONDITIONS 48 CNS DISORDERS 826 MISCELLANEOUS 3172 NUMBERS TOTAL 20,436 33

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27 HEALTH CAMPS IN TSUNAMI AFFECTED AREAS

28 URBAN HEALTH CENTRE

29 Public Health Activities Monitoring of Pulse Polio Immunization State Task Force- RNTCP in Medical Colleges Sentinel Surveillance- NACP Mass Drug Administration- Filariasis DOTS Centres with the RNTCP NGO Collaborating centre for Post Tsunami Relief and Restoration NGO Training- Lutheran World Service, ADRA

30 PARTNERSHIP FOR RURAL HEALTH CARE

31 COLLABORATIONS WITH NHPs World Health Organisation (Delhi) ICMR, TB Research Centre (Chennai) RNTCP, HIV- State and Central Govt.

32 COLLABORATIONS NGOs ADRA, BGEA, PMSS, PRANA National Agro Foundation Lutheran World Service, India

33 RECENT PRESENTATIONS ISMS National Conference, Coimbatore 34 th IAPSM, National Conference, AIIMS Delhi RNTCP Zonal Task Force (Hyderabad), RNTCP National Task Force (Delhi)

34 Prevalence of Diabetes in Urban Pondicherry (Dr. V. Mohan) PONDICHERRY INSTITUTE OF MEDICAL SCIENCES DEPARTMENT OF COMMUNITY MEDICINE FAMILY FOLDERS Socio-demographic details Individual health card Eligible couple card Maternal Health card Under-five health card OP Visit cards REGULAR UPDATE BY House to house visit by HW (F) Daily recording and reporting Monthly review Meetings Supervision by MSW, RMO ELECTRONIC DATABASE All data computerized Epi info package 6. UHC MUTHIALPET PONDICHERRY (PDY) (2003) NO. OF FAMILIES-1511 BASELINE POPULATION- 6,607 (2004) NO. OF FAMILIES-1888 POPULATION- 8,233 (M-4131, F-4102) (2005) POPULATION 10,371 NO. OF FAMILIES-2333 (M-5162, F-5209) (2006) NO. OF FAMILIES-2677 POPULATION 12,026 (M-3329, F-3278) 1.RHC, CHUNAMPET (TN) 2.RHC, ANAICHIKUPPAM (TN) 3.UNIV.HEALTH CENTRE(PDY) 4. PHC, KALAPET(PDY) 5. PHC KATERRIKUPPAM(PDY) < 5% Changes in Population (Births Deaths Migrations Marriages) NUMBER OF PERSONS WITH DIABETES: 643 Males-346 Females-297

35 Tuberculosis case-finding and treatment under RNTCP: Patient, health system delays and reasons for default in and around Puducherry. From the RNTCP DMC Lab. Registers in 4 Medical Colleges and 5 Govt. PHCs and DTC Patients referred for treatment outiside Puducherry, Contact once Enlist all TB patients diagnosed under RNTCP During I & II Quarter of 2007 SAMPLING, OBTAIN CONSENT,RECRUIT 300 PATIENTS (100 IN EACH GROUP) FOR FOLLOWUP Patients referred for treatment within Puducherry Contact twice Patients started on Treatment at DMC/TU Contact twice July 1 - December 31, 2007-Contact and interview patients at their residence or DOTS centre to study the patient and health system delays. Contact MO (PHC), DOT Provider, DTO to find Methods to improve feedback mechanism in RNTCP. January 1- June, 2008-Contact and interview patients reported to default to find out reasons for default. Contact MO (PHC), DOT Provider, DTO to find Methods to decrease default in RNTCP July-October, 2008-Record the outcome of these patients from the RNTCP Treatment cards/monthly/quarterly reports. October- December Report writing- Collate,analyse and present Findings in final study report

36 Challenges in PPP for Health Care Cost containment (?4.5 Lakhs/month) Effective use of private resources Logical diversion of public resources Synergy to reduce duplication Resource mobilization

37 THANKYOU