Public-Private-Partnership for Health (PPPH) in Uganda. Gavino Maciocco

Transcription

1 Public-Private-Partnership for Health (PPPH) in Uganda Gavino Maciocco

2 Uganda. Strutture sanitarie per appartenenza: governo, privato not for profit e privato for profit.

3 Uganda. Posti letto ospedalieri pubblici e privati HOSPITAL BEDS Beds % Govt (Incl National and RR Hospitals 9,448 52% PNFP 7,882 43% Institutional 175 1% Private 712 4% Total 18, % 3

4 Financing Health Services in in Developing Countries 1987 CHARGES USERS OF GOVERMENT HEALTH SERVICES The more common approach to to health care care in in developing countries has has been to to treat it it as as a right of of the the citizenry and and to to attempt to to provide free free services to to everyone. This This approach does not not usually work. USE NONGOVERMENT RESOURCES EFFECTIVELY PROVIDE INSURANCE OR OTHER RISK COVERAGE DECENTRALIZE GOVERNMENT HEALTH SERVICES

5 Le RIFORME GLOBALI del settore sanitario Anni PRIVATIZZAZIONE DEI SERVIZI SANITARI PROMOZIONE DEL MERCATO ASSICURATIVO SERVIZI SANITARI PUBBLICI RASI AL SUOLO SVILUPPO DI PROGRAMMI VERTICALI

6 International Health Policies in the 2000s Global Health Partnerships

7 Global Health Partnership

8 CATT PROTETTORATO OLICI BRITANNICO - Comb oniani 1894 CATTOLICI Padri Bianchi Rubaga Hospital 1899 Mengo Hospital 1897 PROTESTANTI Church Missionary Society

9 INDIPENDENZA

10 WAR IN UGANDA

11 Financing Health Services in in Developing Countries 1987 CHARGES USERS OF GOVERMENT HEALTH SERVICES The more common approach to to health care care in in developing countries has has been to to treat it it as as a right of of the the citizenry and and to to attempt to to provide free free services to to everyone. This This approach does not not usually work. USE NONGOVERMENT RESOURCES EFFECTIVELY PROVIDE INSURANCE OR OTHER RISK COVERAGE DECENTRALIZE GOVERNMENT HEALTH SERVICES

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13 Nkozi

14 Figure 13 - Average amount of fees - Outpatients and Inpatients Kisubi Nk ozi Comboni Naggala ma Ibanda Matany Maracha Angal Rubaga Kalongo Average all H Average UF x Outpatient ,6 Average UF x Inpatien ,9 0

15 VARIABLE STUDIED GROUP A GROUP B User Fees range : Outpatients Inpatients Fees expressed in Uganda Shillings Fees expressed in Uganda Shillings User Fees structure Mainly flat rates Fees for services Fee for a paediatric admission (malaria) Bed Occupancy Rate 86 % - 95 % 23 % - 38 % (data available for two hospitals only) Paediatric admissions as % of total admissions User Fees collection as % of annual running costs Government financial contribution as % of annual running costs External aid 47 % - 60 % 29% - 37 % 9,5 % - 24,5 % 73,9 % - 87,7 % 13,6 % - 25,9 % 3,3 % - 25,2 % Substantial, continuous and well structured From very little to non existent Administration and management Attention paid to equity and accessibility Good management Sound keeping of service and financial records User fees consciously set and structured to ensure equity and accessibility Poor management. Poor keeping of service and financial records Little concern for equity and accessibility

16 CUAMM Course on Hospital Management in Africa April 2009 Public-Private-Partnership for Health (PPPH) in Uganda Dr. Sam Orach Uganda Catholic Medical Bureau

17 Government Funding to PNFP Health Institutions Allocations of Gov.t Funds to PNFP health sector Hospitals Lower Level Units Health Training Schools Drugs Total B Ug Sh /98 98/99 99/00 00/01 01/02 02/03 03/04 04/05 05/06 06/07 07/08 08/09 17