Abstract: Karnataka has been one of the pioneer states in the country in providing comprehensive public health services to its people by establishing Primary Health Units to deliver curative, preventive and promotive health. The changing demographic profile of the State results an increasing population in the 15-59 age group. A pre-requisite to reap this ‘population dividend’ is to ensure a healthy and empowered population. Although figures for most health indicators are encouraging in Karnataka but, there are wide inequities in the health status within the State. These range from geographic inequity such as urban/rural, north/south, gender based disparities and age wise disparities that cut across all aspects of the health system. Even with several policies and reforms within the health sector, the State continues to grapple with preventable diseases like diarrhea and tuberculosis and faces issues such as malnutrition and low vaccination rates. NFHS III (2005-06) examined the reasons for poor utilization of government facilities across the states of India. The results show that 64% households in Karnataka do not use a government facility, as compared to 47% in Tamil Nadu and 50% in Kerala. In Karnataka the primary reason was poor quality of care as reported by 51% of respondents. The other major reasons were facility not being nearby was responded by 45% of respondents, timing by 25%, waiting time by 32% and staff absent by 14% of respondents. As a result 71.1% of per capita expenditure on health in Karnataka is by the private sector and out of pocket contribute up to 80% of the total financial resources for health care.
Deficiencies in the public sector health system has forced poor and deprived sections of the society to seek health services from the private sector. Evidence indicates that, in many parts of the State, the private sector provides a large volume of health services but with little or no regulation. The private sector is not only the most unregulated sector but also it is the most potent and untapped sector. To address the inefficiency and inequity in the health system, Karnataka has initiated many health sector reforms. One of these reforms has been to collaborate with the private sector through Public Private Partnership (PPP) to reach the poor and underserved sections of the population.
The research study compiled 12 in-depth case studies of public/private partnership projects across the State. The case studies examined issues such as scope and objectives of the public and private partners, mechanisms used, performance monitoring, payment mechanisms, stakeholder/beneficiary perspectives and sustainability of the partnership. Each case study was exclusive in terms of the scope, coverage and the purpose of the partnership. The study also provides insights into how they work, how the poor have been targeted, constraints and bottlenecks, implementation and management of partnerships and performance of these partnerships in reaching the targeted population. The paper argues that, if well designed and implemented in stages, PPP is an innovative mechanism that benefits the poor. It would be unfair to categorise PPP as privatisation or marketisation because most of the partnerships that are designed to deliver health services. This paper highlights significant policy perspectives on public/private partnership in health sector. Operational issues in the context of equity, accessibility to the poor and the deprived groups are discussed.
Title: THE IMPACT OF PUBLIC-PRIVATE PARTNERSHIP IN PUBLIC HEALTH OF KARNATAKA
Author: PROF. MANJAPPA D. HOSAMANE, JAYASHRI M
International Journal of Management and Commerce Innovations
ISSN 2348-7585 (Online)
Research Publish Journals
