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Pursuing PPP in Health in the Philippines

Ms. Rosa Gonzales, Department of Health The Role of Non-State Providers in Delivering Basic Social Services for Children Regional Workshop April 19-20, 2010, ADB Headquarters. Pursuing PPP in Health in the Philippines. The Drivers for PPPs. Achievement of health outcomes, rising demand

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Pursuing PPP in Health in the Philippines

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  1. Ms. Rosa Gonzales, Department of Health The Role of Non-State Providers in Delivering Basic Social Services for Children Regional Workshop April 19-20, 2010, ADB Headquarters Pursuing PPP in Health in the Philippines

  2. The Drivers for PPPs • Achievement of health outcomes, rising demand • for better/improved health • Ongoing and sustaining/complementing the gains • achieved from parallel health reforms • -2000 DOH Reengineering espousing leadership in • the health sector, shift in roles and functions • -Present reforms on health governance/financing • stress on performance and “value for money” • (eg PBGs, fiscal autonomy of health facilities and • capitation schemes)

  3. The Drivers for PPPs • Initial step towards formulating a policy and • operational framework for PPPs are addressed • through Administrative Orders for key processes • and programs: 2000-2008 • Examples: • - Chapter on PPP in the NOH • - Electronic Procurement System using a Private Sector Platform • - The National and Regional Coordinating Committee on Public-Private • MIX Dots • - Public-Private Collaboration in Delivery of Health Services (incldg FP, • Repro Health) • - Rapid Reduction of Maternal and Neonatal Mortality • - DOH and Dept of Labor (DOLE) Partnership: Strengthening Support • for Workplace Health Programs

  4. The Drivers for PPPs • Initial step towards assessing PPPs in Health in a • more comprehensive manner was started in 2008 • with assistance form the ADB Support for Health • Sector Reform, specifically, aiming to: • - benchmark Philippine experience with international • - identify and characterize PPP initiatives: strengths /weaknesses • - identify opportunities for expanding PPPs • - identify the PPP policy options for DOH • The follow up technical assistance from ADB started in • 2010 to assist DOH in formulating a policy framework • and strategic direction for PPP in Health

  5. PPP Types and Objectives Addressed (Sample: 10/30 PPPs Identified)

  6. SAFEMON • Program Overview: Provide quality & affordable FP Services and upgrade the practice of midwifery (ie capacitate midwives for entrepreneurship and Private practice. • IMAP (Bohol) started SAFEMOM, conducted baseline study to • determine FP needs and scan existing PPPs • Secured technical assistance from PRISM in establishing the • lying-in clinics • Initiated training service programs for midwives (ie BEST) • Secured Philhealth accreditation • Secured additional funding assistance from LGU • Systems in place: conduct of regular case conferences, • referral, MIS, communications & marketing plan

  7. Key Achievements: • Increase of clients by 60% and revenues • by 40-60%. Earned credit-worthy status. • Expansion of the referral system (to capital city in the • region) • Growth in IMAP (increased number of membership, • more benefits and increased income for midwives, • more employment, well capacitated through a • packaged training program • Partners Benefits: Increased incomes for doctors, • and support for IEC advocacies. Provided policy • inputs in DOH and collaborated closely with LGU • in delivery FP/MCH services • Became an advocate and rescuer for FP/MCH programs • in localities where it was least prioritized

  8. Lessons Learned • Engaged/maximized partnerships for services and • resources that it could not assume well (local and • and private hospitals) • Applied business concepts (eg socialized pricing) to • enhance operations and services) • Contractual arrangements (MOUs) merit improvement • in terms of more specific targets and deliverables. • Other binding agreements such as penalties for • non-compliance were not included

  9. STRENGTHS of PPPs • Offers richness of experience because of diverse • types and forms • Partnership can be tripartite or more • (eg with the corporatized ILHZ & emphasis on • people or community responsibility) • Some have been scaled-up with new funding • because of encouraging results • (eg SAFEMOM, KLM: Movement Against Malaria) • Support systems (eg IT) improved operations • (eg LUMC)

  10. WEAKNESSES of PPPs • Informality of governance structures: absence of • long-term planning, weak contractual arrangements • and accountability • Relies heavily on charismatic leadership rather than • putting premium on strengthening of institutional • structures • Relies on foreign donors for funding • Can duplicate in some instances because objectives • are not well integrated into the broader health • system

  11. The Challenges for DOH • As leaders or overseers: capacity for contract • management, monitoring and evaluation • Institutionalizing the PPP Unit in DOH with an • overstretched staff and undersized DOH: In doing • ME, should we contract PPP monitor solely for this? • Developing a policy framework with more and • sound evidence. Hence, a PPP Research Agenda? • Access to vital resource on PPP documentation and • institutionalizing these in the policy process of • DOH that PPP concerns/updates are reported in • the Execom

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