Partnership Working in Public Health

This document discusses public-private partnerships (PPPs) in public health. It begins by outlining the objectives of the lecture, which are to conceptualize the importance of PPPs and their implications for public health approaches. It then provides examples of global health issues like tuberculosis that disproportionately impact poor communities and discusses how PPPs can encourage investment in developing treatments. Key benefits of PPPs include leveraging the strengths of both public and private sectors. The document outlines several examples of PPPs in the health sector in Bangladesh, including for immunization programs and nutrition initiatives. It emphasizes the importance of community engagement for improving quality, strengthening accountability, and supporting progressive partnerships in health.

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Partnership Working in Public Health

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Introduction to Public Health

Module # 6
partnership working in public health
DR. SHAIKH ABDUS SALAM
Dept. of Public Health
North South University

Dr.Shaikh Abdus Salam

OBJECTIVES OF THE
LECTURE
By the end of this lecture you will be able
to:
o Conceptualize
the importance of PPP and utilization
The various implications of public health approaches
how to perform health promotion and health prevention
oUnderstand the ways to influence communities towards

healthy living habits and community participation.

Dr. Shaikh Abdus Salam 1

About 9 mil people worldwide suffer from
TB which is one of the leading causes of
deaths of adults in the developing world.
The number of TB cases worldwide has
grown with the spread of HIV and 13% of
deaths of people with AIDS are due to
TB. Despite the importance of TB,
however, no new drugs for TB have been
developed since the 1960s. TB is a
disease that largely affects poor people
in LMIC. These people have little money
to spend of drugs and there is minimal
economic incentive for pharmaceutical
companies to develop new TB drugs.
Food for thought
Can actors in global health work together to
encourage the development of new drugs for
TB and other neglected diseases?
What would they have to do to encourage
public and private sector investment on such
drugs?
What would they have to do with investors
that if they are able to develop such drugs
that there will be a market for them?
PPP
PPP:
1) Bilateral cooperation-
2) Regional cooperation-
3) International cooperation-
4) Global partnership-
Public-private partnership
(PPP)
Mid 1990s- interest in global health rose
100 years old TB vaccine
Insufficient attention for developing HIV
and malaria vaccine
Private pharmaceuticals found less profit
in developing low-cost diagnostics,
vaccines, drugs, medical devices
Public-private partnership
(contd.)
Rockfeller foundation encouraged global
health actors
Combine the strength of both public and
private organizations
Seek border sources of financing
Tackle intellectual property issues to
ensure availability and affordability of
diagnostics, vaccines, drugs and medical
devices
What is PPP?
PPP in health: an approach to addressing
public health problems through the
combined efforts of public, private and
development organizations complimenting
each other by contributing or sharing their
core competency.
Some important PPP for public health
- Global alliance for TB drug development
- International AIDS vaccine initiatives
- Malaria vaccine initiative
- Medicines for malaria venture
What does PPP do in PH?
PPP allows greater private sector
participation in the delivery of services
PPP allows the public agencies to tap
private sector technical, management and
financial resources to achieve certain
public agency objectives such as
- greater cost and schedule certainty,
- supplementing in-house staff,
- innovative technology applications,
- Specialized expertise or access to private
capital.
Reasons for PPP
Accelerating the implementation of high priority
projects by packaging and procuring services in new
ways
Turning to the private sector to provide specialized
management capacity for large and complex programs;
Enabling the delivery of new technology developed by
private entities;
Drawing on private sector expertise in accessing and
organizing the widest range of private sector financial
resources;
Encouraging private entrepreneurial development,
ownership, and operation of related assets;
Allowing for the reduction in the size of the public
agency and the substitution of private sector resources
and personnel.
Large international NGOs like Oxfam, World Vision, Caritas, CARE,
MSF
increasingly vocal about their role within the health care system
able to deploy large sums of money and large numbers of
personnel quite effectively
Growing number of private philanthropic organizations, like the
Rockefeller Foundation, Ford Foundation, and Bill and Melinda
Gates Foundation, and now this part of the private sector is highly
competitive with the usual forms of bilateral (national aid agencies)
and multilateral (UN agencies and World Bank) aid in the health
sector
With the WHOs emphasis on improving health systems, it became
a staunch advocate of partnering with the private sector in dealing
with worldwide health problems, including the infectious diseases
of public health importance
Key benefits of PPP
PPP provides benefits by allocating the
responsibilities to the party either public or
private that is best positioned to control the
activity that will produce the desired result

The primary benefits of using PPP to deliver

services include:
- Expedited completion compared to conventional
delivery methods
- Cost savings
- Improved quality and system performance from the
use of innovative materials and management
techniques
- Substitution of private resources and personnel for
constrained public resources and
- Access to new sources of private capital
Ten essential public health
services
Diagnose and investigate the health problems and health hazards in the
community.
Mobilize community partnerships.
Develop policies and plans that support individuals and community health
efforts.
Inform, educate and empower people about health issues.
Monitor health status to identify the community health problems.
Enforce laws and regulations that protect health and ensure safety.
Monitoring and evaluation of population based health care services.
Operational research to find out innovative solution to the health problems.
Assured competent public health and personnel health care work force.
Link people to needed personnel health services and assure the provision of
comprehensive health care when otherwise unavailable.
Proposed Sectors of PPP in
Bangladesh
Health Sector
Education Sector
Infrastructure Development
Tourism Sector
ICT Sector
Industries
PPP in health sector
PPP in health sector of
Bangladesh
Expanded program of immunization (EPI):
One of the greatest PH achievement in
Bangladesh
Provides vaccination against six diseases:
Neonatal tetanus
Polio
Diphtheria
Measles
TB and
Whooping cough
PPP in health sector of
Bangladesh (contd.)
Strong commitment to improving national EPI
Technical and financial assistance of international donors
WHO, UNICEF, USAID, JICA, rotary international, SIDA, GAVI
42% paid by GoB & rest by donors (2014)
During mid 80s GoB sought cooperation from NGOs
Around 20-25 NGOs working jointly with GoB for EPI
Prominent NGOs: BRAC, CARE, icddr,b, Proshika,
RDRS, rotary international, Smiling sun
Partnership on vaccine, human resources,
infrastructure, logistics, awareness buidling
PPP in health sector of

Bangladesh (contd.)
Nutrition program in Bangladesh:
Two phases
Bangladesh integrated nutrition program (1995-2002)
National nutrition program (2002-2010)
High rates of LBW and malnutrition BINP was introduced with World Bank
fund
BINP was 1st large scale multi-sectoral project on nutrition in Bangladesh
Learning from BINP influenced to launch NNP
Objectives of NNP: to reduce malnutrition among women, adolescent girls
and children
PPP in health sector of
Bangladesh (contd.)
Health financing:
Household expenditure 63%
MOHFW development budget 18%
MOHFW revenue budget 13%
Non profit NGOs and donors 3%
Other public revenue 3%
Hospitals in Dhaka
Around 7, 350
Private 86%
NGO running 12%
GoB running 2%
Importance of community engagement
in PPP
To Improve Quality by
Information sharing and input from key stakeholders to develop
evidence-based services;
Building capacity in communities and within the organization;
Contributing to better health outcomes through empowering
individuals, families and local communities
To Strengthen Accountability by
building trust and credibility with communities that input is
honored and acted upon
To Support Progressive Partnerships by
Developing bridges between the health system, non profit
organizations working in health and social services;
Engaging in processes that support clients as partners in the
management of their health and health care;
Developing internal partnerships to align and improve health
services across large continuum.