Providing Healthcare

The article “Public-Private Partnerships in Maternal Health Services” by T K Sundari Ravindran (EPW, 26 November 2011) is timely. It will be good to realise that the best way to care for the poor is through the public sector which does not have concerns of “economic viability”. If the idea is to supplement the public sector with the enormous resources that the country has created in the private sector, the paradigms and expectations need to be tailored accordingly. This is what the World Health Partners’ (whp) project in Uttar Pradesh (up), referred to in the article, attempts to do. We also focus on above-the-poverty line segments to build the service delivery infrastructure in order to reduce the onus on the public sector and, as a logical extension, use special subsidies to address the needs of the segments below the poverty line (bpl) through the same infrastructure.

One point worth noting, which the article does not mention, is that WHP’s UP project is primarily focused on family planning. This being a preventive service, it does not induce too much interest among the private providers, particularly in rural areas where the need is the most but the caseload for individual providers is very limited. WHP deals with this challenge by creating an economic opportunity by the provision of curative care through a technology-based or business-linked service delivery system but makes provision of family planning mandatory. The investment in the technology was about Rs 1.2 lakh when WHP was established three years ago and has now been brought down to Rs 40,000 (and likely to come down further in view of cheaper hardware now being available). The entire investment is made by the rural entrepreneurs.