Photo: DFID | Flickr Creative Commons
Health is one of the United Nation’s Sustainable Development Goals (SDGs). However, it is not feasible for any country, rich or poor, to provide its entire population with all needed health services. Accordingly, the private sector has an important role to play in closing the healthcare gap, as it contributes financial resources, innovation, and expertise.
The managed equipment services (MES) arrangement, used in Kenya, is one way to do this. MES is a business model emerging in Kenya’s healthcare system involving partnerships between the private sector and public healthcare providers that offers solutions to some of the challenges posed by the dynamic healthcare industry.
Photo: Direct Relief, Flicker Creative Commons
The Kenyan government launched its national long-term development plan, Vision 2030, in 2008 with the aim of transforming Kenya into a newly-industrialised, middle-income country providing a high quality of life to all citizens by 2030, in a clean and secure environment.
Constructed around three key pillars – economic, social and political – the blueprint has been designed to address all aspects of the country’s infrastructure and economy, with a key component of the social pillar consisting of ambitious healthcare reforms. Ultimately, the government’s goal is to ensure continuous improvement of health systems and to expand access to quality and affordable healthcare to tackle the high incidence of non-communicable diseases that affect the region.
Editor's Note: Join us April 22nd at 10AM ET for the 2017 Global Infrastructure Forum when the Multilateral Development Banks (MDBs), the United Nations, the G-20, and development partners from around the world meet to discuss opportunities to harness public and private resources to improve infrastructure worldwide, and to ensure that investments are environmentally, social and economically sustainable. Check out the event site to view the livestream on April 22.
Imagine the difficulty of designing, financing, building and operating a €360 million, 1,000-bed hospital campus that serves a region of 1.6 million people? This is exactly what the government of Turkey is doing in Elaziğ, a city of 350,000 in eastern Anatolia. The facility will serve and accommodate about 20,000 patients and their relatives per day with a broad range of services including women and children’s health, psychiatric services, and a dental clinic.
A project of this size is bound to be challenging and complex. But the approach taken by the Turkish Government has been a success—to involve a private-sector partner through a public-private partnership (PPP) with support from multilateral development banks. How did they do it?
The Indian State of Bihar, by population, is larger than the Philippines. Or, if you prefer, by the number of residents, Bihar would be the 13th largest country in the world. Yet Bihar’s health indicators are consistently worse than India’s average. And despite accounting for nearly 9% of India’s population, not a single specialty health facility in Bihar is among the nearly 340 Indian hospitals accredited by the National Accreditation Board of Hospitals & Healthcare Providers.
The combination of a high population and a significant lack of quality specialty healthcare facilities has a profound negative impact on the people of Bihar. This is an onerous burden in a state that is already one of the five poorest in India, with a per capita income only half of that of the country as a whole.
One of my favorite songs when I was growing up was John Lennon’s “Imagine.” A few months ago, UNICEF created a project around it to highlight the plight of millions of refugee children. As 2016 drew to a close, I couldn’t help but imagine a world with high-quality, affordable, sustainable, well-maintained infrastructure services for everyone.
I’m not sure a video of infrastructure projects set to “Imagine” would fire people up as much as the UNICEF video does. But there is value in reflecting on what we have accomplished in 2016, and what we might hope for and imagine in 2017, to bring this vision closer to reality for millions of people.
- Public Private Partnerships
- Public private partnership
- Labor and Social Protection
- Agriculture and Rural Development
- Climate Change
- Financial Sector
- Global Economy
- Information and Communication Technologies
- Law and Regulation
- Private Sector Development
- Public Sector and Governance
- Urban Development
- The World Region
Imagine you fall ill or have a serious accident. You survive, but to recover you need extensive medical care. The problem? You don’t have insurance and have to pay out of pocket. Your life savings are quickly drained away, as are your dreams. Your children lose hope for higher education; your well-researched business plan becomes a work of fiction.
For millions of people throughout the world, a diagnosis of Chronic Kidney Disease ushers in a lifetime of dialysis treatments. A dialysis session lasts four hours, and is required two to three times a week – so these treatments are often just as logistically challenging as they are physically difficult. But the trials of treatment pale in comparison to no treatment at all, which was often the case for citizens of Bangladesh prior to 2015. That was the year the government offered its citizens dialysis services through a pioneering public-private partnership (PPP) that increased the number of dialysis machines and broadened dialysis services by adding new capacity into existing public hospitals.
I’ve worked in the area of health PPPs for many years, and have seen first-hand how patients benefit from well-structured partnerships. At IFC, our goal is to work with governments with pressing health sector needs and help them develop the right kind of partnership to deliver improved health facilities and services. Like infrastructure PPPs, health PPPs are complicated, long-term deals—but unlike infrastructure PPPs, we have the opportunity to measure results in lives. This makes our work in the field of health PPPs especially important – and rewarding.
. That’s been true in the State of Bahia, Brazil, following the Sometimes, the most persuasive case for a PPP is the success of a past partnership in the same sector Hospital do Suburbio project, which closed in 2010 with help from IFC’s PPP advisory services and has been providing people in one of the State’s poorest suburbs with access to high quality healthcare. Based on the success of the PPP in meeting state government goals for improving local health services, Bahia government officials approached IFC again to discuss a new initiative – , including to rural communities. a partnership to offer imaging and diagnostic services and facilities across the state
Just as the Hospital do Suburbio emerged from great need, people in Bahia faced a shortage of high quality and complex imaging equipment and tests. Some of these were as basic as X-rays and mammography; others demanded state-of-the-art machines and services for CT Scans and MRI tests. This fed into the Bahia’s larger public health challenges, which included low bed turnovers and overcrowded hospitals.
The partnership with the private sector was created to solve this “package” of problems. It was undertaken in partnership with the Brazilian Development Bank (BNDES) and the Inter-American Development Bank (IDB), which together manage the Brazil PSP Program fund, a project that fosters the development of infrastructure and services in Brazil in partnership with the private sector.
To gain a better understanding of how innovation in public-private partnerships (PPPs) builds on genuine learning, we reached out to PPP infrastructure experts around the world, posing the same question to each. Their honest answers redefine what works — and provide new insights into the PPP process. This is the question we posed: How can mistakes be absorbed into the learning process, and when can failure function as a step toward a PPP’s long-term success?
Our eighth and final response in this eight-part series comes from Thomas Maier, Managing Director, Infrastructure with the European Bank for Reconstruction and Development (EBRD).
For countries new to PPPs, there is no doubt a steep learning curve. Fortunately, there is also a growing body of experience that such countries can learn from — the key is to understand the essence of the lessons and then incorporate these changes into the design of government support for PPPs.
Ultimately there is, of course, no substitute for good project preparation, local capacity and the development of solid legal frameworks and local capital markets — we all know these are the building blocks for the long-term success of any country’s PPP program.
Focusing on lessons learned from EBRD’s region, two current examples from Kazakhstan and Turkey come to mind.
One of the most salient features of a public-private partnership (PPP) arrangement is the flexibility to use out-of-the-box solutions in resolving the many challenges in day-to-day operations. As a result, the PPP setup gives operators the liberty to come up with innovative solutions for more effective and efficient delivery of the most basic services.
In the Philippines, Laguna Water — a joint venture company formed as a result of a PPP between the Provincial Government and Manila Water Philippine Ventures formerly known AAA Water Corporation — is benefitting immensely from that flexibility since it took over the operations of the province-run water system in 2009. Although primarily tasked to improve the provision of water and wastewater in the three cities of Biñan, Sta. Rosa and Cabuyao — collectively known as concession area — Laguna Water’s sustainable business model allows it to participate on matters related to community development (including job generation), as well as programs centered on health, safety and environmental protection.
As a staunch advocate of sustainability, Laguna Water takes pride in having significantly improved access to piped, clean and affordable water to 62 percent of the population of the concession area— a far cry from the 14 percent when it started its operations in 2009. The joint venture’s PPP framework has been instrumental in putting in place water infrastructure that provides easier access and better services to customers. Today, Laguna Water is the biggest water service provider in the entire province, and is also ahead in its service-level targets on coverage, water quality and water loss reduction.
Here are some details about our PPP-empowered approach.
- drinking water
- clean water
- Environmental Protection
- Community Empowerment
- water access
- partenariats public-privé
- public-private dialogue
- public-private partnership
- public-private partnerships
- Social Development
- Private Sector Development
- East Asia and Pacific