Wednesday, October 07, 2009

Public-private partnerships for healthcare delivery in the African context: neologisms, sacrosanctity and the re-birth of Garki hospital.

The following abstract has been accepted for presentation at the 2nd WONCA African regional conference in South Africa. The abstract is listed on the conference website. The conference comes up at the end of this month. Please read.

Oral presentation.
FALEGAN Ifeolu Joseph. Consultant Family Physician, Garki Hospital, Tafawa Balewa Way, Area 8, FCT, Abuja, Nigeria. www.advocatehealth.blogspot.com. faleganji@yahoo.com.
The quest for efficiency and sustainability is beginning to impact healthcare delivery globally. There is a gradual departure from the norm. Public-private partnerships for healthcare delivery are being erroneously regarded as new entrants into the field of health systems reform. This axiom is being promoted in the parlance of world bodies in an attempt to improve health outcomes. However, healthcare delivery in every country involves some form of public-private partnership. In many countries where care is devolved through the public system, there is significant input from the private sector and vice-versa. This fact holds true for many African countries.
The public health system is decadent in a number of failed African states. The consequence is an unregulated private-driven healthcare system with a propensity for high out-of-pocket expenses in contradiction to the quality of care received. In Nigeria, for instance, close to 70% of healthcare is delivered by the private sector.
Garki hospital, Abuja, is the first acclaimed public-private partnership for health in Nigeria. The hospital was revived two years ago in a franchise that merged private finance initiative with government’s quest for quality healthcare delivery and has since then been dispensing care to patients from within and outside the Federal Capital Territory.
This presentation examines the different models of public-private partnerships in healthcare delivery drawing on examples from Spain, Australia, England, India and the Garki experiment. The presentation considers the advantages and disadvantages of public-private partnerships, the dichotomy between public and private initiatives and the key issues influencing performance such as competitiveness, cost, quality and flexibility. The implications of these especially as they relate to primary care and the practice of Family Medicine in resource-constrained settings are discussed.

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