A robust public-private partnership alone can revamp the primary healthcare system in the country. The Government cannot do it all on its own
With many brilliant ideas. India has become the hotbed for innovations. However, in healthcare, there are a very few of these innovations which have been scaled up. In India, every year, about six million people go below the poverty line, having to undergo a surgery or hospitalisation. Significantly, a large majority of them comes from remote impoverished areas of the country where a big proportion of the primary health facilities, managed by the State Governments, remains dysfunctional due to acute shortage of doctors, qualified paramedics and other staff, equipment gaps, inconsistent medicine supply and poor monitoring and governance. As a result, once a person is ill, his or her use of health facilities turns out to be costlier since they often have to resort to expensive private healthcare.
A strong, efficient primary healthcare delivery system with early, door-step diagnosis and preventive care, can not only reduce out-of-pocket expenditure on health, but it can also help India keep its commitments in terms of reduction of maternal mortality rates and infant mortality rates, reduce the burden of communicable and non-communicable diseases, and impact overall social indicators like poverty reduction, improved quality of life etc. However, primary healthcare, being large-volume-low-margin business, has failed to attract private sector investment so far as compared to low-hanging fruits and commercially more attractive secondary, tertiary and multi-specialty healthcare, keeping primary healthcare dependent on State and Central healthcare allocations and international donors.
That is the big gap WISH Foundation, the philanthropic initiative of Mr Sunil Wadhwani, erstwhile NRI, co-founder and chairman of IGATE Corporation, has identified as a niche to fill facilitating scale up of hundreds and thousands of innovations within the public health system. WISH works at building a national database of healthcare innovations, implementation partners and impact investors and provides financial and technical assistance to promising, high impact innovations in healthcare with an aim of building an equitable healthcare system, capable of delivering quality healthcare to the underserved populations in priority states of India.
This calls for an integrated approach to strengthen primary healthcare by using innovative approaches and solutions to management, compliances to global clinical and public health standards and leveraging public and private sector resources. It is done in two ways: Scaling up promising, high-impact innovations, and partnerships with State regimes and private sector engaged in healthcare delivery and/or interested to deploy resources to transform healthcare in India.
Primary healthcare being dominated by the Government, a public-private partnership is the most feasible way of strengthening it. WISH has a five-year public-private partnership initiative between WISH Foundation and the Government of Rajasthan executed through a memorandum of understanding to transform the primary healthcare delivery for the underserved populations. The purpose is to establish a fully operational, quality compliant, efficient primary healthcare delivery system in 12 high priority districts of Rajasthan with 20 scaled-up innovations serving five million poor, underserved populations by 2020. The programme aligns with national, State and global goals: achieve priority Millennium Development Goals, Sustainable Development Goals, and Health for All goals of the Government of Rajasthan by addressing critical delivery gaps within the integrated RMNCH+A programme.
The partnership features include the Government providing capital or the infrastructure which it has built but which is not functioning well, offering working capital to the private partner for staff and operations, and, monitoring and regulating the operations. Thus, the primary healthcare centres and the other healthcare facilities continue to belong to the Government but the functional infrastructure and equipment, medical records, medicines, and consumables and access to untied grants is given to a private sector partner.
(The writer is CEO, WISH Foundation)