By Farid Fezoua
Emerging economies and their governments are increasingly looking at new ways to develop healthcare infrastructure and better improve the access and quality of their national healthcare systems. We’re seeing a greater appetite to partner with private healthcare providers and investors and explore new models for healthcare development. As we evaluate each of these opportunities, here’s my take on what makes a public-private partnership worth pursuing:
1.The right commitment. Without a progressive-thinking government to work with, a PPP will lack the advocacy internally to see the partnership through. Whether it be MES or PPP, you’ll need a legal and regulatory framework to work within, progressive policy reform, and most importantly, a government that fully embraces private sector collaboration.
2.The right alignment.
Aligning all the right stakeholders is critically important – from the Ministry of Health to the Ministry of Finance, to customs and medical regulations. Budgetary allocations should be clear, and government ministries should be coordinated. This is one of the most critical parts of a PPP’s success both during the bidding and contract negotiations as well as the program execution phase.
3. The right time and attention.
All partners need to embrace the time it takes to develop the right model for success. In addition to utilizing an adapted procurement framework to evaluate comprehensive outcome-based development models, a good feasibility study is key and can take up to two years to complete. From healthcare infrastructure to the technical and clinical capabilities, the realities across the different levels of the continuum of care should be thoroughly analyzed.
4.The right skills and know-how
Government, the private sector, the financial services community and technology providers alike must invest to cultivate domain expertise and better risk assessment capabilities. And when those don’t exist or aren’t available, all parties need to be honest about the capabilities and be willing to bring in experts and/or adequately augment their in-house capabilities.
5.The right clinical expertise
Africa, despite having the world’s largest disease burden, has the lowest ratio of health workers per population. A willingness to invest, train and deploy both technical capabilities (bio medical engineers, specialized healthcare technology and patient flow planners) as well as education and skills development are critical to ensure the sustainability of any healthcare development.
A great example of successful PPP in Africa is GE healthcare and the Kenyan Government’s partnership to deliver a seven-year Managed Equipment Services Partnership (MES), where radiology infrastructure was provided in 98 hospitals across 47 counties. GE has deployed 585 units of diagnostic imaging equipment including digital mammography, x-ray and ultrasound systems across all 98 hospitals.
It's an example of a unique 4-pillar solution that includes: (1) an adapted technology approach covering wide scale radiology modernization as well as healthcare IT capabilities; (2); sustainable service & maintenance; (3) a $13 million investment in the localized skills development, partnerships and capacity building and (4) a structured financing solution enabling the MoH to sustainably fund its long-term transformation program
Not only is it one of the largest undertaken to date in Africa to support sustainable healthcare development, it’s also indicative of a larger trend to bring more private sector engagement and accountability into public healthcare development.