health ngo meeting
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Health NGO Meeting. Sierra Leone 6th March 2012. A global perspective on health PPPs in developing countries. Health trends PPPs in health care Lessons. Health Spending. Life expectancy. Health expenditures. Rising faster than GDP due to: - PowerPoint PPT PresentationTRANSCRIPT
Health NGO Meeting
Sierra Leone
6th March 2012
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A global perspective on health PPPs in developing countries
• Health trends
• PPPs in health care
• Lessons
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Health Spending
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Life expectancy
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•Rising faster than GDP due to:• Advances in medical technology
(expensive equipment/tests)• Aging populations • More chronic diseases• Demand for better services
•Growth of govt spending on health care is unsustainable, new funding
sources needed.
Health expenditures
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PPPs in health
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PPPs in health
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• Improving cost efficiency• Improving quality of services
• Modernizing facilities, equipment & services• Increasing access to underserved areas & populations
Why PPPs in health care?
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• Government pays Private Operator service payments but only once facility is operational
• Government defines service and output requirements. Inputs, design, etc to bidders
• Buying services, not equipment & facilities.
• Private party is typically responsible for all or part of the capital financing
• Payment is tied to performance not inputs/milestones
Why PPPs in health care?
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Public Private Partnerships in Health
• Primary care
• Public health
• Vaccinations
• Maternal & child health
• Managementof entire hospital or network of hospitals and/or clinics
• Lab analysis• Diagnostic
tests• Medical
equipment maintenance
• Ambulances
• IT equipment & services
• Maintenance
• Food• Laundry• Cleaning• Billing
Hospital Mgmt
SpecializedClinical
Services
Clinical Support Services
PrimaryCare
Non-clinical
Services
Design&
Construction
• Detailed designs
• Building construction
• Medical equipment
• Capital financing
• Dialysis• Radio-
therapy• Day
surgery• Other
specialist services
Under a PPP, a government or national health insurer contracts with a private partner (for-profit or not-for-profit) for a health care service and/or facility
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IFC’s Role
IFC also provides advice to governments and businesses
Environment & Social Sustainability
Access to
Finance
Business Environment
Public-Private Partnerships
Enterprise Assistance
World’s largest multilateral provider of financing for private enterprises$30+ billion in investment commitments
Advisory services to governments and businesses
Advisory Services and Financing
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Lessons from Global Experience• Use PPPs to expand service / improve quality - Not as means
to simply finance new buildings/equipment • Define services needed (not facilities) - Give operators/bidders
flexibility on how to provide (location, size, design, technology)• Buy from existing private operators where
feasible/economic - Not necessary to duplicate in public facilities• Maximize private sector responsibility for greater benefits -
PFIs are politically expedient, but “full” PPPs deliver more benefits• Long-term fiscal affordability is essential - but not reflected in
“Value-for-Money” analysis• PPPs will only help if part of a broader health sector reform
program
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Next Generation of Health PPPsWe see several areas/themes emerging:
• Contracting out public health insurance activities
• Shift to defining PPPs in terms of services, not facilities/equipment
• Integrated care (networks)
• More “full” PPPs, but with varying responses to risk sharing
• Radiotherapy
• Diagnostics/ imaging projects
• Medical education
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IFC Advisory Services in PPPsEmmanuel NyirinkindiManager: Sub-Saharan AfricaEmail: [email protected]
Elan Cusiac-Barr IFC SenegalEmail: [email protected]
Peter BoeréHealth SpecialistEmail: [email protected]