Development Drivers and Limitations
Global Development Network series
Edited by Natalia Dinello and Shaoguang Wang
Chapter 7: Public–Private Partnership in the Provision of Health Care Services to the Poor in India
A. Venkat Raman and James Warner Björkman Throughout the world, public–private partnerships have emerged as a promising model for health-sector reform. Change is needed partly due to resource constraints in the public sector (Mitchell-Weaver and Manning 1992) and partly due to a widespread belief that the public sector is endemically inefficient and unresponsive, while market mechanisms ensure good quality, cost-effective services (World Health Organization 2001; Bloom, Craig and Mitchell 2000). There is also a growing realization that, given their respective strengths and weaknesses, neither the public sector nor the private sector alone serves the best interests of the health system. Both the public and private healthcare sectors can potentially gain from one another (Wang 2000). However, a partnership with the private sector will require the public sector to reorient its role in financing as well as delivering services. In the Indian context, collaboration with the private sector to provide health services to poor and underserved sections of the population is critical, because approximately 29 per cent of India’s population (almost 300 million people) live below the poverty line and depend on free public health services. But despite its extensive network of health centers and hospitals, India’s public health-care system is unable to deliver health-care services at desirable levels of quality and efficiency due to inherent deficiencies in the system. Consequently, India’s poor are forced to seek services from the private sector, often borrowing money or selling land, cattle and even children to pay for the services. India has...
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