Public Private Partnership

Background:

Public Private Partnership (PPP) is defined globally as "a collaborative relationship which transcends national boundaries and brings together at least 3 parties, among them a corporation (and/or industry association) and an intergovernmental organization, so as to achieve a shared health creating goal on the basis of a mutually agreed division of labour (Ref. Critical reflections on UN business partnerships Jan 2003). Since the beginning of the current Health Sector Reform in Tanzania, PPP features as Strategy Seven of the reform process (POW 1999-2002) and (HSSP 2003-2008).

Component objective:

The PPP component features as a subsidiary cooperation of governmental and private health services where it supports the 4 programme regions in terms of decentralization of institutions i.e. Council Health Service Boards (CHSBs) and Facility Governing Committees (FGCs) with special consideration for voluntary agencies(Christian Social Services Commission [CSSC]). It is institutionalized in the districts of the supported regions and advocated for by the national policy.

The component's main objective is to encourage the cooperation of public and private (in particular church) health service providers in the planning and monitoring processes.

Approach:

The TGPSH - PPP component input, includes working with other National Regional and Council stakeholders in developing a contractual arrangement e.g. service agreement which is already in place and is meant to improve the quality of health services.

The PPP component contributes to the National Health Sector Reform (HSR) in terms of technical support. The component supports advocacy to different levels of the target population, in the four programme regions and the individual councils. The advocacy is meant to promote understanding of the HSR, acceptance of the partnership and putting in place partnership forums for planning (Council Health Planning Teams [CHPTs]), Facility Governing Committees (FGCs) and the Council Health Service Boards (CHSBs). The forums bring together representation of the government, Health Service users, Private sector and voluntary agencies. Health Sector and Local Government Reform Advocacy have been conducted countrywide and to different levels and sections of the Society but more intensively in the four programme supported regions.

Impact - what has been achieved

National level

Implementation of the health sector reform continues to recognize the position and importance of the Public Private Partnership. Strategy Seven of the Strategic plan 2003/08 reinforced. A National PPP Steering Committee composed of key stakeholders; MOHSW,PMORALG, APHFTA, CSSC,TPHA DANIDA and TGPSH officially appointed. TGPSH represented by the PPP component leader.
December 2007:A PPP reinforcement tool “The Health Service Agreement between the government and Service providers” a landmark policy change towards a subsidiary concept in health service provision signed by the MoHSW and PMORALG.
TGPSH takes up the responsibility to inform the Development Partners on PPP developments in the direction to harmonize Technical Co-operation.
April 2008: The National PPP Steering Committee was involved as the main actor in the preparation of the PPP strategy of the Health Sector Strategic Plan 3 (2009-2014)

Regional level

Regional PPP steering Teams in Tanga, Mbeya, Lindi and Mtwara takes the role to co-ordinate meetings to advocate for PPP including implementation of the health services agreement.
The Regional PPP Steering Teams (RPPPSTs) are co-coordinating structures replicating the role of the National PPP steering Committee which is composed of representatives of the RAS,CSSC,APHFTA and NGOs.

Council level

Majority of councils in the country experience HSBs and FGCs ending their three years term of office, and processes for renewal of these structures ongoing.
Group enrollment (Tea, Coffee, Cocoa estates,) boosts Community Health Fund while Joint Rehabilitation Fund boosts functionality of the FGCs.
Advocacy for the Service Agreement takes an active speed in TGPSH supported regions and lake zone councils.
March 3, 2008 Lushoto become number one council in the country to sign service agreement with the ELCT Bumbuli Hospital. Implementation of the SA in Bumbuli division has shown an increase in number of patients/clients in both outpatient and inpatient wards, read attached report.
Costing of health Services identified as a pre-requisite input in an informed service agreement between the government and the relevant service provider.
July 10 & 11^th, Handeni district and Korogwe town council signed the service agreement with Kwamkono and St. Raphael FBO hospitals respectively.