Dr. Anil J. Purty MD, DNB, MNAMS

Associate Professor

Department of Community MedicinePONDICHERRY INSTITUTE OF MEDICAL SCIENCES

Public Private Partnership for HealthOur Experience-Road Ahead

What is Partnership ?

• It is a joint ownership of a program/ proposal by two or more parties to achieve a common goal.

• It is a higher level of collaboration.

Prerequisites of Partnerships

• Super-ordinate Goal• High perceived pay-off to both parties• Equal power with both parties• Mutual Trust

Principles for Partnership

• Joint action at all stages • from planning, follow up and termination• Complimentary roles • expectation of each other are clarified and stabilized• Creation of a temporary system• task force with representatives from both sides• Continuous Communication• lines of communication between partners to be always

kept open

Public Private Partnership in Health Care

PPP is Seeking collaboration with private sector in the situations where the

public health system is not immediately able to provide guarantee.

PPP at Global Level in Health

• Global Alliance for Vaccine and Immunization• Global Polio Eradication Initiative• European Partnership Project on Tobacco

Dependence • UNAIDS/Industry Drug Access Initiative• Stop TB Initiative• Roll Back Malaria

Issues in PPP in Health Care

• Capacity of Private Partner

• Advocacy

• Accreditation

• Regulation by the Government

Application of PPP in India

• Health System Development Projects• National Rural Health Mission• Blindness Control• Diagnostic Support within Medical

College Hospitals

MADRAS MEDICAL MISSION

Professor & HOD

FACULTY

Professor-1Associate Prof-3

Asst. Prof-2Lecturer (Biostat)-1

Tutors-4

HEALTH CENTRES

RHC, ChunampetUHC, Muthialpet

RHC, AnaichikuppamPHC, Kalapet,

PHC, KaterrikupamHealth Centre, Univ.

Medical OfficersMedical Social Workers

Public Health NursesTechnicians

Field Health workers

Office StaffSupportive Staff

DriversElectrician

SecurityGardner

CookSafaikaramchari

Total staff : 94

PIMS DIRECTOR

PONDICHERY INSTITUTE OF MEDICAL SCIENCES(A Unit of Madras Medical Mission)

Dept of Community Medicine

‘Reaching the Unreached’

RHC ChunampetPop: 9,408

UHC MuthialpetPop:12,026

Hope HospitalAnaichikuppam

Pop: 10,027

RNTCP,ADRA (India) TB Project in TN, RCH (FNGO), NACP,PUDA

State Govt. PHC Kalapet, Pop: 12,458

State Govt. PHC Katerrikuppam

Pop:10,312

Health Centre Pondicherry University

Pop: 2320

o Teaching and Trainingo Primary Health Care to over 1,00,000 Populationo Community Based Researcho Health Educationo School Health Programmeo Liason with Govt. Departments for NHPso Co-ordination with National and International

NGOs for Public Health Practice

ACTIVITIES

Teaching and Training

• MBBS Students Semester I-VII as per MCI and University guidelines

• Community Based postings/teaching• ROME Scheme• Training of allied health staff working with

Govt. and NGOs

Community Postings

SCHOOL HEALTH PROGRAMME

Dental School Health Programme

Training of Field Health Workers

COMMUNITY EDUCATION

DEPT. OF COMMUNITY MEDICINEANNUAL REPORT – 2006

OPD-PATIENTS

SL.NO CENTRES TOTAL NO.OF PATIENTS

1. UHC-MUTHIALPET 256172. RHC- KOONIMEDU &

HOPE HOSPITAL12477

3. RHC-CHUNAMPET 204364. PHC-KALAPET 332875. PHC-KATTERIKUPPAM 145556. UNIVERSITY HEALTH CENTRE 4612

TOTAL 1,10,984

Dept. of Community MedicineAnnual report-2006

Income from Centres

Centres Total income 1. UHC- MUTHIALPET Rs. 10,94,317

2. RHC-CHUNAMPET Rs. 4,83,547

3.RHC- KOONIMEDU& HOPE HOSPITAL

Rs. 2,46,653

4.UNIVERSITY HEALTH CENTRE Rs. 2,02,234

Total Rs. 20,26,751

Dept. of Community MedicineAnnual report-2006

Income from Centres

Total Income from Centres - Rs. 20,26,751/-

Total Income from Camps - Rs. 2,49,725/-

Total Income of Dept. - Rs.22,76,476/-

Estimated Expenditure: - Rs. 50,00,000 !!

URBAN HEALTH CENTRE-MUTHIALPET

ANNUAL REPORT-2007

PARTICULARS JAN-DEC-05 JAN-DEC-06Total population 10371 12026

Male 5110 6012

Female 5261 6014

No. of families 2333 2677

Hindu 1950(83.6%) 2299(85.9%)

Muslim 105(4.5%) 95(3.5%)

Christian 278(11.9%) 283(10.6%)

Family Size 4.4 4.5

No. of EC 1742(16.8%) 2020(16.8%)

Family PS 1018 1138

PERMANENT 928 997

Tubectomy 926 992

Vasectomy 2 5

TEMPORARY 90 141

CC 42 82

IUCD 43 47

Pills 5 12

TOTAL FPC 58% 56.3%

EFPC 57% 53.7%

No. of death 29 55

Total Live Birth 141 127

ANNUAL REPORT-06

M

U

T

H

I

A

L

P

E

T

UHC

MORBIDITY REPORT OF MUTHIALPET-UHC

MORBIDITY NUMBERS

GASTRO. INTESTINAL INFECTION 1876

ACUTE RESPIRATORY INFECTION 4133

TUBERCLOUSIS(PULMONARY & EXTRA PULMONARY)

17

EYE INFECTIONS 141

GENITO URINARY INFECTION 175

NUTRITIONAL DISORDERS 470

MUSCLO-SKELETAL DISORDERS 3613

SKIN INFECTION 466

ENDOCRINAL DISORDERS 08

CARDIOVASCULAR CONDITIONS 97

PSYCHIATRIC DISORDERS 07

FEBRILE CONDITIONS 821

CNS DISORDERS 43

MISCELLANEOUS 13,749

TOTAL 25,616

ANNUAL REPORT -2007 CHUNAMPET RHC

PARTICULARS JAN-DEC-05 JAN-DEC-06Total population 7914 9408

male 4012 4737

female 3902 4671

No. of families 1821 2192

hindu 1786 2164

Muslim 18 19

Christian 17 9

Family Size 4.3 4.2

No. of EC 1263(15.9%) 1455(15.4)

Family PS 863 1079

PERMANANT 848 1055

Tubectomy 846 1053

Vasectomy 2 2

TEMPORARY 15 24

CC 5 15

IUCD 9 9

Pills 1 -

TOTAL FPC 68.3% 74.1%

EFPC 67.7% 73.5%

No. of death 30 30

Total Live Birth 120 127

MORBIDITY REPORT OF CHUNAMPET-RHC

MORBIDITY NUMBERS

GASTRO. INTESTINAL INFECTION 3628

ACUTE RESPIRATORY INFECTION 3587

TUBERCLOUSIS(PULMONARY & EXTRA PULMONARY)

33

EYE INFECTIONS 504

GENITO URINARY INFECTION -

NUTRITIONAL DISORDERS 925

MUSCLO-SKELETAL DISORDERS 2293

SKIN INFECTION 2606

ENDOCRINAL DISORDERS 1033

CARDIOVASCULAR CONDITIONS 512

PSYCHIATRIC DISORDERS 23

FEBRILE CONDITIONS 48

CNS DISORDERS 826

MISCELLANEOUS 3172

TOTAL 20,436

HEALTH CAMPS IN TSUNAMI AFFECTED AREAS

URBAN HEALTH CENTRE

Public Health Activities

• Monitoring of Pulse Polio Immunization• State Task Force- RNTCP in Medical Colleges• Sentinel Surveillance- NACP• Mass Drug Administration- Filariasis• DOTS Centres with the RNTCP• NGO Collaborating centre for Post Tsunami

Relief and Restoration• NGO Training- Lutheran World Service, ADRA

PARTNERSHIP FOR RURAL HEALTH CARE

COLLABORATIONS WITH NHPs

World Health Organisation (Delhi)

ICMR, TB Research Centre (Chennai)

RNTCP, HIV- State and Central Govt.

COLLABORATIONS NGOs

ADRA, BGEA, PMSS, PRANANational Agro FoundationLutheran World Service, India

RECENT PRESENTATIONS

ISMS National Conference, Coimbatore

34th IAPSM, National Conference, AIIMS Delhi

RNTCP Zonal Task Force (Hyderabad), RNTCP National Task Force (Delhi)

PONDICHERRY INSTITUTE OF MEDICAL SCIENCESDEPARTMENT OF COMMUNITY MEDICINE

6. UHC MUTHIALPETPONDICHERRY (PDY)

1.RHC, CHUNAMPET (TN)2.RHC, ANAICHIKUPPAM (TN)3.UNIV.HEALTH CENTRE(PDY)4. PHC, KALAPET(PDY)5. PHC KATERRIKUPPAM(PDY)

(2003)NO. OF FAMILIES-1511

BASELINE POPULATION- 6,607

(2004)NO. OF FAMILIES-1888

POPULATION- 8,233 (M-4131, F-4102)

(2005)POPULATION 10,371

NO. OF FAMILIES-2333(M-5162, F-5209)

(2006)NO. OF FAMILIES-2677POPULATION 12,026

(M-3329, F-3278)

REGULAR UPDATE BY• House to house visit by HW (F)• Daily recording and reporting

• Monthly review Meetings• Supervision by MSW, RMO

ELECTRONIC DATABASEAll data computerized

Epi info package

FAMILY FOLDERSSocio-demographic details

Individual health cardEligible couple cardMaternal Health card

Under-five health cardOP Visit cards

NUMBER OF PERSONS WITH DIABETES: 643Males-346 Females-297

Prevalence of Diabetes in Urban Pondicherry (Dr. V. Mohan)

< 5%Changes

in Population

(BirthsDeaths

MigrationsMarriages)

Tuberculosis case-finding and treatment under RNTCP: Patient, health system delays and reasons for default in and around Puducherry.

Enlist all TB patients diagnosed under RNTCP During I & II Quarter of 2007

SAMPLING, OBTAIN CONSENT,RECRUIT 300 PATIENTS

From the RNTCP DMC Lab. Registers in 4 Medical Colleges

and 5 Govt. PHCs and DTC

Patients referred for treatment outiside

Puducherry, Contact once

Patients referred for treatment within

PuducherryContact twice

Patients started on Treatment at DMC/TU

Contact twice

July 1 - December 31, 2007-Contact and interview patientsat their residence or DOTS centre to study the patient and health system delays. Contact MO (PHC), DOT Provider, DTO to find Methods to improve feedback mechanism in RNTCP.January 1- June, 2008-Contact and interview patients reported to default to find out reasons for default. Contact MO (PHC), DOT Provider, DTO to find Methods to decrease default in RNTCP

July-October, 2008-Record the outcome of these patients from theRNTCP Treatment cards/Monthly/quarterly reports.

October- December 2008- Report writing- Collate,analyse and presentFindings in final study report

(100 IN EACH GROUP) FOR FOLLOWUP

Challenges in PPP for Health Care

• Cost containment (?4.5 Lakhs/month)• Effective use of private resources• Logical diversion of public resources• Synergy to reduce duplication• Resource mobilization

THANKYOU