Daily Times

In many developing countries, the deficiencies and gaps in government health systems have posed significant barriers to achieving improved health outcomes. This predicament is particularly pronounced in Pakistan, where the public sector has struggled to provide equitable and high-quality healthcare services. Consequently, the health system’s inability to effectively and efficiently address the population’s healthcare needs has resulted in the underutilization of its resources. To bolster the health sector and provide proper, high-quality healthcare, two primary approaches can be employed: the substantial improvement of the public healthcare system and the regulation of private entities. However, a third, perhaps more promising avenue lies in the partnership between both sectors. For several years, international and local Non-Governmental Organizations (NGOs) have endeavoured to bridge the gaps in health service delivery, research, and advocacy. Their role has become even more critical in regions where the public sector’s capacity is strained and government resources are insufficient.

In 2010, the Sindh Public Private Partnership (PPP) Act was enacted, granting the government and its agencies the authority to collaborate with private entities for various projects. PPPs are arrangements between the government and private businesses to provide public assets or services through private-sector investment and management for a specified period. Under this framework, the PPP unit of the Sindh Health Department initiated a project known as “Public Private Partnership Contracts in Health.” Expressions of interest were solicited from NGOs, resulting in approximately 30 organizations expressing interest in the project. Subsequently, requests for proposals were issued to 12 organizations, with five being selected. Four of these NGOs were tasked with maintaining, improving, and operating healthcare facilities, while the fifth was responsible for running community ambulance services.

NGOs engaged in Public Private Partnership programs encounter multiple challenges, primarily related to securing sufficient and consistent funding to carry out their work.

The backbone of healthcare in interior Sindh consists of Basic Health Units (BHUs), Rural Health Clinics (RHCs), Taluka Headquarters Hospitals (THQs), and District Headquarters Hospitals (DHQs). However, these institutions often face challenges in functioning optimally due to various issues, including inadequate human resources, delayed funding, insufficient budget allocations, transportation concerns, and the need for capacity building among staff. In the PPP model, NGOs have taken administrative control of these healthcare facilities but frequently face difficulties due to a lack of timely and proper funding. NGOs engaged in Public Private Partnership programs encounter multiple challenges, primarily related to securing sufficient and consistent funding to carry out their work. These non-profit organizations often depend heavily on funding to fulfil their missions, and any disruption in the funding flow can seriously hinder their operational activities and overall progress. As the PPP model assigns a clear allocation of risks between partners and ties private sector payments to predetermined, measurable performance standards, it becomes imperative for NGOs to maintain transparent financial practices. Many NGOs rely entirely on funding, making it crucial to establish robust accounting systems.

Accountability to fund providers, including the government, is paramount. With proper financial systems in place, NGOs can monitor expenditures and submit timely reports, thereby building trust between public and private partners and increasing the likelihood of continuous support. Accurate and transparent financial management enhances an NGO’s reputation, credibility, and standing within its community. It also ensures that NGOs can provide an accurate account of their spending to regulatory bodies. An organization with well-defined financial plans and policies can build a strong reputation and reduce the chances of government objections.

The PPP model holds great promise for the development of the healthcare sector in Pakistan, and its success can help dispel apprehensions regarding such partnerships. If PPP healthcare projects achieve their objectives, they can significantly expand their scope and coverage in the country, leading to more efficient and sustainable development. Provincial governments are increasingly eager to collaborate with private organizations through the PPP model to meet development needs. However, the relationship between the government and NGOs must mature and become more seamless for these partnerships to flourish. Identifying the challenges facing organizations within the PPP model is a crucial step in overcoming these obstacles. With a clear understanding of the issues at hand, government authorities can design plans to improve and address the concerns of their private partners.

Timely disbursement of funds to non-profit organizations is of paramount importance to achieve the desired goals. In conclusion, the partnership between the public and private sectors, particularly with the involvement of NGOs, has the potential to enhance healthcare delivery in Pakistan. By addressing funding challenges, improving financial management, and fostering strong partnerships, the PPP model can pave the way for more efficient, equitable, and accessible healthcare services, ultimately benefiting the people who need them most.

The writer is a rights activist and freelance journalist.