Public-Private Partnership, Contracting Arrangements and Managerial Capacity to Strengthen RCH Programme Implementation Lessons and Implications from Interventions in India

Abstract

Strengthening management capacity and meeting the need for Reproductive and Child Health (RCH) services is a major challenge for the national RCH programme in India. Central and state governments are working through multiple options to meet this challenge, responding to the complexity of issues in RCH which cut across social, cultural and economic factors, as well as reflecting the immense geographical barriers to access for remote and rural populations. Other barriers are also being addressed, including lessening financial burdens and creating Public - Private Partnerships (PPP) to expand access. For example, the NRHM has been initiated with particular focus on rural population. However, there are a number constraints faced by departments of health in implementing these initiatives. In this paper we focus on one key area: the development of management capacity for working with the private sector. A synthesis of the learning from three case studies of public-private partnerships in the RCH area is discussed. Two case studies pertain to state level initiatives in Gujarat and Andhra Pradesh and third study focuses on the national level mother NGO scheme. The objective of these case studies was to investigate how management capacity was developed through the implementation of these three public-private partnerships initiatives and contracting out of RCH services. The case studies also focused on the partnership in service delivery setting by examining the structure and process of partnership experiences, understanding the management capacity and competency in make-up of various public-private partnership initiatives in RCH, and identify pathways towards developing management capacity of partners to address key challenges in implementation.