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APHRC/Kenya – Public-Private Partnerships are Crucial for Healthy Cities

June 2009 – Public-Private Partnerships are Crucial for Healthy Cities

A recent assessment of health facilities conducted in three slums in Nairobi, Kenya by APHRC and other partners reveal that majority (85%) of health facilities that serve the city’s informal settlements are Private-for-Profit (PFP). The assessment further reveals that most of these facilities, which majority of the slum residents visit commonly for health care needs do not meet the government’s regulatory standards for operation.

Personnel in these private facilities are not trained in some of the most basic guidelines provided by the Kenyan government through its two health ministries such as infection control and Integrated Management of Childhood Illness (IMCI) – only 27% of personnel in PFP facilities had received training on infection control, compared to 89% of those working in public hospitals. In addition, since the private facilities charge a small fee, they remain inaccessible to most slum residents. These factors largely explain why informal settlements continue to register high disease burden and death rates as they are left with few or no options when it comes to accessing health care.

The assessment is based on a situation analysis of health facilities in Kibera, Korogocho and Viwandani slums of Nairobi which was funded by the Doris Duke Charitable Foundation (DDCF). Among the 503 facilities visited, a mere 1% were public, 85% were PFP, and the rest were Private-not-for-Profit (non-governmental and/or faith-based).With a rapidly increasing population of slum dwellers, what can the Kenyan government and others in similar situations do to ensure that these segments of their population have access to quality healthcare?

The analysis explored the viability of Public-Private Partnerships among the health facilities. Such partnerships would provide an opportunity for the government and the private practitioners to work together for the common good of the people. This ensures that private facilities meet regulatory requirements set by the government, have their personnel trained on key health areas, and enable the facilities to offer subsidies/charge a lower fee for their services.

Such a partnership is viable and is an option that both private facilities and the government are willing to explore. A large percentage of both public and private health providers agree that they both work towards the same goals and that the government should have a say in the kind of services that private facilities offer. Of the private facilities, 86% said they would be willing to comply with the government’s standards if there were any benefits or if government supported them with essential supplies and commodities, and a further 87% agreed to having the government supervise them through a third party.

The assessment was part of a DDCF-funded initiative that brought together various partners including APHRC, African Medical Research Foundation (AMREF-Kenya), City Council of Nairobi, JHPIEGO – an affiliate of Johns Hopkins University, Nairobi Health Management Board, Population Council, AAR Health Services, Kenya Medical Training College and the National Health Insurance Fund. Under the ‘Partnership for a Healthy Nairobi’ (PHN) banner, the initiative was aimed at leveraging each others strong points and areas of expertise to improve the quality of health services for poor communities in Nairobi. The PHN proposes to strengthen community ownership of health, fostering better public-private partnership, training the health workforce and strengthen district health service management and planning. The partnership is a good example of how strong collaborations can help to overcome obstacles that limit the capacity of both public and private health systems to deliver primary health care.

Source – http://www.aphrc.org/news.asp?ID=44

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