What is hampering PPP model in government-led maternity schemes?


New Delhi: Financial and administrative delays, lack of transparency and absence of ease in the process of empaneling the private sector are hindering public–private partnerships in government-led health schemes, according to a study published in the British Medical Journal (BMJ).

The study explored the perception of various stakeholders on expectations, benefits, barriers and facilitators of private sector participation in government-led health schemes—specially Janani Suraksha Yojana (JSY) for maternity service delivery. The study was conducted by Jhpiego, an affiliate of Johns Hopkins University.

“The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers,” the study said.

The researchers conducted face-to-face in-depth interviews with participants including private obstetricians, government health officials and Federation of Obstetrics and Gynaecological Societies of India (FOGSI) members in Jharkhand and Uttar Pradesh. Eighteen private obstetricians from nine cities across Uttar Pradesh and Jharkhand, 11 government health officials and two FOGSI members were interviewed.

“Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilization of their presence, resources and expertise for providing quality maternal and newborn health services,” the study said.

The study said simplifying and strengthening the processes, communication strategies and branding can help revitalize the idea.

“Factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service,” it said.

The policy for accreditation and empanelment under the government’s flagship programme, the National Health Mission (NHM), offers opportunities for both leveraging the private sector and ensuring financial and clinical protection of pregnant women seeking care at private facilities.

JSY, under NHM, is a conditional cash transfer scheme covering the whole country. In 10 select high-focus states, the scheme targets all pregnant women delivering babies at health facilities with entitlement to cash transfers after delivery.