Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in South Western Uganda

Justus Asasira, Frank Ahimbisibwe
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Abstract

Background: Uganda’s government embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) on health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low-income setting like Uganda. Methodology: This was a qualitative study, data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study. Results: The hospital is a Church of Uganda founded, and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, has multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van. Conclusions and Recommendations: Our study concludes that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote more funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.
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医疗保健中的公私伙伴关系及其对健康结果的影响:来自乌干达西南部鲁哈罗教会医院的证据
背景:乌干达政府接受私人提供包括保健在内的社会服务。私营提供者的参与表明,公共设施不足以满足不断增加的人口的高需求。这是通过伙伴关系安排完成的。本文讨论了公私伙伴关系(PPP)对当地人口卫生保健结果的影响,以及改善卫生保健结果的机会,以及像乌干达这样的低收入环境中私营提供者面临的挑战。方法:这是一项定性研究,数据于2017年1月通过访谈(使用半结构化问题)在Ruharo教会医院(RMH)行政部门、卫生工作者、地区卫生办公室收集,并对患者/客户使用结构化问卷。这是一项刚刚起步的研究,样本量为22人。医院有三个科室;有组织的有用康复服务(OURS)、综合医疗服务(GMS)和眼科服务(ED)。医院的所有部门都参加了这项研究。结果:该医院是乌干达教会创办的,每年预算为50亿先令(1,351,351.4美元),有多种资金来源,包括每年初级保健资金,并向客户提供充分的保健服务。虽然有些服务是免费的,但其他服务,如眼科治疗,对客户来说却很昂贵。该医院通过外展和以设施为基础的服务提供保健服务的混合模式受到重视,但它没有救护车,只依靠一辆医院货车。结论和建议:我们研究的结论是,如果私营医疗机构在合作安排下得到支持,他们可以为客户提供充分的服务,并减轻公共设施的拥挤。我们建议政府通过雇用更多的次借调工作人员、采购药品和救护车,投入更多资金支持该医院,使其能够补贴各项服务,特别是眼科治疗和伙伴关系未支持的其他服务。
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