Public Private Partnership in Pakistan: An example for strengthening decentralized health services

THE CHALLENGE. Pakinstan's Vehari district in the Punjab region has high maternal, infant and child mortality rates, especially in the 85% of its population who live in rural areas. THE OPPORTUNITY. In 2005, Plan Pakistan (an international, child-centered, humanitarian NGO) successfully negotiated with the Vehari District Government a joint maternal and child health program. It comprised of (a) increased government's investment in building/remodeling health facilities and in hiring/maintaining health staff, in order to match (b) Plan Pakistan's investments in health promotion, outreach and training of volunteers, health staff and community leaders. The project was conceived as a private public partnership, under the umbrella of the current decentralization/devolution initiatives, was successfully used to improve the health conditions of mothers and children. THE RESULTS. (1) Key maternal and child health facilities were remodeled by the government; (2) Training to government health staff and community volunteers and leaders was completed; (3) A strong health promotion program was implemented using mass media and group events ; (4) A joint Plan-government investment plan was discussed and approved by both agencies; and most importantly, significant population-based results. The number of annual outpatient visits by children increased from 20,506 to 41,863 in three years; the number of children's hospitalizations also increased by 40%; the mortality of hospitalized neonates also fell from 50% to 30% after the NICU of the district hospital was remodeled and equipped. CONCLUSION. This model of private public partnership could be applicable in other parts of Pakistan and elsewhere.