Public-Private Partnerships and Health Care Delivery: A Case of Mbarara Municipality

Abstract

Public-Private Partnerships in healthcare is one of the approaches that has been embraced in Uganda’s health sector to realize a change in deteriorating health services. In Mbarara municipality there are many facilities that have embraced the partnerships and the study in four private health facilities bases on some of the Public Private Partnership (PPP) facilities to document the contribution of these private partners in the health sector. The study used mixed methods; qualitative and quantitative and two designs descriptive and case study. A sample of 58 respondents was drawn from health workers, clients (patients seeking healthcare from these facilities on the day of data collection), health inspector and hospital administrators from the 4 facilities. From the findings, 67.2% of the patients who sought services from these facilities were females and 32.8% males, majority of clients were peasants by occupation, average number of days spent inpatients (admitted) in the hospital was 3 days and for outpatient department, patients were spending an average of 81.6 minutes an equivalent of 1hour and 21minutes. The services supported under the partnership include: ART drugs and HIV/AIDS care, immunization, maternal child health, anti-malarial treatment, malaria control programs including provision of free mosquito nets to community members and outreach programs. Some of the services are free, others subsidized to make them affordable to users. The facilities get support in form of Primary Health Care (PHC) fund to support outreach programs, some hospitals had sub-seconded staff, get medical supplies from Joint Medical Stores (JMS), medical access and National Medical Stores (NMS). These facilities also get funding from charities and donors. Clients seeking ART meet a cost between Uganda shs 15,000 and 20,000/= to have them registered at the facility. Other healthcare services offered in these facilities are subsidized and clients meet a cost between Uganda shs 10,000 and 25,000 for outpatients and 25,000 to 50,000/= for inpatients depending on the number of days spent in the hospital. The clients’ user fees is the main source of revenue for these facilities. Patients requiring operation services found it expensive for example at RMH found the packages for eye operate costing 230,000 and 350,000= shs for one and both eyes respectively. Beneficiaries’ satisfaction was generally ranked higher than in public facilities and 97.1% of the patients would prefer to visit a Public Private Partnership facility the next visit. The study concluded that Public Private Partnership in health are making a difference, clients appreciate the healthcare packages under the partnerships. Patients turn up in faith based facilities was found higher than in non-faith based. PPP have created external links with other countries as they offer charities and donations to subsidize the services more. The study recommended that support to these private facilities be increased from the current amount, and other forms of support be given. The Primary Health Care fund for Mbarara Community Hospital should be re-instated to make it more efficiency. Continuous monitoring of the services provided in these facilities should be ensured such that they don’t deteriorate like it is a case in public facilities. A theatre at Holy Innocents Children’s Hospital should be completed and handle more pediatric cases as it’s a referral for these cases in western region. This will reduce referral cases at Cure hospital.