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Public private partnerships for emergency obstetric care: lessons from maharashtra.

Chaturvedi S, Randive B - Indian J Community Med (2011)

Bottom Line: This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme.Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs.Capacities in the public health system are inadequate to design and manage PPPs.

View Article: PubMed Central - PubMed

Affiliation: Foundation for Research in Community Health, 3 and 4, Trimiti B Apartments, 85, Anand Park, Aundh, Pune, Maharashtra, India.

ABSTRACT

Background: The National Rural Health Mission of India advocates public private partnerships (PPPs) to meet its "service guarantee" of Emergency obstetric care (EmOC) provision. The Janani Suraksha Yojana (JSY) has a provision of Rs. 1500 for contracting in obstetric specialists.

Objectives: The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women.

Materials and methods: A cross-sectional study using the rapid assessment approach was conducted in Ahmednagar district of Maharashtra spanning 1-year duration ending in June 2009. Primary data were obtained through interviews with women, providers, and administrators at various levels. Data were analyzed thematically.

Results: The PPP scheme for EmOC is restricted to deliveries by Caesarean section.The administrators prefer subsidization of costs for services in private facilities to contracting in. There are no PPPs executed in the study district. This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme.

Conclusion: The PPPs for EmOC under the JSY have minimally influenced the out-of-pocket payments for EmOC. Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs. Capacities in the public health system are inadequate to design and manage PPPs.

No MeSH data available.


Proportion of JSY assistance to CS expenses in private facilities
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Figure 1: Proportion of JSY assistance to CS expenses in private facilities

Mentions: The said subsidy of Rs. 1500 for a CS is irrespective of the place of delivery. There is no public sector option for EmOC services in rural areas; the women access these services from the private sector. The 16 participants who had a CS in private facilities incurred hospital expenses ranging from Rs. 10,000 to Rs. 30,000, the average amounting to Rs. 15,000. The proportion of cash assistance received to the cost incurred for CS is depicted in Figure 1.


Public private partnerships for emergency obstetric care: lessons from maharashtra.

Chaturvedi S, Randive B - Indian J Community Med (2011)

Proportion of JSY assistance to CS expenses in private facilities
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104703&req=5

Figure 1: Proportion of JSY assistance to CS expenses in private facilities
Mentions: The said subsidy of Rs. 1500 for a CS is irrespective of the place of delivery. There is no public sector option for EmOC services in rural areas; the women access these services from the private sector. The 16 participants who had a CS in private facilities incurred hospital expenses ranging from Rs. 10,000 to Rs. 30,000, the average amounting to Rs. 15,000. The proportion of cash assistance received to the cost incurred for CS is depicted in Figure 1.

Bottom Line: This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme.Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs.Capacities in the public health system are inadequate to design and manage PPPs.

View Article: PubMed Central - PubMed

Affiliation: Foundation for Research in Community Health, 3 and 4, Trimiti B Apartments, 85, Anand Park, Aundh, Pune, Maharashtra, India.

ABSTRACT

Background: The National Rural Health Mission of India advocates public private partnerships (PPPs) to meet its "service guarantee" of Emergency obstetric care (EmOC) provision. The Janani Suraksha Yojana (JSY) has a provision of Rs. 1500 for contracting in obstetric specialists.

Objectives: The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women.

Materials and methods: A cross-sectional study using the rapid assessment approach was conducted in Ahmednagar district of Maharashtra spanning 1-year duration ending in June 2009. Primary data were obtained through interviews with women, providers, and administrators at various levels. Data were analyzed thematically.

Results: The PPP scheme for EmOC is restricted to deliveries by Caesarean section.The administrators prefer subsidization of costs for services in private facilities to contracting in. There are no PPPs executed in the study district. This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme.

Conclusion: The PPPs for EmOC under the JSY have minimally influenced the out-of-pocket payments for EmOC. Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs. Capacities in the public health system are inadequate to design and manage PPPs.

No MeSH data available.