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Anthony Okoth

Chairman

Public Private Partnerships Committee of Kenya Healthcare Federation

PPP Defined

There is no one widely accepted definition of Public Private Partnerships (PPP). Broadly, PPP refers to arrangements between the public and private sectors whereby part of the services or works that fall under the responsibilities of the public sector are provided by the private sector, with clear agreement on shared objectives for delivery of public infrastructure and/ or public services.

PPPs combine the skills and resources of both the public and private sectors in new ways through sharing of risks and responsibilities. This enables governments to benefit from the expertise of the private sector, and allows them to focus more on policy, planning and regulation. In order to achieve a successful partnership, a careful analysis of the long-term development objectives and risk allocation is essential.  In addition, the legal framework must adequately support this new model of service delivery and be able to monitor and regulate the outputs and services provided.  A well-drafted PPP agreement would be informed by both the laws of the country and international best practices to clearly delineate risks and responsibilities.

The need for public-private partnerships arose against the backdrop of inadequacies on the part of the public sector to provide public good on their own, in an efficient and effective manner, owing to lack of resources and management issues. These considerations led to the evolution of a range of interface arrangements that brought together organizations with the mandate to offer public good on one hand, and those that could facilitate this goal though the provision of resources, technical expertise or outreach, on the other. The former category includes of governments and intergovernmental agencies and the latter, the private sector. Though such partnerships create a powerful mechanism for addressing difficult problems by leveraging on the strengths of different partners, they also package complex ethical and process-related challenges. The complex transnational nature of some of these partnership arrangements necessitates that they be guided by a set of global principles and norms.

PPPs initiatives can act as a way of developing local private sector capabilities through joint ownership with large international firms, as well as sub-contracting opportunities for local firms in various services areas. PPPs can also be used as a way of gradually exposing state owned enterprises and government to increasing level of private sector participation and transfer of skills between both entities.

There could be some potential risks for poorly structured PPPs since some of the private sector will do what it is paid to do and no more than that – therefore incentives and performance requirements need to be clearly set out in the contract. Focus should be on performance requirements that are out-put based and relatively easy to monitor. There is need to ensure that government responsibility continues since citizens will continue to hold government accountable for quality of health and other services. Government will also need to retain sufficient expertise, whether the implementing agency and/ or via a regulatory body, to be able to understand the PPP arrangements, to carry out its own obligations under the PPP agreement and to monitor performance of the private sector and enforce its obligations

Public Private Partnership Committee TORs
1. Being the voice of the private sector at the Ministry Level.
2. Engagement with Non State actors like CHAK, SUPKEM and KCCB.
3. Represent KHF in PPP Chatter formulation.
4. Represented KHF in Public sector forums.
5. Mapping out Strategic partners.
6. Bringing up the agenda for the MSF on PPP issues.
7. Mapping all the Public Private Partnership stakeholders.

Key activities to be carried in 2012

  • Follow up on the finalization and adoption of the PPP bill for Kenya
  • Work with all KHF members to ensure appropriate representation on the MOH PPP TWG and other key ICCs and TWGs. This is to ensure that KHF gets an opportunity for policy influence and participates in decisions made that after the health sector
  • Identify opportunities locally, regionally and internationally that will enhance KHF member individual businesses performance including access to opportunities to participate in donor funded projects where the private sector providers could play a role. For example, the USAID funded APHIAPlus have a PPP component and KHF need to be more harmonized in their member participation, for example access to training opportunities, access to some commodities, GF drugs and trainings,social marketing projects, health communication for behavior change, etc.
  • Identify training or capacity building opportunities that shall be shared with KHF members for their own personal professional development and continuous medical education
  • Encourage KHF members to participate in some research partnerships with Government, NGOs, academic institutions whose evidence shall be used to influence policy and best practice change
  • Active participation in PPP-HK
  • Promote Private-Private dialogues and proactively look out for new ventures that will benefit KHF members

Why Private Private Dialogue ?

  • Fragmented Private Sector able to dialogue on critical business issues
  • Demystify the word “Private for profit “vs “Non State”
  • Demand its rightful position in the Health Sector
  • Avert the “pick and choose” option by the government
  • Create business opportunities with partnerships with other private players within the region
  • Promote Self regulation
  • Share best practices and economies of scale
  • Promote Self regulation Share best practices and economies of scale

Why Public Private Dialogue?

  • Represent the Private Sector to dialogue/solve on critical business issues
  • Clarify roles of all non-­‐state players (Private , FBOs and NGOs)
  • Create partnerships/work together to improve overall health
  • PPP Health Kenya
  • Provide the right information to the Government e.g Statistics
  • Emergency Care and disaster response
  • Training of Health Workers