Outsourcing primary healthcare is the new mantra in Arunachal Pradesh. In the first instance of a private-public partnership at the grassroots level of the health system, the government has announced that one primary health centre in each of the state’s 16 districts would now be run by ‘reputed’ NGO/voluntary agency or a non-commercial hospital. If this pilot project is successful, it is likely to be replicated in most of the 84 primary health centres (PHCs), from Tawang district to upper Siang near the China border, by the end of the year. The selected agency will also be involved in the implementation of the National Rural Health Mission and other national health and family welfare programmes, as well as the promotion of community-based disaster preparedness measures. ‘‘The PHCs would be in remote and far-flung areas as the model is aimed at improving the health delivery system by reaching the inaccessible areas. This will not only provide quality health services, it will also serve as a reference point for the government-run health delivery system,’’ said Anshu Prakash, commissioner and health secretary, Arunachal Pradesh. The agency would use its own medicines, doctors, para-medical and other staff and consumables, while the building and equipment would be provided by the state. • One primary health centre in each of Arunachal Pradesh’s 16 districts to be run by ‘reputed’ NGO/voluntary agency or a non-commercial hospital • PHCs would be in remote and far-flung areas as model aimed at reaching healthcare to inaccessible areas • If pilot project successful, it’s likely to be replicated in most of the 84 PHCs • A steering committee, with representatives of the government and all stake-holders, to monitor the project ‘‘The selection will be on the basis of reputation and experience of the NGO,’’ said Prakash. The agreement will detail the goals and parameters to monitor performance, along with the respective obligations of the government and the agency. The government plans to monitor the system at several levels. A PHC management committee—with representatives from the agency, the District Medical Officer, the Circle Officer and the local panchayat—will keep an eye on the management of the PHC. At the state level, a steering committee headed by the Commissioner and Secretary (Health & FW), with suitable representation by all stake holders, would monitor the project. The selected private agency is expected to be active in the field and conduct camps in villages. Performance indicators will include the immunisation rate, rate of institutional deliveries, patients treated for tuberculosis and awareness programmes conducted. The government also plans to levy user charges to plough back the revenue—for those who can pay. ‘‘But given the situation in rural areas, collection of large amounts of funds through user charges may not be possible,’’ said Prakash.
