India Health Public Private Partnerships


Public Private Partnerships have begun in the health sector. And they are here to stay. Many talk about it. Few understand its implications. Some get lost in semantics and related discussions, while others see this to be a simplistic solution for many challenges in the health sector. Result is a myriad configuration of opinions and approaches to PPP in the health sector. This myriad configuration has resulted in (a) isolated experiments with mixed results, (b) mismatch between the intent to venture into partnerships and the capacity to design and manage them, (c) design of PPP models without much perspective planning and evidence, (d) launching of PPPs without an enabling environment and adequate structures and systems, (e) lack of evidence to support costing frameworks and the financial implications.


What we Offer?


  • Policy Research & Design
  • Feasibility Assessment
  • Designing PPP Schemes, SOPs
  • Costing of Services for PPPs
  • Partner identification and commissioning support
  • Capacity Building
  • Advocacy, Promotion and Marketing
  • Management support, onsite trouble shooting, hand holding / partnership nurturing support
  • Developing regulatory framework for PPPs
  • Auditing support
  • Fund Management
  • Impact Assessment 


Our References


Medical Collage Shillong, Meghalaya (International Finance Corporation) 2011 
EHI International worked with E&Y to conduct feasibility studies, prepare options for PPP to setup the medical collage at Shillong and develop the transaction related documents medically concession agreements


Transaction Advisors to Set-Up Aawas Bandhu
Three medical collages and Govt. of Uttar Pradesh Super Specialty Hospital in Uttarpradesh (2010-2011)


India, Policy for Public Private Partnerships for State Governments in India (Haryana – 2003, Himachal Pradesh – 2004, West Bengal – 2005, Uttar Pradesh – 2008) 
EHI International developed the Policy Framework for Public Private Partnerships through a series of stakeholder consultation workshop and formative research.


India – West Bengal, (KfW: 2003 – 2008, DfID: 2006-2007) Design and Management support for PPP for Emergency Transportation Services and Diagnostic Services in Rural Hospitals
EHI International developed Partnership Schemes, Standard Operating Procedures, partner selection guidelines, eligibility criteria for setting up a network of 174 ambulance services managed through local NGOs and diagnostic centres in Rural Hospitals managed by private providers. The design for ambulance services ensured only one-time capital investment by the Government and all operational costs and revenue risks are shared by the private operators and services managed through user fees. EHI International also provided operationalization and management support for 4 years including MIS support and capacity building. The design and implementation support was provided by KfW from 2003 to 2008 in 8 districts and the roll out support was extended by DfID in the remaining 10 districts of the State for one year which was also managed by EHI International.


India – West Bengal, (KfW: 2003 – 2008) Design of PPP for Management of Primary Health Centers and Fair Price Medicine Shops in Rural Hospitals 
EHI International developed the Partnership Scheme, Standard Operating Procedures, partner selection guidelines, eligibility criteria for outsourcing the management of Primary Health Centers and setting up a chain of fair price medicine shops supported by a Social Franchising Network Organization for procurement, supply chain management, franchisee identification and management support.

India – West Bengal, (KfW: 2007 – 2008) Promotion, Marketing and Advocacy Support for PPPs in Primary Health Care

EHI Internationals support included development of a comprehensive advocacy and promotion strategy and plan. The strategy covers an optimal mix of mass (radio, television), static and local media including mid media supported by a series of advocacy workshops with communities, grassroots level health workers, health care providers and administrators, folk shows, theatres, documentary films, etc. EHI International implemented the strategy in the eight project districts. 

India – West Bengal, (KfW: 2007) Capacity Building for Management of PPPs

Building capacities among the government functionaries to manage and monitor PPPs and among the private partners to effectively manage the PPPs was considered an integral strategy to nurture and sustain the PPPs. With this objective, EHI International developed training manuals for different audience segments and trained over 2000 government health functionaries and 500 participants from the private partners on management of PPPs. While the focus was on contracts management and monitoring for the participants from the government for the private partners the focus was more on systems management, resource management and MIS.


India – West Bengal, (KfW: 2007 – 2008) Design and Pilot of Voucher Scheme for Ensuring Safety Net for Emergency Transportation Services 
EHI International designed a voucher scheme for emergency transportation services for promoting institutional delivery. The pilot revolves around a network of private ambulance providers who provide free transportation to pregnant women for institutional delivery and seek their reimbursement from the government in exchange of vouchers that they receive from the users. The pilot is operational in one district in West Bengal. 

India – West Bengal, (DfID: 2006 – 2007) PPP Design for Setting up Fair Price Pharmacy Shops in Medical Colleges and District Hospitals

EHI International developed the Partnership Scheme, Standard Operating Procedures, partner selection guidelines, eligibility criteria for setting up a chain of fair price medicine shops in Medical Colleges and District Hospitals.


India – West Bengal, (DfID: 2007) PPP Design and Operationalization Support for Increasing Access to Institutional Delivery Services (Ayushmati Scheme)
EHI International designed a PPP Scheme along with all operational tools and protocols (SOPs, Contract documents, communication strategy, MIS, monitoring framework) for empanelling existing private providers for providing normal and caesarean delivery services in lieu of a financial package that the private partners would receive from the Government against appropriate evidence.

India – Delhi, (2008 – 2009) PPP Design and Operationalization Support for Pre Hospital Emergency Response (Ambulance) Services 

EHI International conducted a qualitative diagnostic research to design the PPP for Pre Hospital Emergency Response (Ambulance) Services for the national capital territory on a capital costs and optimal revenue risk sharing model. A network of 150 advanced and basic life support ambulances will be managed and controlled by a GPS enabled centralized 24X7 emergency response center which will be accessible to the population through a toll free number. EHI International support included design, transaction advice, commissioning support and monitoring for services for one year. 

India – Uttar Pradesh, (2008) PPP Design and Operationalization Support for Management of Public Health Facilities

EHI International conducted a qualitative diagnostic research to design the PPP for management of public health facilities from sub health centers to district hospitals on optimal revenue risk sharing model where the private partner infuses required capital for upgradation and expansion of facilities. The support includes design support, transaction advice, i.e. preparation of RFP and assistance in selection of appropriate partners. 

India – Himachal Pradesh (2004) Developing the Operational Framework for PPP in Health 

EHI International developed the partnership strategy, scheme and operational protocols for Ambulance services, diagnostic services, employees medical benefit scheme, facility management, health tourism, maintenance of medical equipment, health tourism , medical education, social franchising of services and drugs and medical supplies.

India – Haryana (2004) Developing the Operational Framework for PPP in Health 

EHI International developed the strategy and operational protocols for PPPs in primary health care.

India – Rajasthan, (2007) Contracting Framework for PPP and Support for Development of PPP Cell within the Government Department 

EHI International developed transaction documents (RFQ, RFP, partner selection guidelines, etc.) for PPPs in 8 areas in the health sector along with the strategy and framework for setting up a PPP Cell for coordination and management of PPPs in the state. Training manual on PPP Management, Contracts Management and selection of private partners have also been developed.

India, (GTZ: 2008-2009) Health Sector Strategy Support – PPP

EHI International provided national level technical support under the Health Sector Strategy initiative of GTZ. Under this initiative national level technical support is being provided to Government of India on Public Private Partnerships and Quality in health care.