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PESHAWAR: The Khyber Pakhtunkhwa has decided to outsource rural health centres to partner organisations to improve primary healthcare at grassroots level, according to sources.

The government had earlier decided to give 90 rural health centres of the province to Sarhad Rural Support Programme (SRSP), a national non-governmental organisation, but now it has planned to hold an open bidding for award of the contracts through competition.

SRSP, one of the main partners of the government in health sector, runs 570 basic health units (BHUs) throughout the province in 17 districts under an agreement through People’s Primary HealthCare Initiative package, has expressed inability to manage more health facilities.

Contracts will be awarded through open bidding to partner organisations

The chief minister had approved a summary to outsource management of rural health centres to People’s Primary HealthCare Initiative.

Sources said that health department began contracting out health facilities to the partners in 2008 without any open bidding and continued to extend the agreements with addition of more facilities.

The rural health centres are 10-bed small hospitals located in all 26 districts with two male medical officers, one lady doctor and one dental surgeon, supported by two lady health workers, medical technicians, dispensers and nurse to provide 24 hours primary healthcare to the people.

According to the new arrangement, the province has been divided into seven zones and one partner organisation will get contract of two zones only.

Contrary to SRSP contract, the new modus operandi will be applied in accordance with the Public Private Partnership (PPP) Act, 2014 to ensure transparency through open tender. The health department is preparing terms and conditions before inviting bidders.

The department has designated Health Foundation as PPP node and has been assigned urgent measures to give final touches to the programme in collaboration with the finance and planning and development departments.

The government started contracting out health units when epidemics hit people. The performance of SRSP in calamity-hit areas prompted the government to give it more districts but lately there is pressure from PTI top leadership to follow PPP Act in contracting out government’s services.

The government wants not to repeat the mistakes, it made in signing contracts with partner organisations in the past. The government will adopt a system of check and balance. The district health officers (DHOs) will have supervisory and monitoring role.

Presently, PPHI, Merlin and Integrated Health Services manage basic health units in 21 districts where they have all administrative and financial powers. These organisations are responsible for appointments, salaries of staff, electricity, equipments, medicines, maintenance, staff attendance etc at the relevant health unit.

“The government will place advertisements for contracting out the health centres and each of the partner organisations will be allowed to operate in two zones,” sources said. They added that the condition meant to save any of the organisations from workload.

Under the contract, the organisations manage the health units and receive budget from the government to make sure availability of services and essential medicines. The authority of regulating rural health centres will rest with health department contrary to the current mechanism wherein partner organisations are calling the shots in districts where they operate.

The organisations provide consultancy services to the health department and hire staff against vacant seats. They spend money for purchase of medicines and carry out repair work at the facilities.

A PPP committee will accord final approval to the plan before its presentation to the chief minister.

Published in Dawn, November 5th, 2015

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