PESHAWAR: The provincial government has no mechanism to check the performance of partner organisations that have been tasked to run the administrative and financial matters of the basic health units in 22 districts of the province, according to sources.

The Khyber Pakhtunkhwa health department has been contracting out health facilities to international and national non-governmental organisations since 2008. Under the agreement, the government puts all the financial resources of the respective districts at the disposal of the partners but there is no mechanism to see if these organisations meet the targets set forth at the time of the agreement signed before the contract.

Sources said that health department didn’t have contract management system owing to which the process of awarding contract was not smooth and the facilities were handed over to the organisations through Memorandum of Understanding or simple agreements signed by health officials and partners.

In October, a Health Foundation Act was tabled in Khyber Pakhtunkhwa Assembly to enable the department to make preparations for all such contracts and agreements and its subsequent implementation through a system of check and balances.

Bill tabled in assembly to enable health department to make preparations for such contracts

Under it, Khyber Pakhtunkhwa Health Foundation will be established to work for the development, promotion and facilitation of public-private partnership through various means, in line with the health policy of the provincial government.

In 1995, a health foundation was established but its powers were limited. The upcoming law is like Khyber Pakhtunkhwa Public Private Partnership Act 2014. The former is health-specific while the later is applied to all departments, including health, to ensure that the contractual assignments to the organisation improve patients care.

As opposed to the existing foundation, a Board of Governors, to be headed by managing director, will be appointed to run it and ensure that the budget allocated to the NGOs is spent for the healthcare of the people.

Outsourcing of service delivery contracts was started under an idea that the NGO would run the basic health units effectively as they would employ staff, supply medicines timely and do quick repairs. The NGOs don’t spend their money but the government gives total budget to them, however, there is no institutional management to evaluate their performance.

Currently, Sarhad Rural Support Programme manages some 570 basic health units in 17 districts, Merlin UK worked in Buner and Lower Dir, and Integrated Health Services ran facilities in Battagram and Torghar while Aga Khan Foundation is working in Chitral. Save the Children, another partner, was stopped from work after federal government didn’t issue ‘no objection certificate’ to it for its role in fake Hepatitis B vaccination campaign in Abbottabad.

Employees, including doctors, nurses and technicians in health units, managed by partners, have also been opposing the government’s decision of giving unbridled powers to NGOs due to which the health department came up with the proposed piece of legislation to upgrade the Health Foundation.

The foundation with vast powers will design and award contracts and sign MoUs with partners and will get implementation status of the contracts on regular basis.

Published in Dawn, December 11th, 2015