Columbia International Affairs Online: Working Papers

CIAO DATE: 11/2011

Public-Private Partnerships for Health Care in Punjab

Nirvikar Singh

September 2011

Center for the Advanced Study of India

Abstract

This study examines the current state of public-private partnerships (PPPs) in health care in Punjab, and possibilities for new kinds of initiatives in this broad category of institutional arrangements. Health care outcomes in India are below the levels that might be expected even at India’s specific level of development. The Indian government has recognized the need for public policy action, and is implementing a massive National Rural Health Mission (NRHM) to improve public sector delivery of health care services, especially in poorer states, and especially to the poor all over the country. The NRHM involves substantial increases in funding, and many innovations in organizational arrangements, including collaborations with a range of private sector entities. While Punjab is a relatively rich state, its health outcomes in many dimensions (e.g. maternal and infant mortality) are not commensurate with its relative income level. Punjab also suffers from relatively ineffective governance, and low public spending on health care. The NRHM provides substantial new funding to the Punjab government, and it, too, is attempting reforms in publicly provided health care services. In parallel, the Punjab government has a well-defined procedure for considering PPPs, including in health care, but with a focus on the construction of infrastructure, i.e., hospitals in this particular sector.