An important step in establishing a public-private partnership (PPP) for expansion of health care coverage is analysis of existing health systems in a locality. This descriptive study delved into the mechanisms employed by the localities to achieve health goals set by the various stakeholders in health. The cities of Surigao, Roxas, Calapan, General Santos and Tacloban; the municipalities of Mambusao in Capiz, and Roxas in Oriental; and the province of Saranggani were the chosen sites. The health sectors of the local government units, including Provincial Health Office, City Health Office, and Rural Health Unit, and at least provincial or district hospital in the areas were included as respondents.
Thirty facilities were included in this study, 15 had past or present PPPs. Thirty nine individual PPPs were documented in this study, most of which were done by municipal/city local governments. The most common type noted was the provision of health technical services, which included health personnel trainings and capacity building. Majority of the private partners are private companies, private medical and paramedical practitioners, and national NGOs. In seven of the PPPs, a joint committee consisting of representatives from both parties decides on matters of the partnerships; however the budget allocation for the partnerships is mainly decided upon the public partner. personnel management in the PPPs is handled almost equally by private and public partners. Most PPPs were established with binding contracts or memorandum of agreement. Overall the respondents rated their partnership as a success.
The present environment in the Philippines allows for the accelerated growth of health service delivery thru PPPs, and LGUs may take advantage of this situation to fill in the gaps of their health system. To be effective, PPPs should establish monitoring systems that will effectively detect progress towards population health and health equity. Distribution of risk and responsibilities should also be determined and explicitly stated in the contracts. Incentives and penalties may ensure compliance of both partners to the contract. Partners should also commit to the fulfillment of the partnership's goals, and improve the overall health status of the community.