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NGO- PPP Partnership in the Management of Difficult Facilities
Public-Private Partnership (PPP) has emerged as one of the important strategies for health sector reforms in Meghalaya. Initiatives have been taken by NRHM, Health & FW Dep’t., Meghalaya to undertake different PPPs in meeting the growing needs for health services.

The conceptual framework to manage health institutions through PPP is given below:
The basic transaction is turning the management and operation of some of the worst CHCs/PHCs through NGOs and Corporate agencies. The NGO operates the health institutions and their sub centres. In return for operating the health centres, the Government of Meghalaya provides the building and all of its equipments, furniture, and supplies. The NGO receives the facilities and use its own funds for whatever is needed, including renovation, equipment, furniture, and beds.

Out of 29 CHCs/PHCs & State Dispensary proposed for handing over to NGOs, 2 CHCs, 19 PHCs and 1 St. Dispensary (to be upgraded to PHC) has been handed over since February 2009.

The NGO hires all staff according to the norms laid by the MoU entered with the Government of Meghalaya. The NGO provides a coordinator out of its own fund to supervise the programme. The health centres are opened 24 X 7 hours. All staff members within the institutions’ premises and are on call 24 hours a day. The centres offer the same primary health care services as government-operated centres, specializing in RCH and outreach. It handles normal deliveries and sterilizations.

Most of the NGOs employ retired government and newly graduated doctors. It is very difficult to attract other physicians as well as auxiliary nurse-midwives. The PPP model requires an NGO that has the financial resources to complement the government’s contributions. It is also essential that the NGOs have full hiring and firing authority over staff.