PESHAWAR: The health facilities outsourced to private firms have shown better performance than the government-run outlets, according to a comparative assessment.

The assessment has been carried out by Adam Smith International, an international organisation. The Khyber Pakhtunkhwa government has outsourced about 20 health facilities to private organisations from the year 2013 to 2019, of which 10 are fully functional while the rest are being operationalised.

Health Foundation of the health department has outsourced the facilities under the Public Private Partnership Act, 2014 to improve patients’ care through availability of human resources and medicines in the hospitals besides ensuring maintenance and provision of equipment and strengthening emergency care.

The assessment, conducted by third party in 2021, covered each parameter of service delivery. It noted that most of the services were available in both the outsourced and non-outsourced hospitals. Seven facilities including four non-outsourced and three outsourced were inspected for the assessment.

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It said that Category-D Hospital in Gara Tajik, Peshawar, and Category-D Hospital in Razmak, North Waziristan, (non-outsourced) did not have emergency and in-patients services. In the OPD services at Razmak hospital, only general OPD was available with only one medical officer at the time of the visit.

The outsourced hospitals had an average bed occupancy rate of 22 per cent while non-outsourced ones had at average bed occupancy rate of 18 per cent, said the assessment.

The ‘terms of reference report’ on comparative assessment of traditional versus outsourced hospitals took into consideration the aspects such as governance, budgeting, funds management, human resource management, operations and procurement. The scope of work included the assessment of three outsourced and four non-outsourced hospitals.

The non-outsourced health farcicalities that were inspected for the assessment included district headquarters hospitals of Lakki Marwat and Hangu and the Category D hospitals in Razmak and Gara Tajik while outsourced facilities were the hospitals of Sholam in South Waziristan; Mamad Gat in Mohmand and Mishti Mela in Orakzai.

The Health Foundation, director-general health services, internal support unit and independent monitoring unit jointly developed a framework for the assessment.

According to the assessment, all the outsourced hospital have enforced automated health management information system, which is being used in their day-to-day operations to record patient’s journey and medical history, whereas most of non-outsourced hospitals are managing data manually.

“From our observations of physical condition, we noted that the facilities in all outsourced hospitals were better than non-outsourced hospitals under basic amenities, basic equipment and hygiene and waste management,” said the report.

It said that of the overall score, the outsourced facilities received 89 points and non-outsourced 55 points. In service delivery, the score of outsourced hospitals was 83 per cent and non-outsourced 62 per cent while in human resource availability, the former’s score was 99pc and the latter’s 66pc, in management information system it was 87pc and 29pc and in overall facilities it was 87 and 48, respectively.

The report indicated that outsourced health outlets had better stock management system compared to the government-run facilities. It also found the condition with regard to availability of the services of clinical staff, including doctors, nurses and paramedics in outsourced hospitals better than the non-outsourced ones.

It showed that 78pc of the outsourced facilities had availability of medicines as compared to 71pc of the non-sourced hospitals while availability of electricity was 100pc and 52pc, respectively. Additionally, the contracted out facilities had better waste management system, cleaner toilets and drainage and lighting system than the government-run hospitals.

The report said that in addition to improvement in overall facilities, the government would not require recruiting staff in the outsourced hospitals for the next five years and the patients would not suffer due to presence of out-of-order equipment as it was the responsibility of the contractual parties to take care of maintenance and staffing of the facilities. The government releases one-line budget to the outsourced facilities and the parties are responsible to provide the 24 hour services.

Encouraged by the result of the assessment, the health department has decided to outsource primary healthcare services in 15 districts of the province through proper bidding to engage experienced parties to run the facilities. The management of the outsourced facilities remained in contact with the health department and the parties run the facilities as per law.

Published in Dawn, June 6th, 2022