PESHAWAR: The health department has decided to outsource 58 more hospitals to private organisations to improve patients’ care through availability of human resources and medicines besides ensuring maintenance and provision of equipment and strengthening emergency services in these facilities.

The hospitals, to be outsourced, have been identified by a nomination and recommendation committee headed by Dr Shaheen Afridi, the director-general health service Khyber Pakhtunkhwa. The committee took into consideration data of district health information system (DHIS) and Independent Monitoring Unit (IMU) against the targets of Universal Health Coverage (UHC) to identify underperforming health facilities and subsequently recommended their outsourcing.

“This is important to consider the far flung and hard-to-reach areas for outsourcing so that the health services are made available to entire population of the province,” said officials.

They said that in the existing system, the patients suffered in hospitals due to out-of-order machines needed for investigation, absenteeism of staff, supplies of medicines and administrative issues whereas the contracted out facilities were operated by private firms, which ensured maintenance of equipment for uninterrupted investigations, attendance of staff and availability of medicines.

The move meant to improve patients’ care and ensure availability of staff

They said that another important factor, being focused, was the improvement in the quality of care in the outsourced facilities. For the purpose, staff training, display of standards and protocols, robust monitoring and taking patients’ feedback have been made an integral part of this partnership.

Officials said that the facilities outsourced to private companies under Khyber Pakhtunkhwa Public-Private Partnership Act by the Health Foundation (HF) because of their poor performance showed improvement.

The outsourced facilities are still under the control of health department but the administration is shifted to private parties, which work under the relevant district health officers (DHOs) and hospital review committees (RMCs). Headed by DHO, the RMC in a district is consisted of medical superintendent, additional deputy commissioner, project director of private firm, representative of district account office and district specialist co-opted member.

The committee, holds its meting within three months, provides oversight and review progress at local level whereas HF and IMU monitor these outlets at the provincial level.

Officials said that they were working on the plan and within few weeks, 58 health facilities in different districts would be advertised for outsourcing. They said that Expression of Interest (EoI) documents was being finalized. They added that most of the health facilities, being outsourced, included Type D hospitals besides few Type C and Type B.

A comparative assessment report released early this year shows that 19 health facilities outsourced to private firms one and two years ago have shown improvement as compared to the non-outsourced ones. The previously contracted out facilities are located in South and North Waziristan, Kohistan, Bajaur, Kurram, Khyber, Orakzai and Chitral districts.

The assessment, conducted by third party in 2021, covered each parameter of service delivery and 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.

According to the report, the non-outsourced Category-D hospital in Gara Tajik, Peshawar, and Category-D hospital in Razmak, North Waziristan, did not have emergency and in-patients services. Only general OPD was available at Razmak hospital, with only one medical officer at the time of the assessment.

The bed occupancy rate of outsourced facilities was 22 per cent as compared to the 18 per cent of non-outsourced hospitals. The non-outsourced health farcicalities inspected for the assessment included district headquarters hospitals of Lakki Marwat.

Published in Dawn, July 18th, 2022