Public-Private Partnership and Health Care Service Delivery in Enugu State, Nigeria, 2005-2013

Abstract

The District Health System (DHS) was implemented in 2005 by Enugu State Government to improve the health care service delivery in the state, which was hitherto characterized by disjointed planning and inefficiency. Though the DHS attracted increased partnership with private health care service providers, as well as impacted positively on the health status of the people, however, the upsurge in the preventable diseases in the state within the period under study underscored the defect on the policy agenda of the DHS. Attempt was made in this study to investigate Public-Private Partnership (PPP) and health care service delivery in Enugu State, Nigeria. In doing this, the study proceeded from three objectives thus: (1) to ascertain whether weak compliance to the legal framework of the Public-Private Partnership by the Enugu State Government led to actualization of strategic interest of the private sector and donor agencies in health care service delivery in the state; (2) to determine whether the pattern of recruitment and deployment of skilled medical personnel in the district hospitals was responsible for poor health care service delivery and prevalence of preventable diseases in Enugu State; and (3) to establish whether the multiple authority structures of the District Health System adversely affected the integrated supportive supervision approach in health care service delivery in Enugu State. Descriptive survey and documentary methods of data collection were used in the study. Data analysis was based on quantitative descriptive statistics and documentary methods, while ex-post facto research design was used. Purposive sampling technique was used in drawing the sample size of 95 from 225 managerial staff cadre of the various district hospitals. Systems theory forms the philosophical basis of our analysis. The study arrived at following findings after data analysis: (1) weak compliance to the legal framework of the Public-Private Partnership by the Enugu State Government led to actualization of strategic interest of the private sector and donor agencies in health care service delivery in the state; (2) the pattern of recruitment and deployment of skilled medical personnel in the district hospitals was responsible for poor health care service delivery and prevalence of preventable diseases in Enugu State; and (3) the multiple authority structures of the District Health System adversely affected the integrated supportive supervision approach in health care service delivery in Enugu State. We recommended, among others, that levels of governments in Enugu State should endeavor to be wholly committed to the funding of the District Health System (DHS) to ensure long-run sustainability of the scheme

Keywords:The District Health System (DHS) was implemented in 2005 by Enugu State Government to improve the health care service delivery in the state, which was hitherto characterized by disjointed planning and inefficiency. Though the DHS attracted increased partnership with private health care service providers, as well as impacted positively on the health status of the people, however, the upsurge in the preventable diseases in the state within the period under study underscored the defect on the policy agenda of the DHS. Attempt was made in this study to investigate Public-Private Partnership (PPP) and health care service delivery in Enugu State, Nigeria. In doing this, the study proceeded from three objectives thus: (1) to ascertain whether weak compliance to the legal framework of the Public-Private Partnership by the Enugu State Government led to actualization of strategic interest of the private sector and donor agencies in health care service delivery in the state; (2) to determine whether the pattern of recruitment and deployment of skilled medical personnel in the district hospitals was responsible for poor health care service delivery and prevalence of preventable diseases in Enugu State; and (3) to establish whether the multiple authority structures of the District Health System adversely affected the integrated supportive supervision approach in health care service delivery in Enugu State. Descriptive survey and documentary methods of data collection were used in the study. Data analysis was based on quantitative descriptive statistics and documentary methods, while ex-post facto research design was used. Purposive sampling technique was used in drawing the sample size of 95 from 225 managerial staff cadre of the various district hospitals. Systems theory forms the philosophical basis of our analysis. The study arrived at following findings after data analysis: (1) weak compliance to the legal framework of the Public-Private Partnership by the Enugu State Government led to actualization of strategic interest of the private sector and donor agencies in health care service delivery in the state; (2) the pattern of recruitment and deployment of skilled medical personnel in the district hospitals was responsible for poor health care service delivery and prevalence of preventable diseases in Enugu State; and (3) the multiple authority structures of the District Health System adversely affected the integrated supportive supervision approach in health care service delivery in Enugu State. We recommended, among others, that levels of governments in Enugu State should endeavor to be wholly committed to the funding of the District Health System (DHS) to ensure long-run sustainability of the scheme