Programs Focused on Rural, Poor & Scale

Building Multilevel Incentives for a Tiered Network of Private Providers

Gopi Gopalakrishnan, PresidentPrachi Shukla, Country Director

World Health Partners (WHP)

• A non-profit organization• Draws on Janani program lessons in Bihar

for using private sector resources to deliver care to rural poor

• How to use resources outside the public sector to supplement the public sector

Broad Framework

• Private Sector is the only other option to achieve scale

• Taking risk is an important factor to enhance stakes

• Volumes to reduce cost, Value to enforce standards

• Creation of a premium segment to benchmark• Advocacy focused on better regulation

Network Structure

VIDEO SLIDE

C e n t r a l M e d i c a l F a c i l i t y :

GP + Specialists

V i l l a g e s

S p e c i a l i s t s

Incentive Structure

Franchised Clinics

TB incentiveSale of SkymedsFee from cell consultationsStature, credibility, recognition

TB incentiveSale of SkymedsGovt. linkagesFee from consultationsStature, credibility, recognition

Govt. linkagesReferrals from Sky networkGovt. accreditation

RNTCP training Incentives on consultations

Sky network = increased patients; increased profits

Sky network incentives

• Tangible incentives:• Incentives on case identification, adherence

and reporting• Increased profit due to increased caseloads• Reimbursement from Govt. scheme

• Intangible incentives:• Enhanced social status and credibility• Govt. recognition• Training and communication support

Financial Strategy: Sustaining Provider Interest

Franchise designed for ‘Horizontal Programming’

Broad Range

of Services

generates Adequate Caseloads

Economic Viability

Enforce Standards

Mandate Delivery of Services

e.g. Family Planning