An ADB technical assistance grant for PPP in health services was provided to DBP to support the sub-borrowers under CBHCP, including local government units and private providers, in enhancing modalities for PPP, including (i) innovative strategies to improve efficiency, access, and quality of services; (ii) assisting small-scale health providers with access to credit to support health-related MDGs; and (iii) mobilizing private resources for achieving the MDGs. The grant's impact is improved maternal and child health status by 2015 in the subproject sites through PPP, and its outcome is tested PPP modalities that will have demonstrated potential to increase the use of maternal and child health care and referral services in the PPP subproject sites. The technical assistance (TA) has three outputs: (i) development and promotion of PPP modalities in the health sector, (ii) development of incentives and operational strategies for small-scale health providers in rural and underserved areas to obtain accreditation with the Philippine Health Insurance Corporation (PhilHealth), and (iii) development of a contracting modality for health services.9 DBP is the TA executing agency, while DOH and PhilHealth are implementing agencies.
In the Philippines, the emerging PPPs in health include the following:
(i) outsourcing of clinical or technical (ancillary) services to private enterprises and organizations;
(ii) outsourcing of support services, including laundry, transportation, logistics, security, janitorial, and food and nutrition services;
(iii) contracting out the direct provision of certain health services to a private provider (e.g., TB treatment, health education); and
(iv) contracting or integrating private insurance schemes to cover specific populations, especially in low-income areas.
Three modalities for PPP in health are common in the Philippines: contracting out services, joint ventures, and franchising. Several models of contracting out to the private sector are available, such as the following:
(i) collaboration initiated by private companies or nongovernment organizations to develop or deliver health services for specific public health maladies and diseases and/or to specific groups, such as the development of vaccine manufacturing, Tuberculosis-Directly Observed Treatment Strategy, maternal care, child health services, parasite control, malaria, and HIV/AIDS;
(ii) contracting for integrating private insurance schemes to cover specific populations; and
(iii) outsourcing clinical or technical (ancillary) services to private sector enterprises or organizations.
As part of the TA's outputs, a DOH Administrative Order for PPP in Health was drafted and eventually signed in 1 March 2012 (Annex 1).
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9 There had been revisions in the second and third TA outputs since the submission of the project inception report. Output 2 now focuses on providing technical assistance to PhilHealth in developing a global budget scheme and a monitoring and evaluation system while Output 3 focuses on capacity development.