Health Systems in Action: an eHandbook for Leaders and Managers

9. MANAGiNG heALth SeRViCe DeLiVeRY 9:35
Public-Private Collaborations in Action for Better Health—
Country examples from tanzania and India
Working with private drug shops in Tanzania. for many years the tanzania food and
Drugs Authority authorized Duka la dawa baridi (DLDB), or private drug shops, to provide
nonprescription medicines in the private sector. With an estimated 6,000+ stores, DLDB
constituted the largest licensed retail outlets for purchasing medicines in tanzania.
MSh’s USAiD-supported Accredited Drug Dispensing Outlets (ADDO) program was
designed to improve key aspects of the DLDB enterprises: the physical premises,
stock maintained by the owner, consumer choices, interactions with dispensers, and
recommended treatments. in addition, the government systems in which DLDBs are
embedded—licensing, supply, training, and inspection—had to be strengthened.
After gaining support from key stakeholders, the food and Drugs Authority and regional
government collaborated with MSh to implement the ADDO initiative, combining
commercial incentives with decentralized regulatory oversight. ADDO provided
education, training, and supervision for independent shop owners and dispensing
staff. the quality of products and services was assured through accreditation based
on the achievement of pre-established standards. Routine monitoring by district and
local government and community structures reinforced and helped maintain those
standards.
Marketing condoms in India. through USAiD’s PSP-One india project, Abt Associates
and its media partner, LOWe india, developed a prize-winning campaign to “normalize”
the condom, positioning it as a product like any other. the Condom Bindaas Bol!
(Condoms—Just Say it!) campaign aimed to increase the use of condoms and expand
the condom market. the campaign included humorous television commercials,
newspaper and cinema advertisements, and community contests built around the tV
advertisements.
to supplement the mass media activities, Bindaas Bol reached out to more than 40,000
chemists, retailers stocking condoms, and indigenous medical practitioners and
asked them to be agents of behavioral change by selling condoms openly and without
embarrassment and by encouraging their customers to ask for condoms without
hesitation. the project partnered with these condom marketers to enhance retail
visibility and access, and to stress the importance of correct and consistent use of
condoms. A well-publicized contest rewarded the retailers who had the best display of
condoms and openly discussed condoms with their customers.
working with the private sector: approaches and tools
Division of labor between the government and private sector. To determine the best
mix of public and private health care provision and financing, it is necessary to define
which sets of services each sector can handle most effectively, make certain that complementary
work is done in both sectors, and find a public-private mix that reduces differences
in health care that are unnecessary, avoidable, and unjust.
The appropriate mix will vary from place to place, depending on the demand for services
and the ability and willingness of consumers to pay for care. This division of labor
depends on common objectives and complementary resources. Public-sector policymakers
must join with professional associations and networks to agree on health goals, standards
of care, and indicators of success.
© 2010 MANAGeMeNt SCieNCeS fOR heALth HeAltH SySteMS In ACtIon