The public and the private sector coordination towards policy orientation for health development : a strategic management study of the joint public and private health consultative committee

Abstract

The purpose of this study was to investigate the public-private coordination towards policy orientation for health development by using the JPPHC as a case study. The rationale was based on the quest for the equitable and efficient provision of scarce and limited health resources. Four main objectives were addressed: the critical strategic issues for strengthening the coordination; the basis and areas for coordination; factors which may foster or constrain coordination; and present status, roles, and future perspective of the JPPHC. A qualitative study was conducted. Primary data were obtained through a field survey using in-depth interview of the 20 subjects, selected by applying a set of predefined criteria. Also, the primary data were collected by the participative observation in three formal meetings of the JPPHC working group. Data were compiled by using interview notes and tapes, before interpretation. The secondary data were obtained from review of the related studies relevant to the Public Administration, Policy Sciences, Business Management, and organizational coordination theory. The methodological challenges were the efforts towards the control of biases during sampling, measurement, and interpretation. Four main findings were noted. First, the most common reason for coordination was to reduce insufficient opportunities for participation in decision making, particularly in three areas of mutual interest: health manpower development, health financing management, and management of health facilities. Second, details of factors affecting coordination according to the frame of strategic planning process, were not clearly identified due to unclear mandate, missions and objectives of JPPHC. Third, the present status and roles of JPPHC were obscure due to unclear objectives but future efforts should balance the objectives of government, profit and voluntary organizations. Forth, the 9 strategic issues included to following intimately interrelated elements: 1) Awareness of common interest, 2) Perspective or attitude of each other roles, 3) Establishment and/or strengthening coordination mechanism, 4) Information based 5) Continuing dialogue, 6) Development of joint programme, 7) Establish joint evaluation system, 8) Image, and 9) Mutual benefit. In conclusion, public-private coordination must be “participative” or aggressive rather than “cooperative” or defensive to sustain health development.