1

ZAMBIA : PUBLIC PRIVATE

PARTNERSHIP IN TELEMEDICINE – A WAY TO BEST HEALTHCARE DELIVERY TO REMOTE AREAS

Final Project Mrs. Geeta V. Poojary

2

3 Parts of the Presentation

1 : 650 Health Posts Project, Zambia2 : Pan African e-Network Project3 : Zambia : Public Private Partnership in Telemedicine – A Way to Best Healthcare Delivery to Remote Areas

The Target Audience : The Govt. of Zambia

3

Part 1

650 Health Posts Project, Zambia

4

Ongoing Health Posts Project in Zambia

The Ministry of Health, Government of Zambia is constructing 650 health posts throughout the rural areas of the country.

Building of these health posts is in line with government’s vision of providing equitable access to cost effective, quality healthcare to all citizens of Zambia as close to the family as possible.

The Health Posts will be modern health facilities comprising of the Health Post itself, an incinerator, solar power system, four toilets, one staff house, equipment and furniture, hand pumps, medicines and dressing materials, among others.

5

Zambia Health Post Project

The Government of Zambia has plans to upgrade all district hospitals into general hospitals while Provincial hospitals would be upgraded to Central and teaching hospitals.

To correspond with the construction of these health Posts, the Ministry will have to train health professionals to work in these facilities, thus the upgrading of all Provincial hospitals into training institutions.

6

Zambia Health Post Project

The project is expected to be completed in April 2016.

Under the project, 208 health posts will be constructed in the Copperbelt and Eastern Provinces, 195 health posts will be constructed in the North-Western, Northern, Muchinga and Luapula Provinces and 247 health posts will be constructed in the Western, Southern and Lusaka Provinces of Zambia.

7

Zambia Health Post ProjectThe Provinces

8

Part 2

Pan African e-Network Project

9

Pan-African e-Network Project

Pan-African e-Network Project is the project of distance education and tele-medicine set up by the Government of India in Africa.

The basic objective of the Pan-African e-Network project is to assist Africa in capacity building by way of imparting quality education to students in various disciplines from some of the best Indian Universities /Educational Institutions.

Besides, this would provide Tele-Medicine services by way of on line medical consultation to the medical practitioners at the Patient End Location in Africa by Indian Medical specialists in various disciplines /specialties selected by African Union for its Member States. 

10

Pan-African e-Network Project

The Pan African e-Network Project was conceived by former President of India, Honorable Dr. A.P.J. Kalam.

The Ministry of External Affairs, Government of India is the nodal ministry for the project while Telecommunications Consultants India Limited (TCIL) is implementing the project on a turnkey basis. 

Tele-Medicine consultations are being conducted from Super-Specialty Hospitals from India to the African countries on need basis. Moreover, regular Continued Medical Education (CME) sessions have been started with effect from 22nd April, 2009 from 11 Indian Super-Specialty Hospitals.

11

Pan-African e-Network Project

12

Pan-African e-Network Project

Second phase of the project was inaugurated on 16-08-2010 and included Zambia.

Details of the project are available on Youtube at the following link : https://www.youtube.com/watch?v=eBUmdnab9io

The project envisages connecting all African nations of the African Union by a satellite and fiber optic network that would provide effective communication for Tele-education, Tele-medicine, Internet, Videoconferencing notably diplomatic communications (VVIP) and VoIP services and also support e-Governance, e-Commerce, infotainment, resource mapping, meteorological services etc.

13

Part 3

Zambia : Public Private Partnership in Telemedicine

– A Way to Best Healthcare Delivery to Remote Areas

14

The PPP Project Idea

The 650 health posts will be ready by April 2016.

Now, let us consider extending the telemedicine facility, which is at present being extended to Zambian hospitals, to all these 650 health posts. A PPP Project? (Need)

With this PPP Project, the telemedicine facility will reach remote areas of Zambia. (Need)

15

650 Telemedicine Posts

The 650 health posts can be converted into 650 Telemedicine Posts with this PPP Project.

The Ministry of Health, Government of Zambia can examine this proposal. If not all 650 health posts, even if half of them are converted into Telemedicine Posts, lot of rural folks will be benefitted.

The basic infrastructure is already available which is being put in place by way of 650 Health Posts Project. Thus to that extent the PPP project becomes economical as there is no need to spend on these facilities which are being put up thorugh health post project.

16

650 Telemedicine Posts - Need

The current project of 650 Health Posts will serve the basic needs of the people in the remote area of Zambia.

However, in case of complications in child birth or any other complications, these Health Posts will have to send the patients to District level hospitals.

However, with a little upgradation in the facility and telemedicine facilities, lives of many people can be saved with the help of advice from doctors from superspecialty hospitals from India. (Doing things differently)

17

650 Telemedicine Posts Project - Preparation

The Government of Zambia (GOZ) can invite private companies and place the idea in front of them and invite their responses.

The private partners will critically examine the proposal and come up with their suggestions.

Based on the initial discussions, a consultant can be commissioned to study the proposal and prepare a detailed feasibility report.

GOZ can then internally discuss in the Parliament or at any other level about the support to the Project from GOZ. (Political Champion)

18

650 Telemedicine Posts Project - Preparation

Since this is a project which is for the rural people from the remote area, definitely World Bank can be approached for concessional loan under IDA, as all beneficiaries of the project will not be able to bear the cost initially. (Economics)

However, as the project would save lives, create jobs which will result in upliftment of rural people and their standard improves, they will be able to pay for the telemedicine services.

19

650 Telemedicine Posts Project - Procurement

Once partial funding is decided, GOZ can invite tenders from private partners, local as well as international, for converting Health Posts into Telemedicine Posts, covering all 650 health posts or dividing them into different smaller lots. (transparent bidding process.)

Initially these projects need to be made concessional by GOZ by extending subsidy as this project will be a social upliftment project. (Responsibility of Public Sector)

This is similar to water supply project in Benin referred to in the Video talks during Week 3 of World Bank PPP Project course, where the Government of Benin chose to put in a grant.

20

650 Telemedicine Posts Project - Implementation

While execution risk may be taken care of by involving reputed contractors with excellent track record, the revenue risk will be a major risk which can convert this project into a failure. (identification, mitigation and allocation of risks)

GOZ will need to shoulder this risk. It may market this project as corporate social responsibility project for high end corporates.

21

650 Telemedicine Posts Project - Implementation

As the health posts will be ready next year, which means basic infrastructure facility will be ready.

The PPP Project will take care of network connection to the Pan African e-Network.

Zambia as also some of Zambian hospitals are already connected to the Pan African e-Network.

The project will involve extension of the connection to the remote areas of Zambia.

22

650 Telemedicine Posts Project - Implementation

As basic facility will be available at each site, installation of equipment for network connection is required to be taken care of.

The project will comprise less of basic construction and more of installation of IT hardware equipment and related software. (responsibilities of private partner)

The contracts can include all clauses pertaining to execution, arbitration, force majeure, termination, etc. as per international standards, which is the case for existing Zambian contracts.

23

650 Telemedicine Posts Project - Implementation

Zambian Ministry of Health can monitor the project execution with the ICT Ministry. (Monitoring)

After execution, the private partner can manage the telemedicine posts.

The posts can function as health posts for ordinary health problems, by either charging low fees or no fees.

Whenever special advice is required, the posts can act as telemedicine posts by using the network connectivity and seeking advice of the medical professionals from Lusaka or India.

For this facility, part of the fee may be borne by the government by way of grant to make the project viable.

24

650 Telemedicine Posts Project - Implementation

This may look like a unreal or fancy project. One may call this a flight of imagination.

However, the mileage which a project authority can gain from this project will be immense.

The project will result in a very high class medical assistance at the grassroot level!

If really implemented, this project will be a model for whole of Africa!

25

Acknowledgement

Video talks, Resources provided by the World Bank Group https://www.facebook.com/mohzambia/posts/169477889893543 http://www.lusakatimes.com/2013/07/03/three-indian-firms-win-t

enders-to-construct-650-health-posts-in-zambia/

http://www.moh.gov.zm/press/the-status-of-the-650-health-posts-being-constructed-across-the-country/

http://www.panafricanenetwork.com/ https://www.youtube.com/watch?v=eBUmdnab9io http://pages.au.int/infosoc/pages/pan-african-e-network-paen-tel

e-medicine-and-tele-education

26

THANK YOU