Recovery, Renewal, Resilience

Throughout the pandemic, many health systems across the world have come within days of being overwhelmed with COVID-19 patients, and others have been unable to prevent their systems from being overwhelmed. Pakistan have adopted “health stewardship” as an approach to ensure public health is a “joint function of national and provincial governments, where service delivery relies on mixed health systems”. The response in Singh district, which has the highest rate of COVID-19 cases in Pakistan, was underpinned by public-private partnerships with local government. This provides insights into how public-private engagement can be accelerated during the crisis and how “existing policy windows can be used for longer-term planning for pandemics and Universal Health Coverage”. Consider that:

• Stewarding partnerships enabled rapid acceleration of testing through private laboratories, supported surge capacity to be met in local private hospitals and increased “critical care training of public sector hospitals” through partnerships with private hospitals
• “Health stewardship” can enable advisory relationships with the private sector to create a joint operational response and strategic communications during crisis
• Procurement (e.g. of PPE) and supply chain management can be enhanced through “digitalised data-sharing of cases and hospital capacity across private and public providers”
• Stewardship relationships may be transactional (e.g. limited to purchasing arrangements) but can also include “wide-ranging formal agreements for co-production”, providing an opportunity to reform public and private health partnerships
• Devolved operations have proven to offer a flexible and effective response where there is rapid “data sharing for national-provincial coordination, and well-informed local governments who can mobilize inclusive and co-produced responses”