Last week, as part of its mutual learning series on ‘Unlocking Private Enterprise for Public Good – Redesigning Health Systems for UHC during COVID-19 and beyond’, the Private Sector In Health (PSIH) TWG , in collaboration with the Gates Ventures Exemplars in Global Health program, organised a webinar on ‘New Primary Health Partnership Models – Redesigning Health Systems During COVID-19 and Beyond’.
The webinar focused on emerging innovative primary healthcare partnerships in Singapore, the US and South Africa, with contributions from panellists Dr Lew Yii Jen, Mr. Dan Gwinnell, Mr. Gustav Praekelt and discussant Dr. Lim Yee Wei.
Singapore’s COVID 19 pandemic preparedness clinic partnerships
Singapore has demonstrated health system resilience in managing the COVID-19 pandemic. Since the SARS outbreak in 2003, nationwide efforts have been implemented to prepare institutions and individuals for pandemic response. Multiple efforts resulted in a comprehensive response to COVID-19, including a multi-ministry government taskforce to coordinate actions between clinical and non-clinical stakeholders, centralise efforts and the activation of over 800 Primary Health Care Preparedness clinics (PHPCs) to enhance detection and management of potential cases.
Lessons from previous infectious disease experience, as well as advancing age and rise in chronic disease among the population in Singapore, motivated the government to bridge the gap between public and private health actors. General practitioners (GPs) joining the primary care networks were supported by funding mechanisms that allowed patients to use the country payment scheme to pay for participating GPs. For instance, the Community Health Assist Scheme (CHAS) enables all Singapore Citizens to receive subsidies for medical and/or dental care at participating GP clinics. Other schemes include the PHPCs (mentioned above), activated during COVID-19 to enhance detection and management of COVID-19 potential cases, which private GPs were able join, as well as the National University Health System (NUHS) Primary Care Networks (PCN) scheme, which encourages private GP clinics to organise themselves into networks that support more holistic and team-based care.
PIH’s Public Health Accompaniment Unit in the US
COVID-19 has overwhelmed the capacity of the US’s fragmented, under-funded public health system. With a healthcare system that is not focused on primary care and community care, and with a disjointed federal response, state and county leadership has been essential. In early 2020, Partners In Health was asked by the Commonwealth of Massachusetts to mount an unprecedented contact tracing initiative to help local boards of health cope with the expected surge of positive cases of COVID-19.
Leveraging lessons learned from Massachusetts and over 30 years of global work, PIH launched the Public Health Accompaniment Unit (USPHAU) to accompany other US states, cities, and community partners to rapidly scale up contact tracing and build more equitable and effective health responses to COVID-19 in the US. The USPHAU provides technical advice on a range of different COVID response issues, including testing, care resource coordination and policy. Particularly noteworthy is its assistance in providing services to key populations, such as undocumented, unhoused, indigenous and migrant communities. USPHAU has on-going partnerships in ten jurisdictions across the US.
A COVID-19 digital message service in South Africa
In South Africa, HealthAlert, a population-scale COVID-19 messaging service launched with the National Department of Health in March 2020, has had much success in disseminating locally-relevant, accurate and timely information to 8,052,469 members of the public. Integration of HealthAlert with the National Department of Health, its embrace by prominent, socially active health leaders, and acceptance of the service by both the President and Minister of Health in particular, contributed greatly to its success. This experience highlights the importance of partnerships and underlines the need to focus on infrastructure building versus service provision.
There are plans to build on the success to establish healthConnect as a sustainable long-term approach to improve the health of citizens and strengthen the health system. Specific examples include programmes to support citizens experiencing secondary effects of Covid-19 as well as mental health programmes in collaboration with WHO.
Watch the Recording
These three case studies demonstrate that partnerships need long-term planning that goes beyond COVID-19, and highlight the need for investing in and building innovative health infrastructure that goes beyond service provision. They also underscore the importance of multi-stakeholder partnerships (as opposed to dual partnerships) in addressing issues relating to a subject as multifaceted as health and well-being. The possible role of philanthropy beyond financial aid also needs further consideration. While the circumstances, politics and media landscape vary across countries, strategies addressing the intersection of social and medical pathology are critical to influencing overall health.