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Working with public sectors to improve healthcare services globally: Reflections from Nepal

Working with public sectors to improve healthcare services globally: Reflections from Nepal. Bibhav Acharya, MD Assistant Professor and Director of UCSF Psychiatry HEAL Fellowship in Global Mental Health Co-Founder and Mental Health Advisor, Possible. Outline.

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Working with public sectors to improve healthcare services globally: Reflections from Nepal

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  1. Working with public sectors to improve healthcare services globally: Reflections from Nepal BibhavAcharya, MD Assistant Professor and Director of UCSF Psychiatry HEAL Fellowship in Global Mental Health Co-Founder and Mental Health Advisor, Possible

  2. Outline • Why work with the public sector? • Reflections from working with the Nepali Government • Challenges of public-sector engagement

  3. Spectrum of Public-Sector Engagement Parallel systems Public-sector partnerships

  4. Why Engage?

  5. Impact 2015 2010-2013 2009 2008 Public-Sector Engagement • Performance-based Agreement • Contract (PPP) • Parallel System

  6. Working with the Public Sector: Challenges

  7. What are some Challenges?

  8. Tackling the Challenges • What we did • Results • Attitudes • Behaviors • What we achieved

  9. Pace

  10. What we did • Results • Trust • $$ investment • Expansion and “model program” • Immediate approach post-EQ • Attitudes • NGO time ≠ Gov’t time. • Behaviors • Build personal relationships • Demonstrate long-term commitment Pace

  11. Corruption

  12. What we did • Results • Developed a bribe-free reputation • Developed a long-term partnership • Attitudes • “You bribe once, you bribe always.” • Behaviors • Every NGO member visited the ministry. • Waited for an approval for a year. Corruption

  13. Competing Goals

  14. What we did • Results • Providing a living wage for CHWs • Strengthened the existing CHW network • Attitudes • Readjust goals but maintain core values • Behaviors • Given two difficult choices, prioritized one but picked both. Competing Goals

  15. Discussion

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