Introduction: Since independence, the government has taken various measures to improve and make available healthcare services for all. These include establishment of government hospitals, launch of the National Health Mission, formulation of the National Health Policy etc.

Despite these measures, various gaps exist with regard to India’s healthcare systems, including:

Rural-Urban Divide

  • 75% of healthcare infrastructure is concentrated in urban areas, leaving 73% of the population residing in rural areas with limited access to primary healthcare facilities.
  • PPP can bridge this gap by leveraging the private sector’s expertise and financial resources to establish healthcare facilities in underserved rural regions.
  • Example: Rajiv Gandhi Super Specialty Hospital in Raichur, Karnataka, is a successful joint venture between the Government of Karnataka, Apollo Hospitals Group, and financial support from OPEC. It provides affordable super-specialty healthcare to those living below the poverty line.

Inadequate Healthcare Resources

  • India faces a severe shortage of doctors, nurses, and paramedics, with the doctor-to-population ratio far below the WHO’s recommendations.
  • PPP can play a significant role in improving the efficiency of government hospitals by bringing in private sector expertise in management and organization.
  • Example: Karuna Trust, in partnership with the Karnataka government, efficiently manages Primary Health Centers in Gumballi and Sugganahalli, catering to the tribal community in hilly areas.

High Out-of-Pocket Expenditure

  • The government’s limited expenditure on healthcare (1.13% of GDP) leads to nearly 65% of healthcare expenses borne by citizens, pushing many into poverty.
  • PPP can enhance affordability by collaborating with government insurance schemes such as PM-JAY to ensure financial protection for a larger section of the population.
  • Example: Partnerships under PM-JAY enable private healthcare providers to offer services at subsidized rates to eligible beneficiaries, reducing out-of-pocket expenses.

Low Penetration of Insurance

  • Despite government insurance schemes, a significant portion of the population lacks financial protection for health.
  • PPP can improve insurance coverage by incorporating private sector expertise in insurance management and implementation.
  • Example: Collaborative efforts between the government and private insurers can lead to the expansion of insurance coverage to a broader segment of the population.

Accessibility and Affordability

  • PPP can make healthcare accessible and affordable by leveraging the government’s infrastructure and the private sector’s efficiency and cost-effectiveness.
  • Private sector involvement can lead to the establishment of healthcare facilities in small towns and underserved areas.
  • Example: The Urban Slum Health Care Project in Andhra Pradesh, managed by NGOs, has successfully set up Urban Health Centers in slums, providing healthcare to three million people.

Technology Adoption

  • The private sector’s agility in adopting innovative technologies, such as telemedicine, can enhance healthcare services in rural and remote regions.
  • PPP can promote the integration of modern technology in the healthcare system, benefiting a larger population.
  • Example: Telemedicine initiatives in partnership with private providers can enable remote consultations and diagnostics, reaching patients in far-flung areas.


Public-Private Partnership models present promising solutions to address the gaps in India’s healthcare system. By combining the strengths of both sectors, PPP can improve healthcare accessibility, affordability, and efficiency. It can lead to the establishment of healthcare facilities in underserved areas, bring in additional financial resources, and accelerate the adoption of innovative technologies. However, to ensure success, a delicate balance must be struck between the government’s welfare motive and the private sector’s commercial viability. By working in tandem, PPP has the potential to create a sustainable long-term model that transforms India’s healthcare landscape for the better.

Legacy Editor Changed status to publish March 9, 2024