Working in the public sector

A Public and Non-Profit Partnerships Model in Healthcare

Often in developing countries, since the public sector has not yet delivered results, trying to develop a new system that is devoid of governmental intervention seems to be a really good alternative.

But at Karma Health we are committed to working with the government to bring lasting change.

We strongly believe the Public sector ensures Stability, and the Non-profit Private sector ensures Innovation and Trust.

Nepal’s Ministry of Health building in Kathmandu.

Here are the three major reasons why working in the public sector is our bottom line:

One: The state is often the only stable structure in such societies.

Yes, various other non-state actors exist and some of them may be influential, resourceful and even efficient. But a common theme that resonates throughout the development world is the emphatic rise and equally emphatic fall of ‘projects’.

They often act alone with enviable confidence, and sadly, in this process, overlook the process of creating critical networks and bonds in the communities they serve. As disorderly as the state may seem, there are often no institutions which are as ordered. You may call the state mechanisms too bureaucratic and too slow, but not having protocols in place is even worse. Yes, we need change, but not at the cost of destroying everything. Like a seasoned surgeon will cut through an abscess to cure it and drain the impurities out of the body, and it is unwise to cut the limb altogether that has the abscess; it is unwise to see off the government altogether. The idea is to make state mechanisms simpler, more responsive and more welcoming. This can be done, more easily from within than without.

Two: Governments are good partners in that they tend to partner with sustainable projects.

Projects with specific end-dates that inject resources without consideration for sustainability have been commonplace in the development sector and also in global health. It is often seen in specific thematic areas and/or geographic locations that non-governmental sector actors often have budgets that outrun government budgets in developing countries. Bringing resources is not an issue, however the way some periodic projects and projects with no guarantee of continuing beyond a certain number of years are allowed to run lead to decreasing demands from the government facilities, and when such projects finally end they often create voids that leave a vast majority of common people devoid of basic services or resources. It may be difficult for the government alone to fill the gap after the funds or the superior implementing machine set up by the wealthy and more resourceful non-governmental agency is no more.

The largest government health clinic in Rajpur Rural Municipality, South-Western Nepal. This facility does not have an emergency or inpatient setup, neither does it have a laboratory or X-ray facility. Karma Health is working to strengthen this clinic into a major municipal facility of its model of Municipal Health System.

Three: Lasting change can be brought through the Public Sector.

Creating parallel systems and structures that do not align with the broader national planning is another main reason why many ‘projects’ fail to create lasting change. National planning is the direction set for the country by documents as the Constitution and Health Policy — which are written by experts — often the best in the world. We can certainly argue why some components of the projects may not be useful, or at times why entire documents are flawed, but rejecting the depth of experience and knowledge in drafting those masterpieces would be unwise. What is lacking in underdeveloped societies like ours are one, the implementation of already good policies into practice, and two, the lack of specific accurate data that would be used during the design of the policies. So, as we venture into innovative ways of implementation, and bringing efficiency into management, we are aware of the enormous advantage that we can generate through the systems that have been set.

Bonus Reason:

We also have one other reason which is central to how we work. We live on local knowledge. We have seen time and again that the ‘projects’ that do not take into account the intricate local details are bound to fail. Often development projects are planned by ‘experts’ who have a superficial knowledge on the ground, and the implementing local partners just submit progress reports that contain the number of programs conducted and money spent, with no real measure of real impact. This often does more harm than good in the long run, despite the best intentions of everybody involved. This is why we at Karma believe in acting locally — we live in the communities we serve in — developing deep and meaningful life-long bonds with the people we serve. We do that because there are reasons that are beyond mere germs, genetics and infrastructure that determine health; our health is the sum total of how we live and work, how we mourn and celebrate- the social determinants play a pivotal role in shaping the health of the communities and we firmly believe in working on them for building healthy communities.

We at Karma Health are fixated on ensuring that everyone, everywhere has dignified healthcare.

With all the above at heart, Karma Health is dedicated to blending local, human-centered innovation, the efficiency of a company and the passion of dedicated believers to transform public-sector health care in under-resourced societies as a vital step to ensure everyone has dignified healthcare. And this fixation, that everyone everywhere is entitled to dignified healthcare, is our guiding light.