United Nations Public Service Award Winners


Initiative: Suburbio Hospital Public-Private Partnership


Institution: Secretaria da Fazenda do Estado da Bahia


Problem: In 2007, the Government of Bahia was challenged to offer the population, especially the poorest and most vulnerable, solutions to daily challenges, such as a better access to quality health care. There was not a single emergency public hospital in the metropolitan region of Salvador, where about 1 million people reside. They were forced to travel considerable distances to acquire emergency services. Considering the need, the Government of Bahia decided to build five large hospitals in different regions of the State.


Solution: According to the Brazilian Constitution, the entire population of the country is entitled to receive free access to health services. The Brazilian SUS (Unified Health System, acronym for Sistema Único de Saúde) aims to provide universal and egalitarian health services to citizens around the country, especially to those in need. To increase the offer and quality of health services in the region, the State Health Secretariat decided to implement a Public-Private Partnership (PPP) model for the emergency hospital in the capital called the Suburbio Hospital. The participation of the private sector in the Suburbio Hospital, via a long-term contract, considerably improved the general service levels of the region and allowed the operation of the unit to be made in compliance with the fiscal responsibility law. Additionally, it reduced public authorities’ transaction costs, increased the control and governance, aligned private and public interests and created the necessary economic incentives to improve the provision of better services.


Impact: Structuring the Suburbio Hospital as a PPP generated important results for the health sector in Bahia and considerably improved the overall efficiency. The 298-bed facility provides traditional emergency care as well as specialized treatment for trauma, orthopedic and cardiac emergencies, and other complex injuries. The hospital is equipped with a surgical center, clinic, medical laboratories, physical therapy unit, hemodynamic unit, and pharmacy. In the first years of the concession, the hospital presented high performance levels, great speed in performing emergency surgery, high bed turnover rates (a minimum of 4.9 is required and on average is 23.6), low rate of hospital infections (6.5 per 1,000 patients, considerably below the maximum rate required of 20), high level of user satisfaction (between 85 per cent and 95 per cent) and high professional qualification. By March 2012, it had already exceeded its target on number of patients treated, serving nearly twice as many inpatients and outpatients as targeted in the PPP contract, and providing over twice as many diagnostic services. In its first year of operations, it served about 350,000 inpatients and outpatients and provided nearly 530,000 diagnostic services. Also, the hospital has created 1,200 new positions for doctors, nurses, physiotherapists and other health professionals.



Category 1:

Improving the Delivery of Public Services


Related SDGs: 










Latin America and the Caribbean Group


More information: 

Suburbio Hospital Public-Private Partnership

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