It began with a self-appraisal by the government. The government's mid-term report card of the 10th Plan outlines huge gaps in governance in states and hints at the unfeasibility of meeting development targets. The approach paper to the 11th Plan calls for faster and inclusive growth and is gung-ho about public-private partnerships (PPP).

While infrastructure dominates the Rs 350 billion PPP plans, the 2006 Asian Development Bank report says that state governments have marked water, waste management and health as focus areas. However, there are hurdles in PPP. Civil society is wary of privatisation and inefficient deal-making through such partnerships. Another genre of PPP, however, is proving to be much more effective. These are not government initiatives seeking private contracting partners; on the contrary, they are private initiatives, which are adopted by the government. Innovators of this model have bridged time and distance of India's rural hinterland to take health, education and social sector services to remote villages.

Foundations of Byrraju, Satyam and the Emergency Management Research Institute (EMRI) exemplify this intervention and approach. A call to the EMRI centre triggers the levers of communication that gets doctors and professionals to reach patients to a hospital in 38 minutes. Within seconds, the location of the village from where the call is made is identified on GIS maps. Public and private hospitals located in the vicinity appear on the screen with a drop-down menu showing the hospital's specialty, availability of beds, doctors and preparedness to handle the emergency. The closest team of stand-by ambulances with a ‘pilot' driver and an emergency management technician reach the destination. Expectedly citizens are open to these services. The EMRI has a presence across Andhra Pradesh and handles 23,000 calls per day.