The paper discusses selected cases of private-public partnerships, which have recently been initiated by several state governments in India. The analysis of these initiatives suggests inadequacies of proper institutional mechanisms to implement the private initiative policies effectively. The discussion brings out number of policy and management issues in developing and implementing these options. It has been argued that there is need to have "public policy towards private sector" and this policy framework should have sector-wide (addressing both public and private sector roles together) focus. The policy, inter alia, should address the question of public-private mix in health sector, scope of private-public partnerships, role of subsidies and incentives in promoting these partnerships, addressing issue of protecting the public sector from any reduction in budgetary allocations. Further, the paper points out that the success of any private initiatives critically hinges upon number of factors. There is need to have explicit, transparent and adequate mechanisms which ensure: involvement of all stakeholders in the process; co-ordination across various departments within the government and various implementing agencies; ensuring availability of critical resource such as qualified manpower; appropriate monitoring and governance system; provision of adequate information to all participants; institutionalisation of appropriate management structure to handle new tasks; and strengthening public systems. These are considered necessary pre-requisites for evolving effective public-private partnerships. The role of regulatory mechanisms to ensure proper standards of care is also considered important. All these suggest the need for a number of policy measures.