Public-Private Partnerships: A Strategy for Effective Private Partnerships in Health Care Provision: A Policy Option
Abstract
Context: One of the most effective ways to cope with the financial constraints of health system, especially in developing countries, can be to engage the private sector in the form of a public-private partnership (PPP). Hence, the purpose of the present study is to introduce PPP as a general policy to increase the effective participation of the private sector in health system.
Methods: Initially, existing literature was reviewed to identify methods, areas, and experiences in PPP. Then, an expert panel was organized with researchers, professors and experts in health services management and policy making. At the beginning of the panel, the content obtained in the previous step was presented, and then the requirements of PPP implementation in healthcare was discussed.
Results: Considering the discussions, we can summarize the factors affecting PPP implementation in three topics: A) Private Sector Conditions: Sufficient number of eligible companies, significant financial gain for private companies; B) Public Sector Conditions: Principles, policies and indicators related to outsourcing of services, availability of transferable services, units or substations to private sector, lower cost of providing services in the private sector than the public sector; C) Background: Political, legal, economic and cultural conditions, successful experiences in other cities and provinces, support of the health system scientific body, common language and contract conditions.
Conclusion: Given the private sector’s capabilities and potentials to improve the quality and quantity of services provided, transparent PPP policies should be developed as an appropriate strategy for effective private sector participation in the provision of health care, and required infrastructure must be provided.
1. Sedighikamal L, Talebnia G. A Review of Privatization in Iran. International Journal of Management, Accounting and Economics. 2014;1(1):81-92.
2. Jalaee Esfand Abadi SA, Samimi S. Study of the barriers to private sector investment in Iran (in accordance with Iran's Communicated general policies). Scientific Journal Management System. 2014;2(7):89-109.
3. World Health Organization. Iran (Islamic Republic of): WHO statistical profile. 2015.
4. Ghobadian A, O'Regan N, Gallear D, Viney H. Private-Public Partnerships: Palgrave Macmillan UK; 2004. XV, 318 p.
5. Davies P. The role of the private sector in the context of aid effectiveness. consultative findings. 2011.
6. Vian T, McIntosh N, Grabowski A, Nkabane-Nkholongo EL, Jack BW. Hospital Public–Private Partnerships in Low Resource Settings: Perceptions of How the Lesotho PPP Transformed Management Systems and Performance. Health Systems & Reform. 2015;1(2):155-66.
7. Ghobadian A, O'Regan N, Gallear D, Viney H. Private-public partnerships: policy and experience: Palgrave Macmillan; 2004.
8. Osborne S. Public-private partnerships: Theory and practice in international perspective: Routledge; 2002.
9. Jindal RM, Patel TG, Waller SG. Public-private partnership model to provide humanitarian services in developing countries. Journal of the American College of Surgeons. 2017;224(5):988-93.
10. Tabibi SJ, Maleki MR, Nasiripour AA. Designing a Public-Private Partnership Model for Public Hospitals in Iran. International Journal of Hospital Research. 2018.
11. Grahame A. The Private Finance Initiative (PFI) Commons Briefing papers RP01-117. In: UK Parliament: House of Commons Library UG, editor. 2001.
12. Sadka E. Public-Private Partnership; A public economics perspective. Cesifo Economic Studies 2007;53(3):466-90.
13. Mani MK. Public-private partnership. The National medical journal of India. 2009;22(4):207-8.
14. Jabbari Beyrami H, Gholamzadeh Nikjoo R, Jannati A, Dadgar E. Introducing Public-Private Partnership Options in Public Hospitals. Hakim Research Journal 2013;16(3):201- 10.
15. Demotes-Mainard J, Canet E, Segard L. Public-private partnership models in France and in Europe. Therapie. 2006;61(4):325-34, 13-23.
16. Akintoye A, Beck M, Hardcastle C. Public-private partnerships: managing risks and opportunities: John Wiley & Sons; 2008.
17. Taylor R, Blair S. Public Hospitals, Options for Reform through Public-Private Partnerships. The World Bank’s Private Sector and Infrastructure Network. United States, Washigton: 2002.
18. Roehrich J, Barlow J, Wright S. Delivering European healthcare infrastructure through public-private partnerships: the theory and practice of contracting and bundling. 1 ed. Das TK, editor. London: Information Age Publishing; 2013.
19. Brzozowska K. Advantages and Threats of Public – Private Partnerships in Larger Infrastructure Projects. Warszawa: CeDeWu.PL: 2006.
20. Pârvu D, Voicu-Olteanu C. Advantages and limitations of the public private partnerships and the possibility of using them in romania. Transylvanian Review of Administrative Sciences. 2009;5(27):189-98.
21. Roehrich JK, Lewis MA, George G. Are public–private partnerships a healthy option? A systematic literature review. Social Science & Medicine. 2014;113:110-9.
22. Anyaehie U, Nwakoby B, Chikwendu C, Dim C, Uguru N, Oluka C, et al. Constraints, challenges and prospects of public-private partnership in health-care delivery in a developing economy. Annals of medical and health sciences research. 2014;4(1):61-6.
23. Lin CF. Outsource Power, Import Safety? Challenges and Opportunities of the U.S.-China Food Safety Regulatory Cooperation. Food and drug law journal. 2017;72(1):32-52.
24. Njau RJ, de Savigny D, Gilson L, Mwageni E, Mosha FW. Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania--challenges in implementation. Malaria journal. 2009;8:201.
25. Scheffer MC, Dal Poz MR. The privatization of medical education in Brazil: trends and challenges. Human resources for health. 2015;13:96.
26. Webb S. Public-private partnership tackles TB challenges in parallel. Nature reviews Drug discovery. 2009;8(8):599-600.
27. Sinanovic E, Kumaranayake L. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. Cost Effectiveness and Resource Allocation. 2006;4(1):11.
28. Pantoja A, Lönnroth K, Lal S, Chauhan L, Uplekar M, Padma M, et al. Economic evaluation of public-private mix for tuberculosis care and control, India. Part II. Cost and cost-effectiveness. The International Journal of Tuberculosis and Lung Disease. 2009;13(6):705-12.
29. Ferroussier O, Kumar M, Dewan P, Nair P, Sahu S, Wares D, et al. Cost and cost-effectiveness of a public-private mix project in Kannur District, Kerala, India, 2001–2002. The International Journal of Tuberculosis and Lung Disease. 2007;11(7):755-61.
30. Johns B, Probandari A, Mahendradhata Y, Ahmad RA. An analysis of the costs and treatment success of collaborative arrangements among public and private providers for tuberculosis control in Indonesia. Health policy. 2009;93(2-3):214-24.
31. Floyd K, Arora V, Murthy K, Lonnroth K, Singla N, Akbar Y, et al. Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India. Bulletin of the World Health Organization. 2006;84:437-45.
32. Ramaiah AA, Gawde NC. Economic evaluation of a public–private Mix TB project in Tamil Nadu, India. Journal of Health Management. 2015;17(3):370-80.
33. Hernandez-Aguado I, Zaragoza GA. Support of public–private partnerships in health promotion and conflicts of interest. BMJ Open. 2016;6(4).
34. Lei X, Liu Q, Escobar E, Philogene J, Zhu H, Wang Y, et al. Public–private mix for tuberculosis care and control: a systematic review. International Journal of Infectious Diseases. 2015;34:20-32.
35. Phalkey RK, Butsch C, Belesova K, Kroll M, Kraas F. From habits of attrition to modes of inclusion: enhancing the role of private practitioners in routine disease surveillance. BMC health services research. 2017;17(1):599.
36. Ashton T. Contracting for health services in New Zealand: a transaction cost analysis. Social Science & Medicine. 1998;46(3):357-67.
37. Loevinsohn B, Ul Haq I, Couffinhal A, Pande A. Contracting-in management to strengthen publicly financed primary health services—The experience of Punjab, Pakistan. Health policy. 2009;91(1):17-23.
38. Al-Jazaeri A, Ghomraoui F, Al-Muhanna W, Saleem A, Jokhadar H, Aljurf T. The impact of healthcare privatization on access to surgical care: cholecystectomy as a model. World journal of surgery. 2017;41(2):394-401.
39. Kebede Y, Fonjungo PN, Tibesso G, Shrivastava R, Nkengasong JN, Kenyon T, et al. Improved specimen-referral system and increased access to quality laboratory services in Ethiopia: the role of the public-private partnership. The Journal of infectious diseases. 2016;213(suppl_2):S59-S64.
40. Alkhamis AA. Critical analysis and review of the literature on healthcare privatization and its association with access to medical care in Saudi Arabia. Journal of infection and public health. 2017;10(3):258-68.
41. Dutta S, Lahiri K. Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India. International journal of health policy and management. 2015;4(7):467.
42. Farahbakhsh M, Sadeghi-Bazargani H, Nikniaz A, Tabrizi JS, Zakeri A, Azami S. Iran's Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan. Health promotion perspectives. 2012;2(2):287.
43. Nikniyaz A, Farahbakhsh M, Ashjaei K, Tabrizi D, Sadeghi-Bazargani H, Zakeri A. Maternity and child health care services delivered by public health centers compared to health cooperatives: Iran’s experience. Journal of Medical Sciences. 2006;6(3):352-8.
44. Gharaee H, Tabrizi JS, Azami-Aghdash S, Farahbakhsh M, Karamouz M, Nosratnejad S. Analysis of Public-Private Partnership in Providing Primary Health Care Policy: An Experience From Iran. Journal of primary care & community health. 2019;10:2150132719881507.
45. Mousavi SM, Sadeghifar J. Universal health coverage in Iran. The Lancet Global Health. 2016;4(5):e305-e6.
46. Iyer V, Sidney K, Mehta R, Mavalankar D, De Costa A. Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India–Lessons for universal health coverage. PloS one. 2017;12(10):e0185739.
47. Hallo De Wolf A, Toebes B. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health. Health and human rights. 2016;18(2):79-92.
48. McPake B, Hanson K. Managing the public-private mix to achieve universal health coverage. Lancet (London, England). 2016;388(10044):622-30.
49. Morgan R, Ensor T, Waters H. Performance of private sector health care: implications for universal health coverage. Lancet (London, England). 2016;388(10044):606-12.
50. Wadge H, Roy R, Sripathy A, Fontana G, Marti J, Darzi A. How to harness the private sector for universal health coverage. Lancet (London, England). 2017;390(10090):e19-e20.
2. Jalaee Esfand Abadi SA, Samimi S. Study of the barriers to private sector investment in Iran (in accordance with Iran's Communicated general policies). Scientific Journal Management System. 2014;2(7):89-109.
3. World Health Organization. Iran (Islamic Republic of): WHO statistical profile. 2015.
4. Ghobadian A, O'Regan N, Gallear D, Viney H. Private-Public Partnerships: Palgrave Macmillan UK; 2004. XV, 318 p.
5. Davies P. The role of the private sector in the context of aid effectiveness. consultative findings. 2011.
6. Vian T, McIntosh N, Grabowski A, Nkabane-Nkholongo EL, Jack BW. Hospital Public–Private Partnerships in Low Resource Settings: Perceptions of How the Lesotho PPP Transformed Management Systems and Performance. Health Systems & Reform. 2015;1(2):155-66.
7. Ghobadian A, O'Regan N, Gallear D, Viney H. Private-public partnerships: policy and experience: Palgrave Macmillan; 2004.
8. Osborne S. Public-private partnerships: Theory and practice in international perspective: Routledge; 2002.
9. Jindal RM, Patel TG, Waller SG. Public-private partnership model to provide humanitarian services in developing countries. Journal of the American College of Surgeons. 2017;224(5):988-93.
10. Tabibi SJ, Maleki MR, Nasiripour AA. Designing a Public-Private Partnership Model for Public Hospitals in Iran. International Journal of Hospital Research. 2018.
11. Grahame A. The Private Finance Initiative (PFI) Commons Briefing papers RP01-117. In: UK Parliament: House of Commons Library UG, editor. 2001.
12. Sadka E. Public-Private Partnership; A public economics perspective. Cesifo Economic Studies 2007;53(3):466-90.
13. Mani MK. Public-private partnership. The National medical journal of India. 2009;22(4):207-8.
14. Jabbari Beyrami H, Gholamzadeh Nikjoo R, Jannati A, Dadgar E. Introducing Public-Private Partnership Options in Public Hospitals. Hakim Research Journal 2013;16(3):201- 10.
15. Demotes-Mainard J, Canet E, Segard L. Public-private partnership models in France and in Europe. Therapie. 2006;61(4):325-34, 13-23.
16. Akintoye A, Beck M, Hardcastle C. Public-private partnerships: managing risks and opportunities: John Wiley & Sons; 2008.
17. Taylor R, Blair S. Public Hospitals, Options for Reform through Public-Private Partnerships. The World Bank’s Private Sector and Infrastructure Network. United States, Washigton: 2002.
18. Roehrich J, Barlow J, Wright S. Delivering European healthcare infrastructure through public-private partnerships: the theory and practice of contracting and bundling. 1 ed. Das TK, editor. London: Information Age Publishing; 2013.
19. Brzozowska K. Advantages and Threats of Public – Private Partnerships in Larger Infrastructure Projects. Warszawa: CeDeWu.PL: 2006.
20. Pârvu D, Voicu-Olteanu C. Advantages and limitations of the public private partnerships and the possibility of using them in romania. Transylvanian Review of Administrative Sciences. 2009;5(27):189-98.
21. Roehrich JK, Lewis MA, George G. Are public–private partnerships a healthy option? A systematic literature review. Social Science & Medicine. 2014;113:110-9.
22. Anyaehie U, Nwakoby B, Chikwendu C, Dim C, Uguru N, Oluka C, et al. Constraints, challenges and prospects of public-private partnership in health-care delivery in a developing economy. Annals of medical and health sciences research. 2014;4(1):61-6.
23. Lin CF. Outsource Power, Import Safety? Challenges and Opportunities of the U.S.-China Food Safety Regulatory Cooperation. Food and drug law journal. 2017;72(1):32-52.
24. Njau RJ, de Savigny D, Gilson L, Mwageni E, Mosha FW. Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania--challenges in implementation. Malaria journal. 2009;8:201.
25. Scheffer MC, Dal Poz MR. The privatization of medical education in Brazil: trends and challenges. Human resources for health. 2015;13:96.
26. Webb S. Public-private partnership tackles TB challenges in parallel. Nature reviews Drug discovery. 2009;8(8):599-600.
27. Sinanovic E, Kumaranayake L. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. Cost Effectiveness and Resource Allocation. 2006;4(1):11.
28. Pantoja A, Lönnroth K, Lal S, Chauhan L, Uplekar M, Padma M, et al. Economic evaluation of public-private mix for tuberculosis care and control, India. Part II. Cost and cost-effectiveness. The International Journal of Tuberculosis and Lung Disease. 2009;13(6):705-12.
29. Ferroussier O, Kumar M, Dewan P, Nair P, Sahu S, Wares D, et al. Cost and cost-effectiveness of a public-private mix project in Kannur District, Kerala, India, 2001–2002. The International Journal of Tuberculosis and Lung Disease. 2007;11(7):755-61.
30. Johns B, Probandari A, Mahendradhata Y, Ahmad RA. An analysis of the costs and treatment success of collaborative arrangements among public and private providers for tuberculosis control in Indonesia. Health policy. 2009;93(2-3):214-24.
31. Floyd K, Arora V, Murthy K, Lonnroth K, Singla N, Akbar Y, et al. Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India. Bulletin of the World Health Organization. 2006;84:437-45.
32. Ramaiah AA, Gawde NC. Economic evaluation of a public–private Mix TB project in Tamil Nadu, India. Journal of Health Management. 2015;17(3):370-80.
33. Hernandez-Aguado I, Zaragoza GA. Support of public–private partnerships in health promotion and conflicts of interest. BMJ Open. 2016;6(4).
34. Lei X, Liu Q, Escobar E, Philogene J, Zhu H, Wang Y, et al. Public–private mix for tuberculosis care and control: a systematic review. International Journal of Infectious Diseases. 2015;34:20-32.
35. Phalkey RK, Butsch C, Belesova K, Kroll M, Kraas F. From habits of attrition to modes of inclusion: enhancing the role of private practitioners in routine disease surveillance. BMC health services research. 2017;17(1):599.
36. Ashton T. Contracting for health services in New Zealand: a transaction cost analysis. Social Science & Medicine. 1998;46(3):357-67.
37. Loevinsohn B, Ul Haq I, Couffinhal A, Pande A. Contracting-in management to strengthen publicly financed primary health services—The experience of Punjab, Pakistan. Health policy. 2009;91(1):17-23.
38. Al-Jazaeri A, Ghomraoui F, Al-Muhanna W, Saleem A, Jokhadar H, Aljurf T. The impact of healthcare privatization on access to surgical care: cholecystectomy as a model. World journal of surgery. 2017;41(2):394-401.
39. Kebede Y, Fonjungo PN, Tibesso G, Shrivastava R, Nkengasong JN, Kenyon T, et al. Improved specimen-referral system and increased access to quality laboratory services in Ethiopia: the role of the public-private partnership. The Journal of infectious diseases. 2016;213(suppl_2):S59-S64.
40. Alkhamis AA. Critical analysis and review of the literature on healthcare privatization and its association with access to medical care in Saudi Arabia. Journal of infection and public health. 2017;10(3):258-68.
41. Dutta S, Lahiri K. Is provision of healthcare sufficient to ensure better access? An exploration of the scope for public-private partnership in India. International journal of health policy and management. 2015;4(7):467.
42. Farahbakhsh M, Sadeghi-Bazargani H, Nikniaz A, Tabrizi JS, Zakeri A, Azami S. Iran's Experience of Health Cooperatives as a Public-Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan. Health promotion perspectives. 2012;2(2):287.
43. Nikniyaz A, Farahbakhsh M, Ashjaei K, Tabrizi D, Sadeghi-Bazargani H, Zakeri A. Maternity and child health care services delivered by public health centers compared to health cooperatives: Iran’s experience. Journal of Medical Sciences. 2006;6(3):352-8.
44. Gharaee H, Tabrizi JS, Azami-Aghdash S, Farahbakhsh M, Karamouz M, Nosratnejad S. Analysis of Public-Private Partnership in Providing Primary Health Care Policy: An Experience From Iran. Journal of primary care & community health. 2019;10:2150132719881507.
45. Mousavi SM, Sadeghifar J. Universal health coverage in Iran. The Lancet Global Health. 2016;4(5):e305-e6.
46. Iyer V, Sidney K, Mehta R, Mavalankar D, De Costa A. Characteristics of private partners in Chiranjeevi Yojana, a public-private-partnership to promote institutional births in Gujarat, India–Lessons for universal health coverage. PloS one. 2017;12(10):e0185739.
47. Hallo De Wolf A, Toebes B. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health. Health and human rights. 2016;18(2):79-92.
48. McPake B, Hanson K. Managing the public-private mix to achieve universal health coverage. Lancet (London, England). 2016;388(10044):622-30.
49. Morgan R, Ensor T, Waters H. Performance of private sector health care: implications for universal health coverage. Lancet (London, England). 2016;388(10044):606-12.
50. Wadge H, Roy R, Sripathy A, Fontana G, Marti J, Darzi A. How to harness the private sector for universal health coverage. Lancet (London, England). 2017;390(10090):e19-e20.
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| Issue | Vol 4, No 3 (2020) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/htaa.v4i3.6353 | |
| Keywords | ||
| Public-Private Partnerships health care Policy Option | ||
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How to Cite
1.
Gharaee H, Azami-aghdash S. Public-Private Partnerships: A Strategy for Effective Private Partnerships in Health Care Provision: A Policy Option. Health Tech Ass Act. 2021;4(3).
