Public private partnerships in healthcare sector in middle income Literature review

Public private partnerships in healthcare sector in middle income countries - Literature review Example As well, theoretical as well as empirical studies point to the potential contribution of private sector to reforms aimed at improving the quality and accessibility of health systems. The focus of the study is the increased focus of public-private partnerships (PPP) as a way of increasing capital finance as well as improving the efficiency and quality of service provision in low and middle-income countries. The partnership involves the public sector entering into long-term contract with private sector in order to enable the public sector access private capital for building and renovating health facilities and agreeing to deliver services over the contract period. Such contracts are designed and agreed upon some pre-determined specifications of the required outputs and define the financial, working and clinical standards, which the private sector has to meet. In low and middle-income nations, governments remain the ultimate funder of health care by making periodic payments to private s ector in return for services delivered (Hellowell, 2012 p.71). Public-private partnership is an institutional arrangement built on foundation of fresh public management that claims objectives such as improved efficiency, quality as well as competition of public sector services. In striving to achieve these objectives, PPP aims at achieving value for money while reducing the demands on the state budget by involving the private sector in provision of traditional infrastructure services like health care. Adoption of PPP policy within industrialized nations is often viewed as a tool for further development of public services, while its application in developing nations is a way for reducing poverty and improving the service offered to citizens in such nations. Early 1990s PPPs policy was widely adopted in industrialized nations like USA, UK and Australia; nevertheless, this policy has been diffused in developing nations (Appuhami, Perera & Perera, 2011, p.431). The approach of PPP is at tractive to developing countries that often experience macro-economic problems like poor infrastructure that burden the government budgets and excessive government budget. State-based healthcare service provision and private sector health services have existed together in various low and middle-income nations for decades with many nations having a huge portion of healthcare spending paid by the state. Private providers are heterogonous made up of formal business entities like independent hospitals, informal entities that include unlicensed providers as well as non-profit and non-governmental organizations (Basu, Andrews, Kishore, Panjabi & Stuckler, 2012, p.3). Various studies have disaggregated consumption of health care by income levels and appeared to show that the private sector mainly provide health services to more affluent populations. In the emerging economies, some nations are taking bold steps with the PPP’s by indulging the private sector in both infrastructures re newal and delivery of clinical services in the integrated partnership. Health care is a labour-intensive industry where clinical and ancillary services absorb most the expenditure allotted to many health systems; therefore integrating clinical services with provision of capital infrastructure in PPP offer unique opportunity for