Public-Private Partnerships in Health Care: Approaches and Policies
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Apr 12, 2026
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Ibrahim Yousef Harmoush
https://orcid.org/0009-0003-8925-4727
https://orcid.org/0009-0003-8925-4727
Abstract
Public-private partnerships (PPPs) have become an indispensable strategic technique worldwide for healthcare delivery, by mobilizing the private sector's financial, technological, and managerial capabilities. as well as responding to the global trend toward state downsizing. However, the design and implementation of these partnerships are not always successful, given the varying values, objectives, and regulatory and legal frameworks adopted by the partners.
This research aims to review the most prominent legal methods for partnership in the health sector a worldwide, and then propose the best policies, lessons and recommendations drawn from global experiences to achieve a successful partnership. The results showed that countries utilize a wide range of legal techniques to engage the private sector in healthcare provision, such as infrastructure contracts, concession contracts, and integrated healthcare service contracts, all the way to privatizing the entire sector. The research also demonstrated that achieving successful partnerships requires two key stages, preparing for the partnership and implementing it. The preparation stage requires a preliminary diagnosis of the country's health sector, creating a favorable political and social environment for its success, and establishing a legal and institutional framework. The implementation stage requires objective selection of the partnership approach, leveraging international expertise, ensuring economic feasibility, covering demand and inflation risks, as well as protecting vulnerable populations and ensuring oversight and accountability.
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Keywords
Health sectorPublic-private partnershipInfrastructure contractsDigital health facilityRecommendations for a successful partnership
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McKee, M., Edwards, N., & Atunc, R. (2006). Public–private partnerships for hospitals. Bulletin of the World Health Organization, 84(11).
Monteiro, R. (2011, October). Managing healthcare PPPs: Building public sector capacity. Health PPPs, Handshake, 3.
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Mutua, J., & Wamalwa, N. (2020). Leasing of Medical Equipment Project in Kenya: Value for Money Assessment. Africa Portal. https://www.africaportal.org/publications/
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Ombashi, B., Cepiku, D., & Persiani, N. (2023). Public-private partnership in the health care sector: The case of Albania. Vestnik of Saint Petersburg University Management, 22(1), 23-36. https://doi.org/10.21638/11701/spbu08.2023.102
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Pekdemir, D. (2017). Alternative financing models in public facilities: The case study of Medical Campuses, Healthcare PPP Program in Turkey. European Real Estate Society, 8(7), 5720-5734.
Perihan Senel Tekin, Y. C. (2010, April). Analysing public-private partnership policy as a financing method in turkey health sector with political mapping [Conference Paper].
Peters, B. G. (1998). With a little help from our friends: Public-private partnerships as institutions and instruments. In J. Pierre (Ed.), Partnerships in urban governance: European and American experience. Macmillan Press.
Raman, A. V., & Björkman, J. W. (2015). Public-Private Partnerships in Healthcare. In E. Kuhlmann, R. H. Blank, I. L. Bourgeault, & C. Wendt (Eds.), The Palgrave international handbook of healthcare policy and governance. Palgrave Macmillan, pp 376–392 https://doi.org/10.1057/9781137384935_23
Rosenthal, G. D., & Newbrander, W. C. (1996). Public policy and private sector provision of health services. The International Journal of Health Planning and Management, 11(3), 203-216.
Sekhri, N., Feachem, R., & Ni, A. (2011). Public private integrated partnerships demonstrate the potential to improve health care access, quality and efficiency. Health Affairs, 30(8), 1498-1507. https://doi.org/10.1377/hlthaff.2010.0461
Shirley, M. (2008). Institutions and development. World Bank.
Sosa Delgado-Pastor, S., Brasher, E., Foong, S., Montagu, D., & Feachem, R. (2016). Innovation roll out. Valencia’s experience with public-private integrated partnerships (Healthcare public-private partnerships series, No. (3). https://globalhealthsciences.ucsf.edu/sites/globalhealthsciences.ucsf.edu/files/pub/pwc-innovation-rollout-af8_0.pdf
Stemmer, E. (2008, February). Contractual structures and risk allocation and mitigation in the context of Public Private Partnerships in the Health Sector (No. 49605). Finance Economics & Urban Department Finance & Guarantees Group.
Sveman, E., & Essinger, K. (2001). Procurement of health care services in Sweden in general, and the example of procurement of acute care in the Stockholm Region. In European integration and health care systems: A challenge for social policy. Swedish Federation of County Councils.
Taylor, R., & Blair, S. (2002). Public policy for the private sector; options for reform through public–private partnerships (Note Number 241). The World Bank’s Private Sector and Infrastructure Network.
Transparency International. (2016). Global corruption barometer: Europe & Central Asia 2016. https://www.transparency.org/en/gcb/europe-and-central-asia/europe-central-asia-2016
UN. (2019). Political declaration for the UN High-Level Meeting Meeting on UHC. https://www.uhc2030.org/news-events/uhc2030-news/political-declaration-for-the-un-high-level-meeting-meeting-on-uhc-555296/
United Nations Economic Commission for Europe (UNECE). (2016, February). Draft standards (revised).
Usman, A., Ibrahim, Y. B., & Abu Bakar, A. B. (2018). Malaysian public private partnership. Academy of Accounting and Financial Studies Journal, 22(Special Issue).
Villani, E., Greco, L., & Phillips, N. (2017). Understanding value creation in public-private partnerships: A comparative case study. Journal of Management Studies, 54(6), 876-905. https://doi.org/10.1111/joms.12270
World Bank Group. (2016). Public-Private Partnerships in Health, World Bank Group Engagement in Health PPPs An IEG Synthesis Report.
World Bank Group. (2019). High-performance health financing for universal health coverage, Driving sustainable, inclusive growth in the 21st Century. https://documents.worldbank.org/en/publication/documents-reports/documentdetail/641451561043585615
World Health Organization. (2010). Resolution WHA63.27. In Resolutions and decisions of regional interest adopted by the Sixty-third World Health Assembly.
World Health Organization. (2016). Role and contribution of the private sector in moving towards universal health coverage. https://iris.who.int/handle/10665/249567
World Health Organization. (2017, November 27). M Health: Use of appropriate digital technologies for public health (EB142/20). (in Arabic).
World Health Organization. (2018a). Independent Accountability Panel for Every Woman Every Child Every Adolescent. 2018 report: Private sector: Who is accountable? for women’s, children’s and adolescents’ health. https://www.aidsdatahub.org/sites/default/files/resource/iap-everywoman-every-child-every-adolescent-2018.pdf
World Health Organization. Regional Office for the Eastern Mediterranean. (2018b). Private sector engagement for advancing universal health coverage. (in Arabic). https://iris.who.int/handle/10665/370581
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How to Cite
Harmoush, I. Y. . (2026). Public-Private Partnerships in Health Care: Approaches and Policies. Academic Network for Development Dialogue (ANDD) Paper Series, 3(3). https://doi.org/10.29117/andd.2025.010
Section
Articles in Arabic