Public-Private Investment Partnerships
About
Government-run health systems across the developing world are in disrepair, with poor quality services provided in dilapidated facilities. Public-Private Investment Partnerships (PPIPs) are a novel way for resource-constrained governments in developing countries to simultaneously improve health infrastructure and healthcare service provision, while creating a platform for addressing other system-wide inefficiencies. PPIPs enable national governments to prudently leverage private sector expertise and investment to serve public policy goals—specifically the provision of high quality, affordable preventive and curative care to all citizens. The PPIP model delivers a “complete bundle” of services, while simultaneously providing a vehicle for local economic empowerment.
PPIPs are a special form of public-private partnership (PPP) that comprise long-term, highly structured relationships between the public and private sectors designed to achieve significant and sustainable improvements to systems at national or sub-national levels. PPIPs position a private entity, or consortium of private partners, in a long-term relationship with a government to co-finance, design, build, and operate healthcare facilities, and to deliver both clinical and non-clinical services at those facilities over a decade or more. The new, state-of-the-art facilities or renovated facilities that result from a PPIP are owned by the government during all phases of the contract.
Unlike other PPPs, PPIPs go beyond private investment in buildings and maintenance. The private partners are also responsible for delivering all clinical and non-clinical services at the facilities, from surgery to immunization to ambulances. Most importantly, PPIPs aim to be “cost neutral” to patients, who incur the same out-of-pocket payments, usually zero or minimal, as they did in the previous dilapidated and poorly run public facilities.
The GHG’s Role
In order to serve as a thought leader and repository of information on private sector delivery of health services, the GHG’s Health Systems Initiative works to document, evaluate, and disseminate knowledge about PPIP experiences in low- and middle-income developing countries. To date, the GHG has organized series of international conferences and south-south learning exchanges on PPIPs to facilitate discussion of their potential uses to strengthen health infrastructure and service provision in the developing world. At the request of several Ministries of Health and Finance, the GHG is producing a standardized atlas of PPIP case studies for health leaders and policy makers to better understand the breadth and key success factors of well-functioning PPIPs.
PPIP Overview
For an in-depth explanation of PPIPs, including descriptions of three flagship PPIPs, please see the recently published PPIP
Overview.
Landmark PPIP Conferences
Following a baseline-setting conference on PPIPs at Wilton Park, UK in April 2008, the GHG has met with Ministries of Health in several countries across sub-Saharan Africa to inform and educate them about the PPIP model, determine their interest in exploring it further, and work with them to identify potential projects.
Enhancing Health Systems through Public-Private Investment Partnerships: Lessons Learned from Lesotho
March 31-April 2, 2009, Maseru, Lesotho
On March 31 - April 2, 2009, the GHG co-hosted a learning conference in Maseru, Lesotho on Sub-Saharan Africa’s first-ever large-scale public-private partnership to include infrastructure development and a service delivery contract. The conference was co-hosted by the GHG, the Lesotho Ministry of Finance and Development Planning, and the Lesotho Ministry of Health and Social Welfare. The focus of the conference was on the cross-sector collaboration around the rebuilding of the country’s main referral hospital, the Queen Elizabeth II. Ministers of Health and Finance for six other African countries traveled to Maseru to learn from the Lesotho PPIP experience. Read the Lesotho
Conference Report.