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Ann Med Health Sci Res. 2014 Jan;4(1):61-6. doi: 10.4103/2141-9248.126615.

Constraints, challenges and prospects of public-private partnership in health-care delivery in a developing economy.

Author information

1
Department of Physiology, University of Nigeria, Enugu Campus, Enugu State, Nigeria ; Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
2
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
3
Department of Physiology, University of Nigeria, Enugu Campus, Enugu State, Nigeria ; Department Obstetrics and Gynecology, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
4
Department of Health Management, College of Medicine, University of Nigeria, Enugu Campus, Enugu State, Nigeria.
5
Enugu State Health Board, Enugu State, Nigeria.
6
Department of Medicine, Medway Maritime Hospital, Gillingham, Kent, UK.

Abstract

BACKGROUND:

In Nigeria, concerns on the quality and financing of health-care delivery especially in the public sector have initiated reforms including support for public-private partnerships (PPP) at the Federal Ministry of Health. Likewise, Enugu State has developed a draft policy on PPP since 2005. However, non-validation and non-implementation of this policy might have led to loss of interest in the partnership.

AIM:

The aim of this study was to provide evidence for planning the implementation of PPP in Enugu State health system via a multi-sectoral identification of challenges, constraints and prospects.

SUBJECTS AND METHODS:

Pre-tested questionnaires were administered to 466 respondents (251 health workers and 215 community members), selected by multi-stage sampling method from nine Local Government Areas of Enugu State, Nigeria, over a study period of April 2011 to September 2011. Data from the questionnaires were collated manually and quantitative data analyzed using SPSS version 15 (Chicago, IL, USA).

RESULTS:

Only 159 (34.1%, 159/466) of all respondents actually understood the meaning of PPP though 251 (53.9%) of them had claimed knowledge of the concept. This actual understanding was higher among health workers (57.8%, 145/251) when compared with the community members (6.5%, 14/215) (P < 0.001). Post-PPP enlightenment reviews showed a more desire for PPP implementation among private health-care workers (89.4%, 101/113) and community leaders/members (55.4%, 119/215).

CONCLUSION:

PPP in health-care delivery in Enugu State is feasible with massive awareness, elaborate stakeholder's engagements and well-structured policy before implementation. A critical challenge will be to convince the public sector workers who are the anticipated partners to accept and support private sector participation.

KEYWORDS:

Enugu; Government; Health-care; Public-private partnership; Reform

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