Training Course on Public-Private Partnerships in Health (PPPs)

Module 1: Introduction to PPPs in Health
Subtopics:
Concept of PPPs: definitions and scope in healthcare.
Evolution of PPPs from infrastructure projects to health-specific partnerships.
Categories of PPPs:
Infrastructure development (hospitals, clinics, labs).
Service delivery partnerships (outsourcing, co-management).
Financing partnerships (insurance schemes, social impact bonds).
Innovation partnerships (digital health, R&D collaborations).
Benefits of PPPs: efficiency, innovation, expanded access.
Risks: dependency, unequal power relations, profit vs. public good.
Activities/Examples:
Case Example: Kenya’s PPP hospital project (e.g., Kenyatta University Teaching Hospital model).
Group Discussion: “What problems in your local health system could PPPs solve?”

Module 2: Models and Structures of PPPs
Subtopics:
PPP contractual models:
Build-Operate-Transfer (BOT).
Design-Build-Finance-Operate (DBFO).
Lease or management contracts.
Joint ventures and concession agreements.
Division of risks, responsibilities, and rewards.
Key clauses in PPP contracts (service quality, financial risk, dispute resolution).
Role of government agencies vs. private partners.
Activities/Examples:
Case Study: PPP hospital networks in India.
Simulation Exercise: Participants design a PPP model for a regional diagnostic laboratory, specifying roles of public and private players.

Module 3: Financing and Investment in PPPs
Subtopics:
Sources of financing:
Government funds.
Private investors and venture capital.
Multilateral institutions (World Bank, IFC).
Impact investors and philanthropic contributions.
Structuring financial arrangements:
Cost-sharing.
Risk-sharing in demand fluctuations.
Return on investment considerations.
Cost-benefit analysis and value-for-money principles in PPPs.
Incentives and guarantees for private sector participation.
Activities/Examples:
Case Study: Gavi Alliance as a PPP in global vaccine financing.
Exercise: Participants assess a sample PPP budget and identify sustainability gaps.

Module 4: Governance, Accountability, and Regulation
Subtopics:
Institutional frameworks for PPP oversight.
Ensuring transparency in procurement and contracting.
Stakeholder engagement: role of civil society, patients, and communities.
Ethical challenges in PPPs (equity vs. profit motives).
Monitoring, performance evaluation, and reporting standards.
Dispute resolution mechanisms.
Activities/Examples:
Role Play: Simulated negotiation between a Ministry of Health and a private hospital investor.
Case Discussion: Failures in PPPs due to weak governance (e.g., overpricing, service inequities).

Module 5: Evaluating PPPs and Future Directions
Subtopics:
Measuring PPP success:
Access (coverage, equity).
Quality (clinical outcomes, patient satisfaction).
Efficiency (cost reduction, resource utilization).
Global lessons learned from PPPs in Africa, Asia, and Europe.
Challenges: political will, financial sustainability, community trust.
Future directions:
Digital health PPPs (telemedicine, AI, mobile health).
Climate-health PPPs (green hospitals, resilience in disasters).
Research and innovation ecosystems.
Activities/Examples:
Capstone Project: Teams develop a PPP proposal (e.g., rural health center, e-health service, or maternal care program).
Group Presentation: Each team pitches their PPP proposal and receives peer + facilitator feedback