This book provides a comprehensive overview of the law surrounding PPPs in the Middle East and North African region.
The significance of liberalized and integrated Public Private Partnership ...contracts as an essential component of the world legal and policy order is well documented. The regulation of PPPs is justified economically to allow for competition in the relevant public service and to achieve price transparency, thus resulting in significant savings for the public sector. In parallel to the economic justifications, legal imperatives have also called for the regulation of PPPs in order to allow free movement of goods and services and to prohibit discrimination on grounds of nationality. The need for competitiveness and transparency in delivering public services through PPPs is considered a safeguard to achieve international standards in delivering public utility services. First, it assesses the compatibility of the current PPP legislation and regulation in the MENA region with the international standards of legislation and regulation prevalent in many other countries, including the UK, France and Brazil. Second, it compares the practices in the MENA region with those of international bodies such as the OECD and World Bank. Comparisons are then made between MENA countries and those in Europe and Asia with regard to the influence of culture, policy and legal globalization.
The book will be of interest to scholars and students in the field of international contract law, public law and state contracts, finance law and private law.
The future prosperity of most people of the Middle-East and North Africaand the social cohesion of their countriesrests in great part on the ability of governments to enable the private sector to ...respond to this job creation challenge. This is what this report is about. It is about enabling the new generations of entrepreneurs that have emerged over the past years all across the region to play a bigger role in the growth of their countries. It is also about encouraging more investors to believe in the prospects of the region and trusting that business-friendly policy reforms will benefit them and not only a minority of privileged entrepreneurs. From privilege to competition: unlocking private-led growth in the Middle-East and North Africa complements previous regional flagship reports published by the World Bank. In particular, the 2004 flagship report on trade and investment in the MENA region and the 2008 report on education touched upon other fundamental ingredients of economic competitiveness and private sector development. By focusing on market institutions, the quality of implementation of economic policies and the credibility of reforms from the private sector perspective, this report offers a new angle to the growth and employment challenge of the MENA region.
Much of the information relevant to policy formulation for industrial development is held by the private sector, not by public officials. There is, therefore, fairly broad agreement in the ...development literature that some form of structured engagement—often referred to as close or strategic coordination—between the public and private sectors is needed, to assist in the design of appropriate policies and provide feedback on their implementation. There is less agreement on how that engagement should be structured, how its objectives be defined, and how success be measured. In fact, the academic literature provides little practical guidance on how governments interested in developing such a framework should go about doing it. The burden of this lack of guidance falls most heavily on Africa, where—despite twenty years of growth—lack of structural transformation has slowed job creation and the pace of poverty reduction. In 2014, the Korea International Cooperation Agency (KOICA) and United Nations University World Institute for Development Economics Research (UNU-WIDER) launched a joint research project: The Practice of Industrial Policy. The aim is to help African policy makers develop better coordination between public and private sectors in order to identify the constraints to faster structural transformation and design, implement, and monitor policies to remove them. This book, written by national researchers and international experts, presents the results of that research by combining a set of analytical ‘framing’ essays on close coordination with case studies of successful and unsuccessful efforts at close coordination in Africa and in comparator countries.
More than half of the people with Tuberculosis (TB) symptoms in India seek care from the private sector. People with TB getting treatment from private sector in India are considered to be at a higher ...risk for receiving suboptimal quality of care in terms of incorrect diagnosis and treatment, lack of treatment adherence support with a high loss to follow-up rate that could eventually increase their risk of drug resistance. The current study aims at documenting the approach and efforts taken by the Kerala state to partner with the private health care delivery providers for ensuring quality TB care to the people with presumed TB reaching them.
A case study approach was adopted with review of all available literature followed by five Key Informant Interviews to understand the case through a primary descriptive exploration. Grounded theory approach was used to generating the single theory of the case itself that explains it.
Kerala state has taken a variety of interventions to ensure universal access to TB care for citizens reaching the private sector with documented improvement in the quality of TB care. Key learnings from these initiatives were (i) patients need to be at the centre of partnerships, (ii) good governance is essential for ensuring Universal Health Coverage in a mixed health system, (iii) data intelligence is required to guide partnerships, (iv) identification of the correct 'problems' is crucial for effective design of partnerships and (v) a platform for meaningful dialogue of key stakeholders is needed.
Kerala experience demonstrated that if governments take a proactive role in engaging the private sector, in an informed and evidence-based way, they can leverage the advantages of the private sector while protecting the public health interest.
Performance-based evaluation criteria (PBEC) are vital for selecting high-quality suppliers and achieving a PPP procurement performance. Through theoretical and institutional analysis, we found that ...the selection of PBEC centered on operations depends on the discretion of the purchaser. However, in an emerging and transforming PPP market, many factors have affected the scientific exercise of the purchaser's discretion. This means that PPP projects must focus on construction and neglect operation in a certain period. Furthermore, to explore the influencing factors of the definition of PBEC, based on data of 9082 PPP projects between 2009 and 2021 in China, we adopted Ordinary Least Squares to empirically analyze two factors that influence the level of attention that is paid to the operation plan: corruption and accountability. The results indicate that the attention paid to the operation plan significantly increased with the reduction in corruption and the improvement in accountability. Robustness tests demonstrate the robustness of the results. A further heterogeneity analysis shows that the above factors have a more significant impact on non-state demonstration projects and projects with large investments. The contributions of this study are as follows: (1) Theoretically, this paper supplements the relevant research on evaluation criteria and provides new evidence on the impact of corruption and accountability on the defining PBEC. (2) Institutionally, it provides specific paths to limit the discretion of procurement officials when defining evaluation criteria. (3) In practice, it helps procurement officials to scientifically define PBEC and promote the realization of procurement performance.
In the past three decades, levels of and contributors to global health aid have increased at an unprecedented pace. Development assistance for health—financial contributions from public and private ...institutions to low‐ and middle‐income countries to help improve health and health systems—nearly quintupled from 1990 to 2012 (from $5.7 billion to $28.1 billion). DAH is now provided by more than one hundred seventy major global health agencies and organizations, 15 percent of which are private entities (such as the Bill and Melinda Gates Foundation), other not‐for‐profit organizations, and public‐private partnerships. Governments are still the largest source for DAH. While increased DAH is essential and welcome, these system developments raise numerous ethical questions. Are the resources sustainable, and do expenditures target correct priorities? Who should decide, and how should these decisions be made?.
The private sector plays a large role in malaria treatment provision in Nigeria. To improve access to, and affordability of, quality-assured artemisinin-based combination therapy (QA-ACT) within this ...sector, the Affordable Medicines Facility-Malaria began operations in 2010 and transitioned to a private sector co-payment mechanism (PSCM) until 2017. To assess the impact of the scheme on the ACT market, cross-sectional household and outlet surveys were conducted in 2018 to coincide with the final stockages of ACT medicines procured under the PSCM.
An outlet survey was conducted targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability and cost of anti-malarials, including artemisinin-based combinations subsidised under the PSCM (called green leaf ACT on account of their green leaf logo) and those not subsidised (non-green leaf ACT). A concurrent household survey was conducted to determine demand-side factors related to treatment-seeking practices, ACT brand preference and purchase decision. Data were compared with previous ACTWatch surveys to consider change over time.
Availability of artemisinin-based combinations increased significantly over the PSCM period and was almost universal by the time of the 2018 market survey. This increase was seen particularly among PPMVs. While the cost of green leaf ACT remained relatively stable over time, the cost of non-green leaf ACT reduced significantly so that by 2018 they had equivalent affordability. Unsubsidised brands were also available in different formulations and dosages, with double-strength artemisinin-based combination reported as the most frequently purchased dosage type, and child artemisinin-based combinations popular in suspension and dispersible forms (forms not subsidised by the PSCM).
The PSCM had a clear impact on increasing not only the reach of subsidized QA brands, but also of non-subsidised brands. Increased market competition led to innovation from unsubsidised brands and large reductions in costs to make them competitive with subsidised brands. Concerns are drawn from the large market share that non-QA brands have managed to gain as well as the continued market share of oral artemisinin monotherapies. Continued monitoring of the market is recommended, along with improved local capacity for QA-certification and monitoring.
Abstract
Background
To avoid misuse of anti-malarials, correct diagnosis of fever prior to drug prescription is essential. Presumptive treatment in the private healthcare sector is a concern in ...Nigeria, where availability of affordable artemisinin-based combination therapy (ACT) is high following the implementation of subsidy schemes from 2010 to 2017. Similar subsidies have not, however, been implemented for malaria rapid diagnostic tests (RDTs). A market survey in 2018 predominantly designed to assess the ACT market in the private sector also collected data related to RDTs, results of which are presented herein.
Methods
A 2018 market survey consisted of (i) an outlet survey targeting private pharmacies and Proprietary and Patent Medicine Vendors (PPMVs) across different regions of Nigeria to assess supply-side market factors related to availability of RDTs (defined as having stock available for purchase at the time of the survey) and (ii) a household survey to determine demand-side factors related to knowledge of RDTs, healthcare-seeking practices and affordability.
Results
Availability of RDTs at the time of the survey was low in both outlet types and significantly lower in PPMVs (22.1%, 95% CI) among pharmacies versus (13.6%, 95% CI) among PPMVs (p < 0.01). Reasons for not restocking RDTs included low demand and no supply. The majority of households diagnose malaria based on experience, while one-third would visit a PPMV or pharmacy. Half of households had heard of RDTs (48.4%) and 38.6% thought they were affordable.
Conclusions
Low availability of RDTs among PPMVs and pharmacies may be attributed to lack of demand, supply-side issues and cost. Increasing household knowledge of RDTs may aid increasing demand, while subsidized RDTs may address supply and price issues. Addressing the deficit in RDT provision is important for targeting of ACT medicines.
In low-and middle-income countries (LMICs), the private sector—including international donors, non-governmental organizations, for-profit providers and traditional healers—plays a significant role in ...health financing and delivery. The use of the private sector in furthering public health goals is increasingly common. By working with the private sector through public–private engagement (PPE), states can harness private sector resources to further public health goals. PPE initiatives can take a variety of forms and understanding of these models is limited. This paper presents the results of a Campbell systematic literature review conducted to establish the types and the prevalence of PPE projects for health service delivery and financing in Southern Africa. PPE initiatives identified through the review were categorized according to a PPE typology. The review reveals that the full range of PPE models, eight distinct models, are utilized in the Southern African context. The distribution of the available evidence—including significant gaps in the literature—is discussed, and key considerations for researchers, implementers, and current and potential PPE partners are presented. It was found that the literature is disproportionately representative of PPE initiatives located in South Africa, and of those that involve for-profit partners and international donors. A significant gap in the literature identified through the study is the scarcity of information regarding the relationship between international donors and national governments. This information is key to strengthening these partnerships, improving partnership outcomes and capacitating recipient countries. The need for research that disaggregates PPE models and investigates PPE functioning in context is demonstrated.
Dans les pays à faible revenu et à revenu intermédiaire (PFR-PRI), le secteur privé, - notamment les donateurs internationaux, les organisations non-gouvernementales, les prestataires de services à but lucratif et les tradipraticiens -, joue un rôle important dans le financement et la prestation des services de santé. Le recours au secteur privé dans la poursuite des objectifs de santé publique est de plus en plus courant. En collaborant avec le secteur privé par le biais de l’engagement public-privé (PPE), les États peuvent exploiter les ressources du secteur privé pour promouvoir des objectifs de santé publique. Les initiatives PPE peuvent prendre une variété de formes et la compréhension de ces modèles est limitée. Le présent article présente les résultats d’une recension Campbell systématique de la littérature menée pour établir les types et la prévalence des projets PPE pour la prestation et le financement des services de santé en Afrique australe. Les initiatives PPE identifiées à la suite de cette revue ont été classées selon une typologie PPE. L’examen révèle que dans le contexte de l’Afrique australe, la gamme complète des modèles PPE est utilisée, soit huit modèles distincts. On examine la répartition des données probantes disponibles - y compris sur d’importantes lacunes de la littérature, et on présente les considérations cruciales pour les chercheurs, les agents d’exécution ainsi que les partenaires PPE actuels et potentiels. Il a été constaté que la littérature est davantage représentative des initiatives PPE localisées en Afrique du Sud, ainsi que de celles où les partenaires à but lucratif et les donateurs internationaux sont impliqués. La rareté des informations concernant la relation entre les bailleurs de fonds internationaux et les gouvernements nationaux est une autre grosse lacune de la littérature identifiée par l’étude. Cette information est essentielle pour le renforcement de ces partenariats, l’amélioration des résultats du partenariat et le renforcement des capacités des pays bénéficiaires. On démontre ainsi la nécessité d’une recherche qui désagrège les modèles PPE et mène des investigations sur le fonctionnement des initiatives PPE dans le contexte.
En los países de ingresos bajos y medios (PIBMs), el sector privado -incluyendo donantes internacionales, organizaciones no gubernamentales, proveedores con ánimo de lucro y curanderos tradicionales -juega un papel importante en la financiación y la entrega de la salud. El uso del sector privado en la promoción de los objetivos de salud pública es cada vez más común. Trabajando con el sector privado a través del compromiso público-privado (CPP), los estados pueden aprovechar los recursos del sector privado para promover metas de salud pública. Las iniciativas del CPP pueden tomar una variedad de formas y la comprensión de estos modelos es limitada. Este artículo presenta los resultados de una revisión sistemática de la literatura Campbell llevada a cabo para establecer los tipos y la prevalencia de los proyectos del CPP para la prestación y la financiación de servicios de salud en Suráfrica. Las iniciativas del CPP identificadas a través de la revisión se clasificaron de acuerdo con una tipología CPP. La revisión revela que toda la gama de modelos del CPP, ocho modelos distintos, se utilizan en el contexto de Suráfrica. Se discute la distribución de la evidencia disponible -incluyendo vacíos significativos en la literatura- y se presentan las consideraciones claves para los investigadores, los implementadores, y los socios de CPP actuales y potenciales. Se encontró que la literatura es desproporcionadamente representativa de las iniciativas del CPP ubicadas en Suráfrica, y de aquellos que involucran socios con ánimo de lucro y donantes internacionales. Una brecha significativa en la literatura identificada a través del estudio es la escasez de información con respecto a la relación entre los donantes internacionales y los gobiernos nacionales. Esta información es clave para fortalecer estas asociaciones, mejorando los resultados de la asociación y capacitando a los países receptores. Se demuestra la necesidad de investigar los modelos que analizan minuciosamente el CPP e investigan el funcionamiento del CPP en su contexto.
在中低收入国家(LMICs), 国际捐助者、非政府组织、营利服 务者和传统治疗师等私人部门在卫生筹资和卫生服务提供中 发挥着重要作用。利用私人部门来实现公立卫生目标正越来 越常见。通过公私参与(PPE) 方式与私人部门合作, 政府可 以使用私人部门的资源来推进公立卫生目标。PPE可采取多 种形式, 目前对这些模式的理解有限。本文描述了一项 Campbell系统综述的结果, 该文献综述的目的是明确非洲南 部卫生服务提供和筹资PPE项目的种类和普及率。综述纳入 的PPE项目根据PPE类型进行分类。本综述发现全部八种不同 的PPE模式在非洲南部均有使用。本文讨论了现有证据的分 布, 包括文献中的重要缺口;描述了研究者、实施者以及现有 和潜在的PPE合作伙伴的主要考虑因素。结果显示, 文献大多 是关于南非的PPE项目, 以及有营利服务者和国际捐助者参与 的项目。本研究发现, 现有文献缺乏关于国际捐助者与国家政 府间关系的信息。此类信息对于加强合作伙伴关系、改善合 作伙伴结果、提供受援国能力非常关键。需要进一步研究来 分解PPE模式, 调查在具体环境中运行的PPE项目。
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