Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature ...about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs.
We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author.
We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five key themes for successful QI projects in LMICs: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components and their follow-up. Few papers formally reported on actual deployment of private-sector capital, and either provided insufficient information or did not follow the formal PPP model, which involves capital investment for a explicit return on investment. Few studies discussed the response to their findings and the organizational willingness to change.
Many of the same factors that impact the success of QI in healthcare in high-income countries are relevant for PPP in LMICs. Vague descriptions of the structure and financial arrangements of the PPPs, and the roles of public and private entities made it difficult to draw meaningful conclusions about the impacts of the organizational governance on the outcomes of QI programs in LMICs. While we found many articles in the published literature on PPP-funded QI partnerships in LMICs, there is a dire need for research that more clearly describes the intervention details, implementation challenges, contextual factors, leadership and organizational structures. These details are needed to better align incentives to support the kinds of collaboration needed for guiding accountability in advancing global health. More ownership and power needs to be shifted to local leaders and researchers to improve research equity and sustainability.
Despite its centrality in the national cyber security strategies of the US and the UK, the public–private partnership is a nebulous arrangement, which is especially problematic in the context of ...critical infrastructure protection. Privately owned and operated critical infrastructure that is regarded as a potential national security vulnerability raises questions about the allocation of responsibility and accountability in terms of cyber security. As with many aspects of cyber security, this issue is often discussed with little reference to previous scholarship that could provide conceptual scaffolding. This article draws on the extensive literature on public-private partnerships in order to assess the tensions and challenges of this arrangement in national cyber-security strategies. It finds that there is a serious disjuncture in expectations from both 'partners'. The government regards privately owned and operated critical infrastructure as a key element of national security but is reluctant to claim a mandate to oversee network security. At the same time, the private sector is not inclined to accept responsibility or liability for national cyber security. This challenge for governments to manage national cyber security raises questions about how well equipped these states are to promote their own security in the information age. Acknowledging the flaws in the 'partnership' is an essential step towards addressing them.
Over the last two decades, product development partnerships have proven to be a successful model of public-private partnership. Product development partnerships are not-for-profit research and ...development organizations, typically funded by public and philanthropic organizations focusing on developing new health products to tackle diseases of poverty such as malaria or neglected tropical diseases. A recent report suggests that about 2.4 billion people have benefitted from more than 60 new health technologies introduced by product development partnerships.1 With several hundred additional products in the pipeline, product development partnerships are expected to make an even larger contribution to global health, alleviating poverty and increasing global health security. Product development partnerships are active in all stages of pharmaceutical product development, engaging with academic research institutions and the pharmaceutical industry to undertake research and development. Product development partnerships also take on activities aimed at providing equitable access to new health products, especially for vulnerable populations in low- and middle-income countries. The coronavirus disease 2019 (COVID-19) pandemic has shown that product development partnerships are highly relevant in responding to global health crises, among other reasons because they can quickly identify drug candidates for the treatment of mild-to-moderate COVID-19 as well as future coronaviruses.The World Health Organization (WHO) has long recognized the essential role of product development partnerships in tackling diseases that have high disease burdens in low- and middle-income countries but are neglected by traditional market dynamics. The collaboration between product development partnerships and WHO has often been ad hoc and disease specific; however, in recent years the collaboration has become more consolidated. Furthermore, the COVID-19 pandemic has brought about important new WHO initiatives relevant for product development partnerships as well as changes to the operations of the latter. Here we discuss these recent developments along the biomedical value chain, and show how they have increased the ability of product development partnerships to develop and deliver much-needed new health technologies
Resumen: La captación y la retención de profesionales en los centros sanitarios de gestión indirecta y de gestión privada obedecen a un marco de regulación distinto del de las instituciones de ...gestión directa. Ese marco legal es el Estatuto de los Trabajadores, que contiene sus propios elementos reguladores en cuanto a capacidad de negociación y condiciones básicas generales. El marco regulador del Estatuto de los Trabajadores permite una amplia capacidad de gestión, negociación y pacto, en el ámbito de la gestión de los recursos humanos, en los procesos de captación, selección y retención, pero desde hace algunos años se han ido incorporando legislaciones básicas e intervenciones de los órganos de control públicos que han modificado esa discrecionalidad para las entidades de gestión indirecta, acercándolas cada vez más al sistema de gestión administrativa para funcionarios/estatutarios, y limitando en consecuencia la capacidad de decisión y adaptación propias de la gestión empresarial o privada. Se analizan las similitudes y las diferencias de los distintos ámbitos de gestión, y se exploran las debilidades y las oportunidades de cada uno de ellos en cuanto a políticas de captación, selección y retención, ofreciendo una reflexión específica en la selección de directivos y mandos, así como un análisis y una valoración de la retención de profesionales en las instituciones sanitarias. Abstract: The recruitment and retention of professionals in indirectly managed and privately managed health care institutions is governed by a different regulatory framework than in directly managed institutions. That legal framework is the Workers’ Statute, which contains its own regulatory elements in terms of bargaining power and general basic conditions, among others. The regulatory framework of the Workers’ Statute allows for a broad capacity for management, negotiation and agreement in the field of human resources management, and specifically in the processes of recruitment, selection and retention, but for some years now basic legislation and interventions by public control bodies have been incorporated which have modified this discretionarily for indirect management entities, bringing them closer and closer to the system of administrative management for civil servants/statutory employees, and consequently limiting the capacity for decision making and adaptation typical of business/private management. This article attempts to explain the similarities and differences between the different areas of management and to explore the weaknesses and opportunities of each of them in terms of recruitment, selection, and retention policies, offering a specific reflection on the selection of executives and managers, as well as an analysis and assessment of the retention of professionals in healthcare institutions.
This paper examines the recent resurgence of interest in public-private partnerships (PPPs) to provide infrastructure in developing countries. First, the paper demonstrates that there has been a ...revival of support for private sector participation in infrastructure. Second, the paper argues that this revival differs from earlier attempts to increase the involvement of the private sector in public service provision in a number of respects. In particular, the current support for PPPs is related to an increased availability of global financial capital. Third, the paper considers the implications of this distinct feature of the revival for development.
Innovation under cap-and-trade programs Taylor, Margaret R
Proceedings of the National Academy of Sciences - PNAS,
03/2012, Letnik:
109, Številka:
13
Journal Article
Recenzirano
Odprti dostop
Policies incentivizing the private sector to reach its innovative potential in "clean" technologies are likely to play a key role in achieving climate stabilization. This article explores the ...relationship between innovation and cap-and-trade programs (CTPs)—the world's most prominent climate policy instrument—through empirical evidence drawn from successful CTPs for sulfur dioxide and nitrogen oxide control. The article shows that before trading began for these CTPs, analysts overestimated the value of allowances in a pattern suggestive of the frequent a priori overestimation of the compliance costs of regulation. When lower-than-expected allowance prices were observed, in part because of the unexpected range of abatement approaches used in the lead-up to trading, emissions sources chose to bank allowances in significant numbers and reassess abatement approaches going forward. In addition, commercially oriented inventive activity declined for emissions-reducing technologies with a wide range of costs and technical characteristics, dropping from peaks before the establishment of CTPs to nadirs a few years into trading. This finding is consistent with innovators deciding during trading that their research and development investments should be reduced, based on assessments of future market conditions under the relevant CTPs. The article concludes with a discussion of the results and their implications for innovation and climate policy.
Public service motivation (PSM) has a documented, positive effect on job satisfaction—especially in the public sector. However, organizational characteristics such as red tape, hierarchical ...authority, and the absence of organizational goal specificity, which are often more present in public sector organizations, may have negative influences on the PSM–job satisfaction relationship. This study explores the impact of these organizational characteristics on sector differences in the PSM–job satisfaction relationship in a “hard case” setting. Using survey data with low-level, white-collar employees, we confirm a positive PSM–job satisfaction association in the public sector compared with the private sector, where we see a negative association. Furthermore, perceived red tape and the absence of organizational goal specificity have negative influences on job satisfaction; nevertheless, sector differences remain in the PSM–job satisfaction relationship when controlled for these organizational characteristics. This suggests that public or private sector status is more important for the PSM–job satisfaction relationship than other organizational characteristics.
Summary Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the ...performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers—including their size, objectives, and technical competence—the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole.
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