Public-private partnerships (PPPs) as a phenomenon have been used considerably in secondary and tertiary level hospitals with regards to diagnostics and cancer treatment. However, at the primary care level this has not been sufficiently employed. Considering that 88 per cent of Nigeria’s health facilities provide mainly primary care services, the potential for PPPs to improve healthcare access across the country is immense.
Despite challenges in management, human and financial resources, information, and technology systems, PPPs can transform healthcare access in remote areas. Wide infrastructure gaps on the continent, growing demand for private sector participation in infrastructure development, dwindling government resources, and the urgent need for alternative funding systems for infrastructure make this a logical option. Additionally, PPP mechanisms can harness the strengths of both the public and private sectors for development. Private sector competencies in innovation and technology, project financing and management, governance and accountability can forge a symbiotic alliance with public sector strengths such as policy setting, national planning, and regulation towards creating public value and improved healthcare access.
These PPPs can be designed and implemented through various contractual mechanisms for facility building, renovation and upgrade of primary healthcare centres which can be championed and supported through relevant government agencies such as Infrastructure Concession Regulatory Authority (ICRC), Federal Ministry of Health (FMoH), and National Sovereign Investment Authority (NSIA). To foster investor confidence and mitigate financial and political risk, the World Bank, and other development finance institutions such as Nigeria’s Bank of Industry (BoI) can help develop, finance, and guarantee bankable PPP pipeline projects.
The COVID-19 pandemic revealed the weakness of primary healthcare systems and structures. Protecting the lives and wellbeing of people will require concerted, inter-sectoral efforts, and PPPs can provide that bridge.
Dr. Oreh is a consultant family physician and Country Head of Planning, Research and Statistics for Nigeria’s National Blood Transfusion Service. She is also an Amujae Leader and Senior Fellow for Global Health with the Aspen Institute in Washington D.C.