Public-private partnerships' contribution to quality healthcare : a case study of South Africa after 1994

M.Comm.PPPs have developed out of a realisation by governments that in order to improve health systems efficiency there is a need to involve the private sector. Governments throughout the world have opted for PPPs to deliver public services, share risks and attain common goals. While the idea of PPPs is not new, it nonetheless has grown in application in recent years especially in developing countries such as South Africa. The neo-liberal GEAR macro-economic policy, that seeked to reduce government spending and to accelerate investment, catalysed the formation of PPPs in South Africa after 1996. The South African health system is a two-tier system consisting of the public sector and private sector. The public health sector is under resourced in terms of health personnel, health resources and funding compared to private healthcare. As a consequence, public health outcomes in South Africa are poor relative to its funding and have deteriorated since 1996, reportedly mainly due to the HIV/AIDS epidemic. On the contrary, private healthcare outcomes are amongst the best in the world. As a result, the demand for private healthcare is higher than that of public healthcare, because it is better resourced and offers better quality care. The research investigates the contribution of PPPs to access quality healthcare in South Africa. The study follows the policy, financial and governance approach to review health PPPs. It suggests that the 7 implemented health PPPs contributed directly and indirectly to improved access to quality healthcare. It recommends the implementation of health PPPs particularly at local government level, to improve access to quality healthcare