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Institutional Sustainability

Structuring Sustainable PPPs for Healthcare Delivery in Africa

Par mikyraza@gmail.com 21 Jan, 2026 2 min de lecture

Access to quality healthcare remains a critical challenge across Africa. Governments face budget constraints, while the private sector holds capital and efficiency expertise. Public-Private Partnerships (PPPs) offer a compelling model to bridge this gap, but only if structured correctly.

The Promise of Health PPPs

Unlike traditional infrastructure PPPs (like roads or ports), social sector PPPs deal with human lives. The goal isn’t just to build a hospital, but to ensure sustainable service delivery.

A well-structured PPP can:

Critical Success Factors

Based on our advisory experience, three factors determine the success of a Health PPP:

1. Appropriate Risk Allocation

The golden rule of PPPs is to allocate risk to the party best able to manage it. In a hospital PPP, construction and maintenance risks should sit with the private partner, while demand risk (patient volume) and regulatory changes often remain with the government.

2. Bankability vs. Affordability

A project must be attractive to investors (Bankable) but also affordable for the government and patients. We conduct rigorous Value for Money (VfM) analyses to ensure that the PPP option is genuinely cheaper and better than traditional public procurement over the project’s lifecycle.

3. Stakeholder Engagement

Health projects are politically sensitive. Early engagement with doctors, unions, and local communities is vital. A PPP perceived as “privatization” without safeguards for the poor will face public backlash.

Conclusion

Structuring a PPP requires a delicate balance between public interest and private return. Prime & Prompt Consulting provides the transaction advisory support needed to navigate these complexities, ensuring that partnerships deliver tangible health outcomes for populations.

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