Collaborative Governance in Public-Private Partnerships

The multitude of public-private partnership (PPP) designs and interpretations reflects the lack of an authoritative definition of PPP. What each definition of PPP has in common is an emphasis on collaboration and shared decision-making towards a common goal. To explore what partnership means to PPPs that are focused on health system strengthening, the researcher conducted a literature review and two case studies: one on Labs for Life, and another on a partnership between the Japanese International Cooperation Agency (JICA), Sysmex, and the Namibian Ministry of Health. The emphasis on collaboration led the researcher to use collaborative governance as a conceptual framework, drawing from a paper by Chris Ansell and Alison Gash (2007). The two PPPs varied greatly in how external factors (e.g. power and prehistory) impacted the partnership, and to what extent the PPPs embraced the collaborative process. The PPPs were similar in many ways, too – both acknowledged the importance of building trust through cultural understanding and expectation management. Third parties were key in both partnerships, enabling the collaborative process. The results of this study underscore the heavy burden that the word, partnership, carries; if public-private partnership implies the purposeful application of collaborative governance, then this study supports an alternative term: public-private interaction (PPI). This new term removes the assumption that all partners are fully equal and that decision-making processes are collaborative and consensus-oriented. Indeed, PPPs (or PPIs) come in all shapes and sizes and degrees to which they are true to collaborative governance. These findings contribute to an evidence base of lessons-learned that will enable PPPs/PPIs to focus on health system priorities while honestly assessing the relevance and application of collaborative governance.