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Public-Public Partnerships in Health and Essential Services

This paper was commissioned jointly by the Southern African Regional Network on Equity in Health (EQUINET) and the Municipal Services Project (MSP) to gather information on the concept of public-public partnership (PuP), which developed in the context of private-private partnerships. As a result, it can be regarded as a partnership in which there is no private sector partner. However, there are many definitions for the new concept. For practical purposes, PuPs can be categorized according to the different types of partners, such as: − partnerships between two public authorities − partnerships between public authorities and communities − development partnerships − international associations They can also be categorized according to the partnership's objectives, such as: - improved services - capacity-building - defense against privatization PuPs can help build stronger community support and accountability for services. Partnerships with a strong community presence and robust accountability mechanisms may also be better able to survive political changes, and so be easier to defend against privatization. PuPs can be used to develop a significant increase in the level of public participation, but time is needed to develop strong partnerships with community participation. The extent of community involvement may also be affected by local political conditions. They can also be used to achieve other objectives, such as paving the way for privatization, as occurs in the US. It is advisable for partners entering a PuP to have a clear statement of their own objectives and show an understanding of other partners’ objectives. PuPs are most effective when all partners have an understanding of each other’s goals and are willing to work together to reach their shared goals. External partners who provide advice and expertise may be crucial, not only by helping with technical improvements but also by playing a facilitative role, helping different partners work together more effectively. The specific objectives of external partners do not necessarily dominate the agendas of PuPs. However, the withdrawal of external funding may damage the viability of some PuPs. Six case studies were analyzed from the water and health sectors: four from South African Development Commission (SADC) countries, one from Western Europe, and one from a former Soviet Union country. They demonstrated that subsequent political developments can change the context and operation of a PuP. The paper recommends further research by local researchers, in collaboration with communities and NGOs.
David Hall, Jane Lethbridge and Emanuele Lobina
Publication Information: 
MSP Occasional Paper No.9
Publication Date: 
Publication Type: 
Occasional Paper