PhD- Thesis
The thesis answers the question: “what is the nature, motive, model, contribution and
effects of Public Private Partnerships (PPPs) on health service delivery?” The general
objective of the research was to assess the effects of PPPs on public health service
provision in Dodoma. The specific objectives were to explore the nature and motives
of PPPs, determine PPP models, stakeholders’ contributions, and effects. The PPP
continuum model and stakeholder theory are used to generate independent and
dependent variables. The independent variables constitute the nature and motives of
PPPs and the optional PPP models available. The dependent variables are distance
travelled, service costs, service types, service time, profits and service reliability.
Cross- sectional case study design is used to guide the study of thirteen PPP cases
purposefully sampled. Themes, patterns, clusters and finally tables are used to present
qualitative data while content, pattern matching, narratives and cross-case analysis
techniques arc used for analysis. Frequencies and pie charts are used to assess
stakeholders’ contributions to the partnerships. To determine the influence of PPPs on
dependent variables, Analysis of Variance (ANoVA) is utilised at the level of 0.05
significance. To separate the effects of PPPs on the continuous variables, t- test is used
to compare pairs of PPP cases. For categorical variables, frequency analysis applies.
The findings show that: firstly, the nature and motives for PPPs were centred on the
models range between simple collaborations to joint ventures. Thirdly, stakeholders’
contributions included labour, expertise, materials and cash. Fourthly, despite
limitations in the initiation and management of the collaborations, the effects of PPPs
were significantly positive for all stakeholders. It is recommended that, firstly, the government should establish specific regulations that can be used as guidance in
initiating and managing various forms of PPPs in the health sector. Secondly, there
should be one responsible unit for managing PPPs in all health projects in the country.
Thirdly, there should be more resource decentralisation to the local level to support
both public and private initiatives in PPP projects.
Mzumbe University