Thiessen Jodi, Bagoi Athaliah, Homer Caroline, Rumsey Michele
WHO Collaborating Centre for Nursing, Midwifery and Health Development, University of Technology Sydney, Ultimo, NSW 2007, Australia
Reproductive Health Training Unit, PO Box 842, Port Moresby, NCD, Papua New Guinea
Rural Remote Health. 2018 Dec;18(4):4608. doi: 10.22605/RRH4608. Epub 2018 Dec 12.
The recent policy environment in both Papua New Guinea and Australia for partnering with private entities to address health issues has led to a public-private partnership (PPP) between the National Department of Health in Papua New Guinea, the Australian Government and the Oil Search Foundation. A reproductive health training unit was formed to provide health worker training in essential obstetric care and emergency obstetric care. This article provides a qualitative evaluation of the PPP, looking at facilitating features and barriers to the PPP's target of improving the competence of frontline health workers in obstetric care service provision in Papua New Guinea.
A qualitative methodology gathered data since the PPP's inception in 2012. A dataset of 85 interviews with partners and relevant stakeholders from across Papua New Guinea was analysed using thematic analysis.
Themes of facilitating features of the PPP were (1) understanding and agreeing with the national plan for PPPs and maternal and child health; (2) having strong champions, strong relationships and a formal decision-making body; and (3) creating autonomy and branding. Themes outlining the barriers to the PPP's effectiveness were (1) lacking governance framework creating confusion in decision making and roles and responsibilities; (2) differing institutional cultures and ownership struggles; and (3) lacking capacity within the institutes themselves, particularly the National Department of Health.
The findings of this service provision case study confirm what has been found in other infrastructure-led PPPs. Further research into how to overcome power imbalances between partners in a PPP as well as setting up a governance framework in a dynamic environment could inform this growing area of collaboration between the private and public sectors.
巴布亚新几内亚和澳大利亚近期出台的与私营实体合作解决卫生问题的政策环境，促成了巴布亚新几内亚国家卫生部、澳大利亚政府和石油搜索基金会之间的公私伙伴关系（PPP）。一个生殖健康培训单位成立，旨在为卫生工作者提供基本产科护理和紧急产科护理方面的培训。本文对该公私伙伴关系进行了定性评估，审视了促成因素以及实现提高巴布亚新几内亚一线卫生工作者产科护理服务能力这一公私伙伴关系目标的障碍。
自2012年公私伙伴关系启动以来，采用定性方法收集数据。运用主题分析法对来自巴布亚新几内亚各地的合作伙伴及相关利益攸关方的85次访谈数据集进行了分析。
公私伙伴关系促成因素的主题包括：（1）理解并认同公私伙伴关系及母婴健康国家计划；（2）拥有强有力的倡导者、稳固的关系及正式决策机构；（3）赋予自主权并打造品牌。概述公私伙伴关系有效性障碍的主题包括：（1）缺乏治理框架导致决策以及角色和责任方面的混乱；（2）不同的机构文化和所有权纷争；（3）各机构自身，尤其是国家卫生部，缺乏能力。
本服务提供案例研究的结果证实了其他以基础设施为主导的公私伙伴关系中的发现。进一步研究如何克服公私伙伴关系中伙伴之间的权力失衡，以及如何在动态环境中建立治理框架，可为这一不断发展的私营部门与公共部门合作领域提供参考。
