The rising demand for primary health care (PHC) due to ageing populations, insufficient public sector service outreach and fiscal stress on government budgets has historically undermined publicly funded primary care globally. Recent geo-political shifts and fundamental disruptions in global aid, a substantial source of support for PHC in many countries of the Global South, accelerates the necessity for country-centric partnerships with the domestic private sector for accessible, responsive primary care. It also opens a window for a systemic shift in approach towards more resilient and converged partnerships that deliver to the public good.

Private primary care providers are responsible for a substantial footprint of primary care, but conventional assumptions of commercial motives have often clouded the approach to formal partnerships. A one-size-fits-all approach cannot be applied to the heterogeneous private sector requiring differentiation between oligarchs and smaller private providers embedded within communities (small clinics, polyclinics, maternity homes, pharmacies, laboratories) that are often more familiar with local needs than the public sector. Ongoing expansion of digitization within healthcare is seeing the emergence of primary care start-ups and local enterprises further necessitating a shift to multi-stakeholder resilient partnerships. A core question is, how can professional, commercial and public sector interests be reconciled?

Traditional approaches have narrowly focused on hierarchal controls of regulation and tight contracts as instruments to engage the private sector but met with weak private sector participation, onerous bureaucratized systems, mutual wariness and uncertain success. A transformative shift is required towards agile, inclusive partnerships – underpinned by converged interests, context specific designs, local pathways for systems responsiveness- while ensuring effective accountability to communities and patients. New fiscal realities require efficient leveraging of country resources across public and private finance to create sustainable partnerships while optimizing private providers for equitable delivery.

The goal of this research topic is to critically examine and advance inquiry on public-private partnership (PPP) models for primary care, shifting focus from conventional hierarchical initiatives towards a partnership-led paradigm that identifies co-created, financially resilient, locally designed and ethically governed collaboration frameworks for cohesive integration of public-private partnerships within mixed health systems. The focus is on exploration of national systems, particularly sub-national levels, to create locally led, more endurable PPPs for primary care aligned with domestic priorities.

We invite articles addressing, but not limited to, the following sub-themes:

-Deploying a partnership lens for pro-poor primary healthcare models within ethical governance: What new models of public private partnerships for primary care can be designed based on common ideation and agile delivery for more cohesive mixed health systems? How can partnership models take into account the varying interests of smaller providers versus larger commercial entities within socially responsive governance? 

-Placing innovations at the core of public-private partnerships: How can public-private partnerships be positioned and optimized to innovate, drive and upscale ethical digital delivery for primary care? And what PPP design features are needed to reconcile digital innovations with ethical delivery and equitable primary care?

-Efficient leveraging of resources across both the private and public sectors: How can public and private finance be leveraged to support smaller private healthcare businesses for production of primary healthcare that delivers to the public good? 

-Shifting accountability downstream for more patient centric partnerships models: How can communities be involved in ensuring accountability of PPPs for more responsive primary care?

This Research Topic seeks to generate provocative future’s thinking and intellectual discussion within the proposed thematic areas to contribute to field building research for PPPs for primary care and policy recommendations for transformative PPPs responses to address new realities in the global south. It will provide important cross-fertilization of thought processes across the disciplines of global health, business, finance, innovation and governance. Attempt will be made to foster diversity with representation from academia, think tanks, public sector, private sector, practitioners, alongside early career researchers and students.

Are you interested in contributing a manuscript to this Research Topic?

Transforming Public-Private Partnerships for Primary Health Care: Navigating Emerging Realities in the Global South