Book contents
- Reviews
- Duality by Design
- Duality by Design
- Copyright page
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Acknowledgements
- 1 Duality by Design: The Global Race to Build Africa’s Infrastructure
- Part I Mitigating Institutional Voids by Design
- 2 Why the Lights Went Out: A Capability Perspective on the Unintended Consequences of Sector Reform Processes
- 3 When the Quest for Electricity Reform and the Need for Investment Collide: South Africa, 1998–2004
- 4 Institutional Enablers of Energy System Transition: Lessons from Solar Photovoltaic Electricity in Eight African Countries
- 5 Harnessing Africa’s Energy Resources through Regional Infrastructure Projects
- 6 Centralized vs. Decentralized Generation in Zambia: Meeting Electricity Demand in the Context of Climate Change
- 7 Delivering Healthcare Infrastructure and Services through Public–Private Partnerships: The Lesotho Case
- 8 Achieving Long-Term Financial Sustainability in African Infrastructure Projects
- 9 A Proactive Social Infrastructure Model for Future Mixed-Use Housing in Egypt
- 10 Collective Action under the Shadow of Contractual Governance: The Case of a Participatory Approach to Upgrade Cairo’s ‘Garbage Cities’
- Part II Exploiting Institutional Voids by Design
- Afterword
- Index
- References
7 - Delivering Healthcare Infrastructure and Services through Public–Private Partnerships: The Lesotho Case
from Part I - Mitigating Institutional Voids by Design
Published online by Cambridge University Press: 14 November 2019
Book contents
- Reviews
- Duality by Design
- Duality by Design
- Copyright page
- Contents
- Figures
- Tables
- Contributors
- Foreword
- Acknowledgements
- 1 Duality by Design: The Global Race to Build Africa’s Infrastructure
- Part I Mitigating Institutional Voids by Design
- 2 Why the Lights Went Out: A Capability Perspective on the Unintended Consequences of Sector Reform Processes
- 3 When the Quest for Electricity Reform and the Need for Investment Collide: South Africa, 1998–2004
- 4 Institutional Enablers of Energy System Transition: Lessons from Solar Photovoltaic Electricity in Eight African Countries
- 5 Harnessing Africa’s Energy Resources through Regional Infrastructure Projects
- 6 Centralized vs. Decentralized Generation in Zambia: Meeting Electricity Demand in the Context of Climate Change
- 7 Delivering Healthcare Infrastructure and Services through Public–Private Partnerships: The Lesotho Case
- 8 Achieving Long-Term Financial Sustainability in African Infrastructure Projects
- 9 A Proactive Social Infrastructure Model for Future Mixed-Use Housing in Egypt
- 10 Collective Action under the Shadow of Contractual Governance: The Case of a Participatory Approach to Upgrade Cairo’s ‘Garbage Cities’
- Part II Exploiting Institutional Voids by Design
- Afterword
- Index
- References
Summary
Many governments in Africa are establishing public–private partnerships (PPPs) to provide healthcare infrastructure and services. We know very little about how healthcare PPPs are planned and implemented in Africa, and even less about the associated outcomes. This paper begins to address this gap through a detailed case study of an innovative, ambitious and complex partnership contract in Maseru, Lesotho. The scheme has been labelled ‘the future of healthcare delivery on the African continent’ and encompasses the design, build, partial financing and full operation of a new hospital facility alongside a wide range of core clinical services. This chapter draws on documentary data to evaluate the main features of the contract, the procurement process and monitoring arrangements and the outcomes in terms of benefits and costs. A key finding is that payments to the private operator are far higher than was expected pre-contractually, and have become a major source of budgetary uncertainty, as well as a demanding call on government’s healthcare resources. We conclude that successful social infrastructure PPPs in Africa will require considerable investments in contract management skills, strong budgeting institutions and mechanisms, and enhanced (and more independent) scrutiny of plans and forecasts of financial impacts.
- Type
- Chapter
- Information
- Duality by DesignThe Global Race to Build Africa's Infrastructure, pp. 203 - 226Publisher: Cambridge University PressPrint publication year: 2019
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