Public-private partnerships : a qualitative approach to prospects for pharmacy in the South African health care environment

Abstract

BACKGROUND: Powerful public-private partnerships (PPPs) can only be established if the partners are able to deal with complexity. Such partnerships may serve to stimulate local community and economic development. Thus, it may maximise the effectiveness of local groups and resources in meeting the needs for rebuilding a community through a partnership representative of the public and private sectors. A problem that exists in South Africa, is the uneven distribution of population ratios dependent on public and private sector health care service delivery, in relation to the proportion of pharmaceutical service providers in the different sectors. OBJECTIVE: The main objectives of this qualitative research investigation were to examine the prospects for PPP development in the pharmaceutical sector of South Africa as well as to explore the possibilities of a proposition for a proposed generic public-private partnership model to be managed and used in the pharmaceutical sector of South Africa. METHOD: The study comprises of the exploration of the research questions by means of a qualitative research design. The study design implicated a balance between the in-depth literature study and a qualitative research process. The researcher employed a grounded theory approach to collect and analyse the data. Data collection represented the identifiable role players and opinion formulators in the South African health care sector. By following a combination of the various qualitative sampling methods and techniques, a total of 38 (n=38) interviews were conducted. The data collected from the interviewees and from the literature study were integrated and analysed by making use of computer assisted data analysis. SETTING: The researcher selected interviewees from the South African health care sector. The interviews included role players in the pharmaceutical sector in both the public and private sectors. The interviewees further represented eight different spheres of the pharmaceutical setting in South Africa. KEY FINDINGS: The investigation identified a range of prospects for PPP development in South Africa and these were reported in terms of views, expectations and scope for success. The management elements for developing and sustaining joint ventures between the public and private sectors were identified and a proposition was formulated in theory to serve as a proposed generic PPP model (PGM) in the pharmaceutical sector for the South African health care milieu. CONCLUSION The exploratory qualitative investigation surfaced the various facets of the complexity of PPPs. The investigation concluded that several barriers, such as competition and market entry disparities between the macro and micro level pharmaceutical entities, which impede PPP development, affected the prospects for PPP development in South Africa. The South African legislation, South African Treasury guidelines, regulations and the views of the SA Competition Commission need transformation to accommodate both the micro and macro level pharmaceutical service providers in the formation of PPPs. Capacity building within the sphere of pharmaceutical service delivery to the bigger population of South Africa may become sustainable on removal of these barriers. A series of recommendations were presented and several critical issues in need of supplementary research, have been identified.