Understanding perceptions and the willingness of decision-makers to adopt a public-private partnership strategy in the Palestinian health sector: an exploratory study

Public-private partnerships (PPPs) are an alternative global financing strategy. It emerged as a key driving strategy in the middle of this century, coinciding with a global health direction that focused on risk sharing. Exploring the readiness and preferences of Palestinian stakeholders toward partnerships offers important perspectives for shaping the future adoption of PPPs. This study employed qualitative methodology, including semi-structured interviews, to gain insight into decision-maker perceptions. Seventeen participants were interviewed, including three from the public sector, eight KIs from non-profit organizations, and six health care providers from the private sector or for-profit organizations. The thematic analysis method was used to analyze data at each stage. Data was transcribed and analyzed descriptively using Braun and Clarke’s (2006) thematic analysis approach. Four key themes emerged from the in-depth interviews conducted with a diverse group of decision-makers in the Palestinian healthcare sector: (1) The importance of conducting feasibility studies and economic evaluations prior to the decision to adopt PPPs (2) The investment environment and clarity of healthcare provider role(s) in the partnership (3) The strategic direction in implementing effective PPPs in the healthcare system (4) Operational challenges related to partnership patterns and structure. The decision to adopt PPPs in the Palestinian healthcare sector offers a promising avenue to enhance service delivery, improve financial sustainability, and address gaps in healthcare provision that might lead to advancing universal health coverage. However, the success of these partnerships is contingent upon a thorough understanding of the local context, including the economic, cultural, and political factors that influence healthcare delivery. Policymakers should prioritize feasibility assessments, establish clear governance structures, and design partnerships with social responsibility at their core.