Facilitators and barriers of public-private partnerships for universal health coverage in sub-Saharan Africa: a scoping review.

Universal health coverage (UHC) provides a platform for attaining 'Health for All'. Attaining UHC requires substantial investment and resources in the health sector. This can be challenging for many sub-Saharan African (SSA) countries. Public-private partnerships (PPPs) could be a potential solution. The implementation of healthcare PPPs for developing health system capacities for UHC presents both significant opportunities and notable challenges. This scoping review, part of a broader review on PPPs, examines the facilitators and barriers of healthcare PPPs and their impact on UHC. The review was guided by Arksey and O'Malley's guidelines for conducting a scoping review. PubMed, Medline (Ovid), Global Health (Ovid), Web of Science, Scopus, and EconLit were searched for peer-reviewed English language publications from January 2013 to December 2023. Nineteen studies were eligible for the final analysis following screening of 944 studies. Identified key facilitators of PPPs for UHC included well-established institutional structures, robust accreditation systems, accountability mechanisms, and political will and support. These factors contributed to improving primary healthcare delivery, which is a critical dimension for UHC. Key barriers identified were limited capacity of implementing partners, regulatory inadequacies, and insufficient funds. These barriers negatively affected the performance of healthcare PPPs, which translates into systemic inequities in access to essential health services, impeding progress towards achieving UHC. Considering contract management capacity of implementers, sources and flow of funds, and regulatory frameworks are highly recommended for UHC to be realized using PPPs.