Enhancing Private Health Sector Preparedness in Oman: An Evaluation of Effective Public-Private Partnerships in Healthcare Disaster Management.

Abstract

The continuous increase in frequency of disasters, their overwhelming impact on public healthcare systems worldwide, and the resultant increasing demand to integrate the private sector into healthcare disaster management efforts, together demonstrate the importance of building effective Public Private Partnerships (PPPs). PPPs – largely developed in the West – provide a framework for integration and achievement of mutual benefits for both sectors. In addition, the Sendai framework for Disaster Risk Reduction 2015–2030, international organisations, and advocates for PPP, prioritise its adoption and recognise it as a promising future agenda. The extensive proliferation of PPP projects in developed countries, and PPP’s increasing popularity in developing countries, highlights the growing need to investigate the various aspects of their operation in order to ensure the achievement of their target outcomes. The thesis argues that existing literature to date does not sufficiently elucidate inter- organisational relationships (IORs) within PPPs and contends that understanding the relational alongside the structural and economic aspects of PPPs is key to managing them effectively. This thesis, a path-finding study in terms of Oman, addresses the gap in the literature by creating an analytical baseline for Oman, as a non-Western Middle East country, it employs a case study methodology with an exploratory qualitative approach to critically investigate the current situation of PPPs between public and for-profit private healthcare sectors, their underlying IORs, and the factors and challenges that can shape them. The broad aim of this research is to extend the research on PPPs in the healthcare DM in Oman and to examine whether the promise of PPPs, implied in theory and supported by literature, is relevant in the Omani context. Furthermore, this thesis proposes an integrative framework, derived from well-established literature, to guide data collection and analysis. The research finds that the organisational, contextual and motivational factors within a specific context could play a significant role in influencing PPPs and shaping their underlying IORs. Understanding the country context is essential for managing these factors and predicting the most effective PPP framework, with the best synergistic outcomes, for that specific context. Moreover, the thesis highlights the limitations of the current PPP situation in Oman. It stresses the importance of building a comprehensive framework that sets up the infrastructure for effective PPPs, and that mitigates limitations such as the lack of regulatory and financial frameworks, and deficiencies in preparedness within the private sector. The empirical findings of this research predict that effective PPPs could be attained for the Omani context, within its hierarchical governance structure setting, with contractual IORs, their asymmetrical balance and a repetitive cyclical flow of process. The thesis calls for attention to the categorisation and classification of PPP arrangements in order to provide greater understanding into alternative types of PPPs. Finally, it provides empirical evidence on the applicability of PPPs to the developing country context, and therefore contributes to extending the spectrum of PPP research.