South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

译文

南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标,但经验仍然有限,而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素,并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实,国家需要制定有效的法规,以监督质量和标准,并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系,而且还需要创新和实验。评估是所有互动的组成部分,不仅要从成功中学习,而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明,私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础,在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。

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