CRITICAL SUCCESS FACTORS AND SUSTAINABILITY OF PUBLIC-PRIVATE PARTNERSHIP HEALTH PROJECTS IN UASIN GISHU COUNTY, KENYA
Main Article Content
Abstract
This study examined the critical success factors influencing the sustainability of Public–Private Partnership (PPP) projects in the health sector within Uasin Gishu County, Kenya. The research was guided by Transaction Cost Theory and Stakeholder Theory, focusing on how institutional frameworks, stakeholder engagement, financial management, capacity building, and technology adoption contribute to sustainable PPP health initiatives. The study adopted a descriptive research design, targeting key stakeholders involved in PPP health projects, including public officials, private partners, and health professionals. Data were collected using structured questionnaires and analyzed through descriptive and inferential statistics, including hierarchical regression analysis. The findings revealed that stakeholder engagement, financial management, and institutional frameworks are significant determinants of PPP project sustainability, with stakeholder collaboration exhibiting the strongest influence. Regression results showed that the inclusion of critical success factors increased the explanatory power of the model (R² = 0.327), although the overall model did not reach statistical significance (p > 0.05). Among demographic variables, cadre differences showed a notable effect, indicating variation in sustainability perception across professional categories. Despite the non-significant model, the findings underscore the strategic importance of structured collaboration, sound policy frameworks, and robust financial practices in sustaining PPP health projects. The study recommends harmonizing PPP policies, institutionalizing stakeholder engagement, diversifying financing mechanisms, and strengthening human resource and technological capacities. The results contribute to the growing body of knowledge on PPP sustainability in Kenya’s health sector and provide practical insights for policymakers, private investors, and healthcare managers seeking to enhance long-term project viability.
Article Details
References
Burke, R. (2023), Project Management-Planning and Control Techniques (Fourth Edition) Chichester: John Wiley & Sons Ltd.
Chepkonga, P., & Nyaga, J.G. (2019). Leadership Style, Culture and Service Delivery in Public Health Sector: A Case Study of Mbagathi District Hospital, Nairobi City County.
Chileshe, N., Kavishe, N., & Edwards, D. J. (2021). Identification of critical capacity building challenges in public-private partnerships (PPPs) projects: the case of Tanzania. International Journal of Construction Management, 23(3), 495–504. https://doi.org/10.1080/15623599.2021.1892947
Chileshe, Nicholas & Njau, Carol & Kiptoo, Brian & Macharia, Lyn & Kavishe, Neema. (2020). Critical success factors for Public-Private Partnership (PPP) infrastructure and housing projects in Kenya. International Journal of Construction Management. 22. 1-12. 10.1080/15623599.2020.1736835.
Cirolia, L. R. (2020) Fractured fiscal authority and fragmented infrastructures: Financing sustainable urban development in Sub-Saharan Africa. Habitat International, 10(4); 102- 123.
Dogan Erdem, T., Birgonul, Z., Bilgin, G., & Akcay, E. C. (2024). Exploring the Critical Risk Factors of Public–Private Partnership City Hospital Projects in Turkey. Buildings, 14(2), 498. https://doi.org/10.3390/buildings14020498
Edwards, Benjamin, Supreme Risk (August 18, 2021). Benjamin P. Edwards, Supreme Risk, 74 Fla. L. Rev. 543 (2022), Available at SSRN: https://ssrn.com/abstract=3907534 or http://dx.doi.org/10.2139/ssrn.3907534
Freeman, R. & Mcvea, John. (2001). A Stakeholder Approach to Strategic Management. SSRN Electronic Journal. 10.2139/ssrn.263511.
Ilesanmi OS, Afolabi AA. Sustainability of Donor-Funded Health-Related Programs Beyond the Funding Lifecycle in Africa: A Systematic Review. Cureus. 2022 May 1;14(5):e24643. doi: 10.7759/cureus.24643. PMID: 35663674; PMCID: PMC9156348.
Johnstone, R (2024): Regulation; Enforcement and Compliance
Kanakoudis, V., Papotis, A., Sanopoulos, A., & Gkoutzios, V. (2007). Crucial parameters for PPP projects successful planning and implementation (pp. 167-184).
Karnes, Y. (2020). Are There Optimal Forms of Public-Private Partnerships? Journal of Behavioral and Applied Management, 20 (2), 51-68.
Kenya Healthcare Federation (2024): Public Private Partnerships Committee of Kenya Healthcare Federation; defining PPP. https://khf.co.ke/public-private-partnership/
Khan, N. N., & Puthussery, S. (2019). Stakeholder perspectives on public-private partnership in health service delivery in Sindh province of Pakistan: a qualitative study. Public health, 170, 1–9. https://doi.org/10.1016/j.puhe.2019.02.004
Kim, J. H. (2019). Multicollinearity and misleading statistical results. Korean Journal of Anesthesiology, 72(6), 558. https://doi.org/10.4097/kja.19087
King’ori (2022): Stakeholders’ Participation and Performance of Medical Managed Equipment’s Services Project in Nairobi County, Kenya
Kirunga, J. N., & Nteere, K. K. (2024). Public Private Partnerships And Sustainability Of Healthcare Infrastructure Projects In Isiolo County, Kenya. International Journal Of Social Sciences Management And Entrepreneurship (Ijssme), 8(3).
Kolesnikov, Y. A., Pavlyuk, A. V., Radachinsky, Y. N., & Rodionova, N. D. (2018). Problems of implementation of public-private partnership in Russia.
Maosa (2019): factors influencing performance of public-private partnerships in healthcare provision in Kenya; the case of Nyamira County.
Miseda, J. O. (2020). Analysis of critical success factors for Health Public-Private Partnerships: A case of the Managed Equipment Services (MES) in Narok County [Thesis, Strathmore University].
Moore A, Bertotti M, Hanafiah A, Hayes D. Factors affecting the sustainability of community mental health assets: A systematic review. Health Soc Care Community. 2022 Nov;30(6):e3369-e3383. doi: 10.1111/hsc.13929. Epub 2022 Jul 28. PMID: 35900123; PMCID: PMC10087471.
Mutuku, K. M. (2023) The Contribution of Public-Private Partnership to Agribusiness in Kenya: A Case Study of Fruit Processing Enterprises. International Journal of Research and Innovation in Social Science, 7(3), 316-327.
Mwange, A. (2023). Determinants of Public-Private Partnership Success in The Health Sector in Zambia: Key Success Variables Analysis. Research Journal of Finance and Accounting. 14. 2023. 10.7176/RJFA/14-15-04.
Neuman, W. L. (2008). Social Research Methods: Qualitative and Quantitative Approaches. Istanbul: Yayinodasi.
Njoroge, M. W. (2019). Effect of Public Private Partnership on Efficiency of Healthcare Services Delivery in Kenyan Public Hospitals: A Case of Public Hospitals in Kiambu County (Doctoral dissertation, United States International University-Africa).
Nyakundi (2020): Stakeholder engagement and management as a determinant of health intervention outcomes: the varied messages communicated during HIV and aids interventions in Kisii county, Kenya. https://doi.org/10.1079/PAVSNNR202116029
Nzioka (2023): Influence of public-private partnership on healthcare service delivery in Nairobi County, Kenya.
Sadeghi, A., Barati, O., Bastani, P. et al. Feasibility of implementing public–private partnership (PPP) in the development of hospital services and optimizing resource allocation in Iran. Cost Eff Resour Alloc 18, 25 (2020). https://doi.org/10.1186/s12962-020-00221-z
World Bank. (2018, February). Public-Private Partnerships in Developing Countries: The Emerging Evidence-based Critique. Oxford University Press, 33(1).
World Bank (2024): Public-Private Partnership in Health https://ppp.worldbank.org/public-private-partnership/ppp-health
Xiaohong, L. (2023). Addressing Challenges and Enhancing Sustainability in Public Private Partnerships (PPPs) in China. Journal of Digitainability, Realism & Mastery (DREAM), 2(04), 24-28.