PPP Projects in the Healthcare Sector

PPP Projects in the Healthcare Sector of Nigeria: Key Commercial Considerations

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PPP Projects in the Healthcare Sector of Nigeria

PPP Projects in the Healthcare Sector in Nigeria is quite lacking as The Nigerian health sector is battling with poor infrastructure, poor equipment, poor funding and low staff capacity.

In fact, in 2021, World Health Organisation survey ranks Nigeria’s healthcare system as the fourth worst in the world.

For 2020, the Federal Government allocated just 4.14% (N427.3 billion) of the budget to healthcare, despite being a signatory to the Abuja Declaration since 2001, where countries pledged to allocate at least 15% of their annual budget to improve the health sector.

Currently, the regulatory mechanisms for health service delivery, quality assurance management and distribution of commodities such as drugs, vaccines, and equipment are largely ineffective. Services in public and private sectors frequently all below acceptable standards. In some cases, the lack of effective regulation is resulting in people receiving (and paying for) treatment of little or no therapeutic value; even worse, some are exposed to dangerous products and practices, and are thereby suffering harm.

Health Care Delivery in Public and Private Sector

Health care delivery in the public sector is currently highly bureaucratized, undermining effective delivery of services, professional ethos, job performance, and morale.

In the private sector, the cost of care is unaffordable to a large percentage of the people, and very high for those who could even afford such services. As a result, the populace is unsatisfied with services provided in both public and private facilities. These birthed the need of PPP Projects in the Healthcare Sector of Nigeria.

The introduction of PPP Projects

The introduction of PPP Projects in the Healthcare Sector of Nigeria was made possible through the National Policy on Public-Private Partnership for Health adopted by the Federal Government in 2005. The policy was introduced as a reform to address the deplorable national health profile as evidenced by poor infant and maternal mortality rates, and low life expectancy.

Brickstone_Renegotiation of PPPs

PPP Projects in the Healthcare Sector

PPPs are defined as a broader partnership between private
contractors and government, in which the common characteristics
are that the public sector contracts (usually on a long-term basis)
with the private sector for the provision of a public service.
Historically, governments have engaged the private sector to deliver
services through healthcare PPPs to achieve one or more of six

  • Finance – financing or co–financing of the project
  • Design – design of the project, including design of the infrastructure and care delivery model
  • Build – construction or renovation of facilities included in the project
  • Maintain – maintenance of hard infrastructure (facilities as well as equipment as applicable)
  • Operate – supply of applicable equipment, IT and management/delivery of nonclinical services
  • Deliver – delivery and management of specified clinical and clinical support services.

PPP Projects in the Healthcare Sector will improve Health systems as there will need for them to become more integrated, addressing
care needs across the continuum, while utilizing technology to
enhance delivery.

Models of PPP Projects in the Healthcare Sector are adapting to these changes. Where early PPPs
focused on building and replacing critically-needed hospital
infrastructure, integrated PPPs were the next evolution, adding
clinical service delivery and private sector management practices to
improve the quality of care delivered, as well as access to specialty

In addition to the above, this White Paper prepared by the Brickstone Africa Team, in much more detail explains a Public-Private Partnership in Healthcare and why it typically arises. 


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