Public Partnerships Research Articles

Evaluating the Implementation of Public-Private Partnerships (PPPs) for Housing Provision in Nigeria: A Case Study of Niger State

Public-Private Partnerships (PPPs) is a joint effort by the public and private sector for the financing, development, operation, and or ownership of public housing and infrastructure. The rapid increase in population and urbanization in Nigeria has resulted in a housing deficit of about 17-23 million. Mortgage financing which is the predominant means of funding housing eludes the low income earners due to their inability to access mortgage facilities. This paper evaluated the implementation of Public-Private Partnerships (PPPs) as an option for public housing delivery in Nigeria using Niger State as a case study. Questionnaires were administered to 200 built-environment professionals in public and private sectors in Niger State and interview was conducted with NSPPPA officials on project conception and management. Official reports and guidance documents on PPP implementation for housing were also reviewed. The responses to the questions were categorized into political, project, financial, and environmental factors and the mean score of responses to each question were calculated before calculating the mean score of each category. Political (4.28) and project (4.24) factors were found to have the greatest influence in implementing PPPs in Niger State. Interview and document reviews also revealed that out of eight housing projects conceived under the Niger State PPP program in 2013 only four were implemented. Of the four implemented projects, two were completed while two were delayed due to lack of funds and disagreements between public and private sector partners. The study recommends among others that all stakeholders in Nigeria’s housing sector should work together to realize the goal of PPPs in housing as stated in the New National Housing and Urban Development Policy (NNHUDP) of 2002 and that government should focus more on the provision of housing for the low income earners as they are the most affected by the housing problem in Nigeria.

Online environments and women's health: an industry-academic public health research partnership to improve health inequities.

Online environments and women's health: an industry-academic public health research partnership to improve health inequities.

Derisking Developmentalism: A Tale of Green Hydrogen

ABSTRACTIn the global race to scale up green hydrogen, a renewed appetite for the visible hand of the state once again promises to expand developmental space for low‐ and middle‐income countries. On the African continent, several countries have announced green industrialization ambitions that rely on mobilizing, through various ‘derisking’ schemes, private (institutional) capital looking for investible opportunities. To examine the transformative potential of this new derisking developmentalism, this article extends the critical macrofinance lens to include Thandika Mkandawire's theorization of post‐independence African developmental states. Using Namibia as an illustration, it argues that an assumption of ‘divine coincidence’ creates the ideological space for the state to forge derisking blocs but structurally weakens its ability to discipline private capital into pursuing green industrialization. As (foreign) capital dominates the state‒capital relationship in derisking developmentalism, the new green rules written by powerful investors and global North governments threaten to transform global South countries into consumers of green hydrogen technology and generators of yield for portfolio investors, thus reinforcing the structural drivers of their ongoing external debt vulnerabilities. Instead, countries should experiment with green public ownership and partnerships that discipline local green industries. Such strategies require replacing the Wall Street Consensus with a supportive global macrofinancial framework the authors call ‘Green Bandung Woods’.

TAFSIR HERMENEUTIKA INTENSIONALISME DALAM PENERAPAN APLIKASI ATLAS

This study aims to determine the meaning of using the Audit Tools and Archives System (ATLAS) application as a financial statement auditing tool, involving Intentional hermeneutics to analyze findings based on historical context, the cultural context in the correlated and explored "text" from which the interpreter tries to interpret the meaning of respective utterances and the language used by the informer utilizing the ATLAS application. Informants in this study include the Managers and Auditor Staff of Thoufan and Rosyid Public Accountants and Partners (Partners) of Achsin Handoko Tomo Public Accounting Firm. The results exhibit that ATLAS presents a complex mapping. The brainchild of ATLAS due to the audit failure cases in Indonesia resulting from a lack of risk assessment/detection in audits has made the Public Accounting Firm implement the ATLAS application. As such, the complexity of the application makes it difficult to implement asthe staffing culture at the Public Accounting Firm causing an imbalance between workload and audit fees for implementing the application.

Implementasi Peran Public Relation Dalam Membangun Reputasi PT Cakrawala Dinamika Energi

This study aims to determine the implementation of the role of public relations in building the reputation of PT Cakrawala Dinamika Energi. This study uses the role theory of public relations (Cutlip 2002: 46) which consists of four roles, namely: communication technician, expert presciber, communication facilitator, and problem solving facilitator and the type of research used is qualitative research. The results of the study show that there are four public relations roles that support the implementation of the public relations role in building the reputation of PT Cakrawala Dinamika Energi, namely the first role of public relations as a communications technician is to build good communication between the public, internal, external and company partners, this is important to prevent adverse impact on the company's reputation in the event of a problem. Second, the role of public relations as an expert presiber is to liaise with a structured public relations department to communicate with the public if there are problems. Third, the role of public relations as a communication facilitator is as an intermediary who maintains a two-way flow of communication between the company and its public, including internal and external. And Fourth, problem solving facilitators in public relations must understand company policies, products, and procedures. The right communication strategy is needed so that the problem has a solution without hurting anyone's feelings.

Starting a conversation about estimands with public partners involved in clinical trials: a co-developed tool

BackgroundClinical trials aim to draw conclusions about the effects of treatments, but a trial can address many different potential questions. For example, does the treatment work well for patients who take it as prescribed? Or does it work regardless of whether patients take it exactly as prescribed? Since different questions can lead to different conclusions on treatment benefit, it is important to clearly understand what treatment effect a trial aims to investigate—this is called the ‘estimand’. Using estimands helps to ensure trials are designed and analysed to answer the questions of interest to different stakeholders, including patients and public. However, there is uncertainty about whether patients and public would like to be involved in defining estimands and how to do so. Public partners are patients and/or members of the public who are part of, or advise, the research team. We aimed to (i) co-develop a tool with public partners that helps explain what an estimand is and (ii) explore public partner’s perspectives on the importance of discussing estimands during trial design.MethodsAn online consultation meeting was held with 5 public partners of mixed age, gender and ethnicities, from various regions of the UK. Public partner opinions were collected and a practical tool describing estimands, drafted before the meeting by the research team, was developed. Afterwards, the tool was refined, and additional feedback sought via email.ResultsPublic partners want to be involved in estimand discussions. They found an introductory tool, to be presented and described to them by a researcher, helpful for starting a discussion about estimands in a trial design context. They recommended storytelling, analogies and visual aids within the tool. Four topics related to public partners’ involvement in defining estimands were identified: (i) the importance of addressing questions that are relevant to patients and public in trials, (ii) involving public partners early on, (iii) a need for education and communication for all stakeholders and (iv) public partners and researchers working together.ConclusionsWe co-developed a tool for researchers and public partners to use to facilitate the involvement of public partners in estimand discussions.

One Health in Turkana County, Kenya: Applications and Lessons Learned

Abstract Pastoralists contribute to social, environmental, and economic well-being in the drylands of Northern Kenya. Pastoralism is also their way of life and how they manage their livelihoods. However, the marginalization of these communities, including the lack of basic infrastructure and services, compounded by the increasing threat of infectious disease and climate change, has led to the loss of livelihoods and poor health. One Health service delivery can improve pastoralists’ health and livelihoods. This case examines the development of the One Health policy in Turkana County, Kenya. The Turkana One Health Strategy (TOHS) is undergoing final approval. We discuss the contributions of the One Health Strategic Plan for the Prevention and Control of Zoonotic Diseases in Kenya, the One Health framework for integrated service delivery, and the Kimormor outreach model to this plan. We also describe recent One Health activities in Turkana and identify the benefits and limitations of each. One Health service delivery improved access to human health, animal health, and administrative services in rural, hard-to-reach areas in Turkana. Empowering communities to lead and take ownership of One Health activities is critical for implementation. One Health service delivery has some limitations, such as being resource and time intensive and being a relatively new concept in healthcare. Turkana County provides a valuable example of how One Health policy turns into practice through multilevel coordination structures, the support of public and private partners, and transdisciplinary research. It can act as a model for implementing One Health activities in Northern Kenya and other countries. Information © The Authors 2023

Public Partnership and Performance of Smart Cities in Malaysia

This study was conducted to explore the relationship between the public partnership with the performance of smart cities in Malaysia. About two hundred (200) respondents identified via LinkedIn and a link to the survey were shared via LinkedIn. About eighty-seven (87) responded to the survey. The questionnaires divided into two parts which are part A is on the respondent profiles, and part B is on government institutions (local level) (10 items), government agencies (14 items), and smart city performance (34 items). A reliability analysis was performed using the SPSS software, and the Cronbach’s Alpha scores for the three (3) variables are high with a score of more than 0.900. The results of the correlation analysis indicated that there are positive and significant relationships between GIL, GA, and SP. The relationship between GIL with SP is a weak correlation (r=0.290**; p=0.006), GA with SP is a moderate correlation (r=0.517**; p=0.000), and the relationship between GIL and GA is a strong relationship (r=0.695**; p=0.000). Hence, it can be assumed that the residents at smart city in Malaysia agreed that the government at the local level and government agencies have an influence on the performance of the smart city.

Third sector provision of dementia support in the community: results from a scoping exercise of charity involvement in the UK

Third sector dementia support is characterised by wide variation and a heavy reliance on volunteer engagement. While there has been a growth in the reach and diversity of different schemes, their short-term funding results in a loss of networks, collaborations and local knowledge. This practice paper reflects on strengthening community-based dementia support and care via public and third sector partnerships. National and local data sources could help charities and commissioners begin to identify inequalities of provision.

Securing containerized supply chain through public and private partnership

Global trade is seafaring commerce; 90% of traded goods are carried by maritime transport, which has become vulnerable to security risks. This has led governments to initiate security programs serving tens of thousands of members worldwide. This paper studies the government's incentive design and the interaction between Customs inspection capacity and the incentives offered in security programs. Using the theory of incentives, we investigate the value of a partnership in improving the security of containerized supply chain. We developed a sequential game featuring the government, firms, and an adversary. The government selects the inspection capacity and incentives to foster the partnership, namely, an operational benefit in the form of a reduced inspection rate, and a security benefit obtained through reductions in the risks of adversarial infiltration. Firms subsequently decide on a collaboration level, followed by a strategic adversary's decision to infiltrate. Using the adversary's best response, we show that, in equilibrium, the government ranks all the firms and induces collaboration with only a subset of them. We demonstrate that, in equilibrium, while security incentives may benefit all participants, tailored operational incentives should be offered strictly to foster collaboration. The required condition to implement the inspection‐free lane for members is also characterized. Our results also inform practice to help security policymakers understand the underlying interaction between Customs inspection capacity and incentive design in forging collaboration with private firms. In particular, as firms opting for collaboration experience lower inspection rates, this further reduces overall congestion, which, in turn, creates a positive externality for nonmember firms. Therefore, having an excess inspection capacity may result in shorter wait times that could dissuade firms from collaborating.

Supporting Evidence-Based Care Through Informatics Innovation to Address the Overdose Epidemic.

Supporting Evidence-Based Care Through Informatics Innovation to Address the Overdose Epidemic.

Improving data collection in pregnancy safety studies: Towards standardization of data elements in pregnancy reports from public and private partners (ConcePTION)

Improving data collection in pregnancy safety studies: Towards standardization of data elements in pregnancy reports from public and private partners (ConcePTION)

A Qualitative Assessment of Clinical Practice Guidelines and Patterns for Congenital Cytomegalovirus in the United States.

Cytomegalovirus (CMV) infection during pregnancy may result in long-term health problems for children with congenital CMV (cCMV). Currently, no prevention or treatment interventions are approved by the Food and Drug Administration for a cCMV indication. Healthcare provider and public awareness is low, and formal clinical practice guidelines and local practice patterns vary. A pilot study of eight cCMV experts was performed using qualitative semi-structured interviews to better understand clinical practice guidelines and patterns in the United States. Results from participant interviews highlighted the need for better prenatal diagnostic techniques, broader neonatal screening opportunities, and more robust evidence supporting intervention strategies. Healthcare provider and public partnerships are essential for advancing cCMV guidelines and improving care delivery. Our results provide a preliminary knowledge base and framework for developing a consensus cCMV research agenda to address evidence gaps that limit the revision of clinical practice guidelines. The changes in clinical practice patterns that may arise as a result of further research have the potential to reduce risk during pregnancy and improve care for children with cCMV infection.

MHealth to improve implementation of TB contact investigation: a case study from Uganda

BackgroundImplementation science offers a systematic approach to adapting innovations and delivery strategies to new contexts but has yet to be widely applied in low- and middle-income countries. The Fogarty Center for Global Health Studies is sponsoring a special series, “Global Implementation Science Case Studies,” to address this gap.MethodsWe developed a case study for this series describing our approach and lessons learned while conducting a prospective, multi-modal study to design, implement, and evaluate an implementation strategy for TB contact investigation in Kampala, Uganda. The study included formative, evaluative, and summative phases that allowed us to develop and test an adapted contact investigation intervention involving home-based sample collection for TB and HIV testing. We concurrently developed a multi-component mHealth implementation strategy involving fingerprint scanning, electronic decision support, and automated reporting of test results via text message. We then conducted a household-randomized, hybrid implementation-effectiveness trial comparing the adapted intervention and implementation strategy to usual care. Our assessment included nested quantitative and qualitative studies to understand the strategy’s acceptability, appropriateness, feasibility, fidelity, and costs. Reflecting on this process with a multi-disciplinary team of implementing researchers and local public health partners, we provide commentary on the previously published studies and how the results influenced the adaptation of international TB contact investigation guidelines to fit the local context.ResultsWhile the trial did not show improvements in contact investigation delivery or public health outcomes, our multi-modal evaluation strategy helped us identify which elements of home-based, mHealth-facilitated contact investigation were feasible, acceptable, and appropriate and which elements reduced its fidelity and sustainability, including high costs. We identified a need for better tools for measuring implementation that are simple, quantitative, and repeatable and for greater attention to ethical issues in implementation science.ConclusionsOverall, a theory-informed, community-engaged approach to implementation offered many learnings and actionable insights for delivering TB contact investigation and using implementation science in low-income countries. Future implementation trials, especially those incorporating mHealth strategies, should apply the learnings from this case study to enhance the rigor, equity, and impact of implementation research in global health settings.

Understanding absences and ambiguities of Post-decision Project Evaluation in the UK's PPPs: drawing from the sociology of ignorance

PurposeThe authors explore the under-researched area of post-decision evaluation in PPPs (public–private partnerships), focusing upon how and whether Post-decision Project Evaluation (PdPE) is considered and provided for in United Kingdom (UK) public infrastructure projects.Design/methodology/approachThe authors’ research design sought insights from overviewing UK PPP planning and more focused exploration of PPP operational practice. The authors combine the extensive analysis of planning documents for operational UK PPP projects with interviews of different stakeholders in PPP projects in one city. Mobilising an open critical perspective, documents were analysed using ethnographic content analysis (ECA) and interviews were analysed using thematic analysis consistent therewith. The authors theorise the absence and ambiguities of PdPE drawing on the sociology of ignorance.FindingsThe authors find a long-standing absence and lack of PdPE in PPP projects throughout planning and operational practice, reflecting a dynamic, multi-faceted ignorance. Concerning planning practice, the authors’ documentary analysis evidences a trend in PdPE from its absence in the early years (which may indicate some natural or genuine ignorance) to different levels or forms of weak inclusion later. Regarding this inclusion, the authors find strategic ignorance played a substantive role, involving “deliberate engineering” by both public sector and private partners. Interview findings indicate lack of clarity over PdPE and its under-development in PPP practice, deficiencies again suggestive of natural and strategic ignorance.Originality/valueThe authors draw from the sociology of ignorance vis-à-vis accounting's absence and ambiguity in the context of PPP, contributing to an under-researched area.

Political Influences of Stakeholders on Early Termination of Public-Private Partnerships: A Study on China’s Toll Road Projects

As a policy innovation for public goods delivery, public-private partnership (PPP) faces great risks in developing countries, and many projects have been terminated before the contract expiry date. This study explores how key stakeholders of the government that is responsible for PPP development, including the upper-tier government, the public, and business partner, can exert political influences through institutional ways over the fate of PPP projects. It argues that political pressures from the upper-tier government and the public, together with political relationship between the government and its business partner, determine whether the government would terminate its PPPs ahead of schedule. Empirically, this study investigates toll road PPP experiences in China. A qualitative comparative analysis (QCA) of 57 toll projects suggests the complexity of causal effect of political factors. In total, the factors of political pressures and political relationship form three pathways to PPP early termination.

THE RED FLAG OF EMERGENCY USE AUTHORIZATION (EUA)

The Emergency Use Authorization (EUA) policy, a representative biodefense policy, was legislated in the United States in 2001 based on lessons learned from Amerithrax, whereas Korea's EUA policy was based on lessons learned from the Middle East Respiratory Syndrome outbreak in 2015. Due to these divergent origins, the U.S. EUA's homeland security objectives were specialized to deal with highly pathogenic biological agents that could be exploited for bioterrorism, whereas the Korean EUA pursues disease containment purposes to strengthen mass‐testing practices. During the early phase of the COVID‐19 pandemic, the U.S. EUA revealed limitations in its integration with public health surveillance, laboratory partnerships, and insurance systems, which hampered the rapid expansion of testing capacities. Thereafter, once the limitations of the EUA were circumvented, the testing capacity of the United States began to catch up with that of South Korea, and later skyrocketed after solving these issues.

New Delhi metallo-β-lactamase–producing Escherichia coli among dogs at an animal rescue facility—Wisconsin, 2022

Background: New Delhi Metallo-β-lactamase (NDM)–producing Escherichia coli are highly resistant organisms that spread quickly. In the United States, organisms with blaNDM are rare and mostly associated with healthcare settings. However, in other countries, blaNDM can be relatively common and are found in community settings. State veterinary and public health partners detected NDM E. coli in a dog from Iran living at a Wisconsin animal rescue facility (ARF), where 40% of dogs had international origins. We investigated to determine spread among dog and human contacts and prevent further transmission. Methods: We screened dogs and humans at the ARF, a local veterinary clinic (clinic A), and ARF staff homes (homes A and B) for colonization with blaNDM. We reviewed veterinary records and conducted a case–control analysis to identify risk factors for blaNDM acquisition among dogs. We evaluated ARF infection control practices. Screening specimens that were positive for blaNDM were cultured. We conducted an analysis of short- and long-read whole-genome sequencing data to evaluate isolate relatedness. We compared NDM E. coli sequences from dogs to all NDM E. coli sequences from humans collected in Wisconsin and nearby states. Results: Screening identified blaNDM colonization in 27 (37%) of 73 ARF dogs and 4 (56%) of 7 dogs in home A, but not in ARF or staff in clinic A. Among ARF dogs with blaNDM, 20 (74%) 27 had international origins and 22 (81%) had ≥1 medical condition. Dogs sharing the same space (OR, 5.1; 95% CI, 1.8–14.7) were associated with blaNDM acquisition. We observed high animal density, soiled environments, and insufficient hand hygiene. ARF staff wore workwear and work shoes off site, including to home A. Sequencing identified 3 multilocus sequence types (STs) using the Achtman scheme among 27 isolates with blaNDM-5. Most isolates were ST361 (20 of 27, 74%) followed by ST167 (6 of 27, 22%) and ST1163 (1 of 27, 4%). Within-MLST cluster variability was <1–3 high-quality single-nucleotide variant differences, each harboring a ST-specific plasmid with blaNDM-5. No NDM-E. coli sequences from humans appeared related. Conclusions: Investigation of a single isolate led to identification of widespread NDM-E. coli transmission among dogs at an ARF. There were multiple NDM E. coli introductions to the ARF, likely by dogs of international origin. Poor hygiene contributed to transmission among ARF dogs and to dogs outside the ARF. Transmission of blaNDM-5 at the ARF and offsite spread to home A demonstrate the potential for unrecognized community sources to disseminate NDM E. coli in community settings. Strategies and lessons learned from interventions to prevent antibiotic resistance in human healthcare settings may inform and support prevention in animal care.Disclosures: None

An interactive patient transfer network and model visualization tool for multidrug-resistant organism prevention strategies

Background: The CDC’s new Public Health Strategies to Prevent the Spread of Novel and Targeted Multidrug-Resistant Organisms (MDROs) were informed by mathematical models that assessed the impact of implementing preventive strategies directed at a subset of healthcare facilities characterized as influential or highly connected based on their predicted role in the regional spread of MDROs. We developed an interactive tool to communicate mathematical modeling results and visualize the regional patient transfer network for public health departments and healthcare facilities to assist in planning and implementing prevention strategies. Methods: An interactive RShiny application is currently hosted in the CDC network and is accessible to external partners through the Secure Access Management Services (SAMS). Patient transfer volumes (direct and indirect, that is, with up to 30 days in the community between admissions) were estimated from the CMS fee-for-service claims data from 2019. The spread of a carbapenem-resistant Enterobacterales (CRE)–like MDROs within a US state was simulated using a deterministic model with susceptible and infectious compartments in the community and healthcare facilities interconnected through patient transfers. Individuals determined to be infectious through admission screening, point-prevalence surveys (PPSs), or notified from interfacility communication were assigned lower transmissibility if enhanced infection prevention and control practices were in place at a facility. Results: The application consists of 4 interactive tabs. Users can visualize the statewide patient-sharing network for any US state and select territories in the first tab (Fig. 1). A feature allows users to highlight a facility of interest and display downstream or upstream facilities that received or sent transfers from the facility of interest, respectively. A second tab lists influential facilities to aid in prioritizing screening and prevention activities. A third tab lists all facilities in the state in descending order of their dispersal rate (ie, the rate at which patients are shared downstream to other facilities), which can help identify highly connected facilities. In the fourth tab, an interactive graph displays the predicted reduction of MDRO prevalence given a range of intervention scenarios (Fig. 2). Conclusions: Our RShiny application, which can be accessed by public health partners, can assist healthcare facilities and public health departments in planning and tailoring MDRO prevention activity bundles.Disclosures: None

Oregon Project Firstline: A needs assessment of healthcare personnel infection prevention knowledge and training preferences

Background: Infection prevention and control (IPC) competency is critical for healthcare personnel (HCP) and patient safety. In collaboration with the CDC new national IPC training collaborative called Project Firstline, the Oregon Health Authority’s (OHA) Healthcare Associated Infection (HAI) Program established a state-level program in 2021. The goal of Oregon Project Firstline is to provide relevant, accessible, and engaging IPC training materials for our state’s HCP. We assessed the IPC learning needs of Oregon’s healthcare workforce, and to understand the preferred methods and formats of training across the various HCP roles. Methods: OHA’s HAI program recruited HCP by distributing electronic surveys through multiple healthcare, regulatory, and public health partners’ email listservs and HCP-targeted newsletters. Survey responses were recorded from September 23 to December 10, 2021. The HAI program assessed respondents’ IPC knowledge, online and in-person job training preferences, frequently used training devices, and trusted sources for IPC information. An individual’s understanding of an IPC topic was categorized based on their self-assessed confidence in their knowledge and ability to teach the topic to others. In total, 6,382 surveyed responses were analyzed. Results: The average understanding among HCP was lowest in IPC topics relating to triage and isolation of contagious patients and fit testing of respiratory protection devices. For these topics, 3,208 HCP (66.21%) and 3,657 HCP (75.48%) HCP, respectively, did not understand the topic well enough to teach others (Fig. 1). The highest number of HCP (n = 2,512, 39.36%) requested additional training in methods on how to educate others about IPC topics (ie, “train the trainer”). Surveyed respondents most frequently used personal computers for job trainings in both work and at-home settings (n = 4,603, 72.12%) and 3,437 HCP (53.85%) were open to either in-person or remote formats for job education. The CDC and OHA were the most frequented and trusted IPC sources among surveyed HCP: 4,124 HCP (64.62%) and 3,584 HCP (56.16%), respectively. Conclusions: IPC is a critical topic in HCP training across all healthcare facility types and employee roles. Effective educational planning includes understanding the learners’ knowledge needs and preferred methods of learning. Our learning needs assessment identified important IPC knowledge gaps and will help ensure that our training courses will be offered in effective educational formats for Oregon’s diverse HCP. Future training will include appropriate triage of potentially infectious patients, respiratory fit testing, and general IPC “train the trainer” sessions. Additionally, we will offer both in-person and remote options.Disclosures: None