Deterrents and predictors of implementation of public private participation in primary health care

Objectives: Public-private partnerships are a new way of thinking about promoting community health, which can lead to increased efficiency, equity, accountability, quality and accessibility throughout the health system. Resource constraints, high costs, and low quality of services have forced health officials and policymakers to reform, including the active participation of the private sector in the provision of primary health care. Therefore, considering the importance of the subject of this study, we aimed to determine the impediments and proponents of the implementation of public private participation in primary health care. Materials and methods: This descriptive study was conducted on a sample of 100 managers, policymakers, operational experts in the Ministry of Health, universities of medical sciences, health networks, and managers of private companies in the field of health services. It was done in 2020. Data were collected using a standard questionnaire on a 5-point Likert scale, to determine qualitative and qualitative content validity from the opinions of 10 professors and experts, and quantitative validity was determined with CVI, CVR = 0.95, and reliability of the questionnaire with Cronbach's alpha = 0.8, respectively. SPSS software version 21 was used for data analysis. Findings: The results of this study showed that the average health record of practitioners is 21 +/- 6.2 years, 80% have a PhD, 90% are in the public sector and 10% are in the private sector. The average score of inhibitors of public private Participation -sector implementation is 93.18 and the average of the public-private Participation sector implementation factors is 53.62. Health managers view "lack of capacity to define incentives and exemptions in health investment plans, lack of investor confidence in government technical and financial studies, lack of sustained funding to support the purchase of guaranteed primary health care and incorrect device managers" Implementation of legal effects on project outsourcing and fear of consequences of outsourcing "are the most important barriers to participation. Factors such as "reinforcing the ongoing oversight and follow-up of health projects by the Ministry of Health, modifying the original use / multipurpose of the project with the aim of attracting investors, enabling private sector funding in collaborative contracts, and encouraging and punishing appropriate medical universities based on Performance appraisal in project outsourcing is the most important factor driving the implementation of partnerships with the private sector. Conclusion: The results of this study showed that "lack of capacity to define incentives and exemptions in health investment plans, investor uncertainty about government-funded technical and financial studies is the most significant deterrent to participation." Strengthen surveillance and follow-up of health project assignments. From the Ministry of Health, changing the main user / multipurpose project with the aim of making it attractive to investors is the most important factor driving public- private partnerships.