Question 1 (25 Marks)

Discuss the main bases of collaborative advantage. Categorize the main bases for the public-private partnership and collaboration in the health sector and identify whether collaborative advantage was always the outcome of such collaboration.

  1. Access resources:

Partnering with the private sector carries the potential for meaningful benefits to be gained for the public partner and the health sector. One of them is the access is the access of the resources. This has reduced government spending (e.g., eliminating large up-front investments of scarce public funds) to a greater extent since the private partners inject more finances of their own in the public health sector with the aim of improving the quality of services and increasing efficiency.(B325Book: Managing to collaborate,

  • Shared risk

The public health sector collaborates with the private sector because the consequences of failure on a project are too high for them when it takes a lone. The primary purpose is to reduce risk or better allocate risk. e.g., the private partner may be better able to manage cost and schedule overruns. (

  • Efficiency

Efficiency produce large quantity of product with less cost and time .Efficiency arguments are often made for collaboration between the public and the private health sector. The private health sector is characterized with a higher operational efficiency which is crucial in improving service delivery and performance.

  • Co-ordination

In the health sector, partnering can also be particularly valuable as a method of leveraging technical or management expertise (e.g., performance-based monitoring and incentives), and spurring technology transfer, all of which can lead to quality improvements. (, Case-study, Public-Private Partnerships and Collaboration in the Health Sector, An Overview with Case Studies from Recent European Experience by Irina A. Nikolic and Harald Maikisch, October 2006)

  • Learning

Partnerships and collaborations between the public and the private health sector also create an atmosphere conducive for the sharing of expertise and technology. This has been instrumental in ensuring improvement in health care by the public sector and ensuring provision of extensive health care services competitively by the public health sector.

  • Moral imperative

Partnerships and collaborations between the public and private health care ensures an enormous force to improve health care services to the society hence ensuring a healthier population.

The above from the main bases of collaborations as it was established that strategic development of alliance, joint ventures, networks and other collaborative relationships is central part of strategy of many organizations. There are different types and purpose for collaborative relationships.

Executive director level takes responsibility for their collaborative activity it is also common for collaborations to employ partnership or alliance managers, director or chief executive, whose role is to manage a particular collaboration on behalf of member organizations.

Most managers are engaged in managing or coping with some aspects of their organizational involvement.

The experience of working collaborative report having to deal with issues and difficulties with the partnership with an aim of achieving the objectives. Partners need motivation in the early stages of the collaboration in order to maintain their focus on their objectives. The individual member partners may find themselves employing some strategic approaches with the aim of achieving their individual aims and the collaborative objectives. Some of these strategic approaches include outsourcing which will give the companies additional resources and facilities to work on their goals and objectives (B325Book: Managing to collaborate, chapter 1)

Question 2 (25 Marks)

Define and discuss the role of the focal actor. Identify from the case, who the focal actor is, the role the focal actor plays and the strategies set by the focal actor. Refer and distinguish between network level and firm level goals. Discuss the importance of the focal actor for this kind of partnerships.

In the private- public partnerships and collaborations in the health sector, the public partner act as the focal factor. The public partner in this case mostly refers to the government or a department to the government. The government is the focal actor because of the following reasons:

  1. Ensuring the benefits of the PPP or PPC is obtained.
  2. Ensuring risks are minimized.(
  3. Ensuring public funds are utilized in accordance with the partnership stated objectives.

Strategies set by the focal actor.

     In ensuring the benefits of the of the PPC or PPP, the government works together with the executive directors of the private partners in evaluating the anticipated benefits and ensuring they are key in appropriately designing and pro-actively managing the PPP or PPC. Such evaluation can uncover risks stemming from an inadequate regulatory framework or low institutional capacity, which may need to be addressed either through special provisions built into the contract or through separate reforms undertaken by the government (e.g., enhancing accreditation systems, updating patient rights policies, enabling transparency in health providers’ performance).(

     The government would also be involved in careful review of the allocation of financial risks and rewards, decision-making mechanisms and responsibilities, and the applicable regulatory and contractual framework. (

    Also to mitigate the risk of excess capacity or new capacity in the wrong place in the health system the government would be involved in effective planning and licensing system that allows for a needs-based distribution of services. (  In many situations, an adequate licensing system should not only selectively issue licenses to operate health facilities based on a set of pre-defined criteria, but might also include the option of a special regulation of high-risk interventions, such as, for example, through a so-called certificate of need procedure.  (Case-study, Public-Private Partnerships and Collaboration in the Health Sector, An Overview with Case Studies from Recent European Experience by Irina A. Nikolic and Harald Maikisch, October 2006)

   A diligent up-front evaluation is also critical for ensuring financial and managing fiscal risks for the public partner.

The focal actor would be involved in a number of activities in formulating its strategies in order to ensure the collaboration is in within its capacity to achieve its desired objectives. They include:

  1. Focusing on describing the collaboration process and conceptualize in terms of phases or stages in a life cycle.
  2. Identification of the attributes or conditions that will determine whether the collaboration will perform well or badly.

A good performance contributions factors are:


         B-Partner selection

         C-Mutual trust



         F-Shared vision

         G-Mutual interdependence

         H-Open communication

  • The development of tools to support collaborative workshops and similar events.

      This approach is concerned with the use and development of modeling methods to support the exploration of issues such as stakeholder management and alternative problem definition. .  (Case-study, Public-Private Partnerships and Collaboration in the Health Sector, An Overview with Case Studies from Recent European Experience by Irina A. Nikolic and Harald Maikisch, October 2006)

Question 3 (25 Marks)

Identify the six dimensions of collaboration and discuss the aim ownership from internal and external ownership perspectives. Identify and discuss what the main collaboration aims and organization aims are and what kind of external ownership is most valid for this partnership. Define the routes of achievement and provide evidence from the case on how this specific collaboration has worked things through.

The following are the six dimensions of collaboration:

  1. Internal ownership
  2. External ownership
  3. Genuineness
  4. Routes to achievement
  5. Focus
  6. Explicitness

Collaboration aims in internal perspective differ from those in external ownership perspectives as discussed below:

  1. Internal ownership perspectives
  1. Collaboration aims

It is a public statement about what the collaborating organizations are seeking to achieve together

  • Organization aims

There are statements relating to the aspirations of each of the organizations involved. They are statements of what organization seek to achieve for themselves in closely associated with their functions, responsibilities and spheres of activity.

  • Individual aims

It is a statements relating to the aspirations of individuals involved that relate to career progression or personal causes.( B325Book: Managing to collaborate, chapter 1)

  • External ownership perspectives
  1. External collaborations aims

It exists where force for collaboration is from external pressuresrather than from any of the members. Most commonly these related to government policyor from other external stakeholderssuch as; pressure group or customers.

  • Non-member individual aims.

It exists where individual has a strong stake or other interest in collaboration even though they are not formally a part of it. It is unlike external collaboration aims.(

The most appropriate and valid external ownership in the private-public partnerships and collaborations in the health sector should have the following qualities:

  1.  The collaborative aims should relate to the collaborative process and substantive purpose. It is essentially aims about what of collaborating. They relate to substantive outcomes and obviously important in all collaborations.
  2. The aims of the private-public sector collaboration should be genuine. They should work on a moral imperative of providing affordable and improved health services to the society with the aim of a healthier population.                 
  3. The external ownership should be one such that would give room for reflection and monitoring how aims have changed in the past with the PPP and PPC.( B325Book: Managing to collaborate, chapter 1)

 Routes of achievement

Routes of achievement refer to the various channels used to achieve the aims of collaboration. Aims can be achieved through the following routes: aims achieved through the collaboration, aims achieved through an individual, organization or other collaboration.

Some of the indicators that this that this collaboration has proved fruitful include:                  i)  Ease in access of resources to achieve their objectives as the collaboration has made possible sharing of resources, expertise, knowledge, connection, technology and capital.

 ii)   Shared risks- The private and the public partners in the health sector collaborate because the consequences of failure on a project are too high for them when it takes a lone. The primary purpose is to share risk. (

 iii)Improved efficiency in the delivery of medical services.  The

partnership has made it easier for the public to access medical services through the various mechanisms that have being put in place. (B325Book: Managing to collaborate, chapter 1)

Question 4 (25 Marks)

Define and discuss the three perspectives of power. Explain the types of power the private sector has in this partnership compared to the public sector

The three perspectives of power include:

  1. Power over

This refers to the power that one partner has over the other as a result of having resources that the other party needs.

  • Power to

This refers to the ability that individual partners have towards creating collaborations with each other or simply the strength of collaborative networks lying with individual partners.

  • Powers for

This refers to the ability by one partner to build the capacity of another in the concept of collaborative empowerment. It results in the unselfish gain by one partner as a result of collaboration with another partner. (B325Book: Managing to collaborate, chapter 10)

In the private-public collaboration or partnership in the health sector, the private sector has the following powers as compared to the public sector:

  1. Bargaining powers:

The private sector has more bargaining powers due to their endowment of resources as compared to the public sector. Bargaining power often derives from having some type of source that another party needs. The source is often in form of skills, knowledge, or informationas well as more tangible forms. The government mostly depends on the scarce public funds in its investment and hence more often than not, the public sector controls more of resources in terms of technology, expertise and infrastructure giving it an upper hand over the government.

  • Collaborative empowerment.

The private sector has the ability of improving the public health sector through sharing. Due to its rich and expansive endowment in terms of technology, expertise and equipment, it sis in a position to share it with the public sector through collaboration hence improving operational efficiency and service delivery within the public sector.(

  • Power to unite and extend collaborations

Being self-sufficient in terms of skills and resources, the private sector reserves the power to create collaborations and extend them at any level they wish. The private sector can create the relationship and help the collaboration function effectively at whichever level.

  • Power to maintain the collaboration

As long as the private sector would feel secure in the collaboration with the public sector and also be able to meet both its organizational aims and the collaboration aims, then it has the ability of maintaining the relationship for a longer period of time and even to some extent extending the collaboration. This is because the private sectors is mostly concerned about improving their organizational image, increasing their turn-over and also maintain an edge in the market. If it would be able to achieve these in the partnership, then they would easily maintain it.( B325Book: Managing to collaborate, chapter 10).

  • Power to appoint the name of the collaboration

The names given to collaboration are one of the most overt objects of power infrastructure and can very significant because it implicitly defines it range of operation.

Names give Collaboration needs to present the face outside world, partners select for a lengthy combination of their own names. The name used to first convene collaboration and acknowledge as temporary label for getting started.

  • Power to control membership.

The particular combination of members will usually have a strong influenceon the collaborative agenda and partner selection is also important for compatibility reasons. Some process for determining who may be involve is inevitable (explicitly stated)

In most cases the power to regulate which member to be included or maintained in the collaboration lies with the private partner in order to offer protection to their interests in the collaboration. .( B325Book: Managing to collaborate, chapter 10).


  1. Case-study, Public-Private Partnerships and Collaboration in the Health Sector, An Overview with Case Studies from Recent European Experience by Irina A. Nikolic and Harald Maikisch, October 2006.
  2. B325Book: Managing to collaborate,chapter 1,2 and 10.