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IOB Study
literature review | IOB Study | no. 378 | Public-Private Partnerships in developing countries | IOB Study | no. 378 | Public-Private Partnerships in developing countries
Public-Private Partnerships
in developing countries
A systematic literature review
April 2013
IOB Study
Public-Private Partnerships
in developing countries
A systematic literature review
Public-Private Partnerships in developing countries
| 3 |
Preface
Public-private partnerships (PPPs) are a relatively recent phenomenon in international
development cooperation. Current policy documents frequently refer to expectations
regarding their potential contributions to global development goals.
In 2000, the Dutch Minister for Development Cooperation and the Minister for Foreign
Trade submited a joint leter to parliament regarding the role of private sector in reducing
poverty.
1
In this document hardly any reference was made to Public-Private Partnerships.
The roles and articulation of public and private agents were still referred to in rather general
terms like fnding the right balance, demarcating responsibilities and right interplay.
Only once, a PPP is mentioned, namely a Worldbank-led initiative for giving policy advice to
governments of development countries to involve the private sector in fnancing and
operating infrastructure (the Public-Private Infrastructure Advisory Facility - PPIAF).
In the international debate on the efectiveness of aid taking place within the OECD
Development Assistance Commitee (DAC), the private sector was until recently hardly
invited as a stakeholder to join the discussions. The atention for multi-stakeholder
partnerships for pursuing development objectives received a major stimulus at the UN
World Summit for Sustainable Development (WSSD), held in Johannesburg (South Africa) in
2002. During the winding up of the debates at the 4th High Level Forum on Aid
Efectiveness taking place in Busan (South-Korea) in the period November 29
th
December
1th 2011 thorough atention was given to the role of public-private partnerships in
development cooperation.
This growing atention was frmly backed by the Netherlands government. Nowadays PPPs
are increasingly considered to be an atractive development instrument and are ofen being
used in the Dutch development programs. However, there are still few diagnostic tools
available to determine when and how PPPs represent a preferred institutional arrangement.
Moreover, the empirical evidence on the efectiveness and efciency of PPPs is notably
scarce.
The study provides insights in the wide variety of PPP arrangements and the sometimes
rather difuse contractual framework under which PPPs take place. Due atention is given to
the motives and rationale for relying on PPPs and the expected outcomes of PPP
arrangements. A major conclusion derived from this review is that PPP evaluations focus
more on resource sharing but pay litle atention to the risk-sharing and revenue
distribution dimension of partnerships.
The Policy and Operations Evaluation Department (IOB) of the Netherlands Ministry of
Foreign Afairs commissioned a research team from APE (Aarts De Jong Wilms Goudriaan
Public Economics bv) to undertake a systematic review of available professional literature
1
In Business against Poverty, Parliamentary Papers, House of Representatives, 2000-2001 session, 27
467, no. 1.
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Preface
and evaluation reports regarding the performance of PPPs. Main questions guiding the
systematic review refer to:
What can be considered to be a public-private partnership?
What is the intervention logic of PPPs?
What results can be expected from PPPs?
What are critical success factors of PPPs?
The APE-team was composed by Stefanie Bouman, Rafq Friperson, Maartje Gielen and Peter
Wilms. Guidance has been provided by a reference group composed by Natalie den Breugom
de Haas and Anno Galema (both Ministry of Foreign Afairs). Comments were received from
Renko Campen (independent consultant). Internal supervision and quality assurance has
been provided by Max Timmerman and Jiska Gietema of IOB.
The Policy and Operations Evaluation department (IOB) sincerely hopes that this
publication will encourage the refections and debates on the options and opportunities for
public-private partnerships in developing cooperation.
Prof. dr. Ruerd Ruben
Director Policy and Operations Evaluation Department (IOB)
Ministry of Foreign Afairs, The Netherlands
Public-Private Partnerships in developing countries
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Table of Contents
Preface 3
Table of Contents 5
List of tables, fgures and textboxes 7
Acronyms and abbreviations 7
Summary and conclusions 11
1 Background 15
2 Objective 16
3 Defnition of key terms 17
4 Research steps 20
5 Overview and classifcation 21
6 Defnition and key criteria of developmental PPPs 23
6.1 Defnition developmental PPPs 23
6.2 Five key criteria of developmental PPPs 23
6.3 Summary table (case studies) 24
7 Intervention logic 25
7.1 Rationale of the PPP 25
7.2 Goals and expected results of PPP 27
8 Results of PPP 28
8.1 Output 28
8.2 Outcome 33
8.3 Impact 36
8.4 PPP pathways 36
8.5 Transaction costs 37
8.6 Risk sharing 37
8.7 Proft sharing 38
9 Success and failure factors 39
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Table of contents
10 Answers on research questions 42
11 Outlook: Evaluating Public-Private Partnerships 44
12 References 50
Annexes
Annex 1 About IOB 57
Annex 2 Research methodology 59
Annex 3 Coding sheet systematic review 64
Annex 4 Summary tables case studies 67
Annex 5 Summary table reviews (overview studies) 93
Evaluation reports of the Policy and Operations Evaluation Department
(IOB) published 2008-2013 108
Public-Private Partnerships in developing countries
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List of tables, fgures and textboxes
Tables
Table 1 Dutch spending on PPPs in 2011 15
Table 2 Number of studies by sector 21
Table 3 Number of studies by region 21
Table 4 Number of studies by type of PPP 22
Table 5 Five key criteria on developmental PPPs (case studies) 24
Table 6 Efect of PPP intervention on output (case studies) 28
Table 7 Efect of PPP intervention on output (reviews) 32
Table 8 Efect of PPP intervention on outcome (case studies) 34
Table 9 Efect of PPP intervention on outcome (reviews) 35
Table A-1 Number of articles collected and remaining afer check for relevance title/
abstract 60
Table A-2 Number of articles remaining afer check on title/abstract and quality 62
Table A-3 Number of case studies by MSSM 63
Table A-4 Defnition and type of PPP (case studies) 67
Table A-5 Intervention logic (case studies) 74
Table A-6 Results of PPP (case studies) 82
Table A-7 Summary table reviews 93
Figures
Figure 1 Remaining number of studies afer each selection step 20
Figure 2 Word cloud of PPP defnitions in reviewed case studies 23
Figure 3 Relationship between PPP design and output 31
Figure 4 Relationship between key PPP design and outcome 35
Figure 5 PPP Transaction costs 48
Textboxes
Box 1 Five key criteria of developmental PPPs 17
Box 2 Types of (developmental) Public Private Partnerships (PPPs) 18
Box 3 Implement a PPP to increase efectiveness 26
Box 4 Evaluation methodology of PPRS program 29
Box 5 Punjabi Education Foundation 31
Box 6 The weak output of the African horticulture partnership 33
Box 7 ASAQ Winthrop led to price reduction of ATCs 34
Box 8 The failure of the Bolivia water concession 36
Box 9 No proft no loss prices 37
Box 10 Critical success factors of PPPs 39
Box A-1 Keywords used for fnding relevant articles 59
Box A-2 Quality criteria (knock-out) 61
Box A-3 MSSM levels and description 62
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Acronyms and abbreviations
Acronyms and abbreviations
3IE International Initiative for Impact Evaluation
ADB Asian Development Bank
AfDB African Development Bank
AVRCD The World Vegetable Center
CGAP Consultative Group to Assist the Poor
CGIAR Consultative Group on International Agricultural Research
CIMMYT The International Maize and Wheat Improvement Centre
DAC Development Assistance Commitee
DBFMO Design Build Finance Maintain Operate
DEReC DAC Evaluation Resource Centre
DFID Department for International Development (United Kingdom)
Evalnet DAC network on Development Evaluation
ERR External Rate of Return
FAO Food and Agriculture Organization
FLO Fairtrade Labelling Organisation
GAFSP Global Agriculture and Food Security Program
GDP Gross Domestic Product
GNI Gross National Income
HH Household
ICARDA International Center for Agricultural Research in the Dry Areas
ICRAF The World Agroforestry Centre
ICRISAT International Crops Research Institute for the Semi-Arid Tropics
ICS Internal Control System
IDB Inter-American Development Bank
IFAD International Fund for Agricultural Development
IFPRI International Food Policy Research Institute
IITA International Institute of Tropical Agriculture
IOB Policy and Operations Evaluation Department
IPM Integrated Pest Management
IRR Internal Rate of Return
IRRI International Rice Research Institute
KIT Royal Tropical Institute
MDG Millennium Development Goal
MFA Ministry of Foreign Afairs
MV Modern Varieties
NGO Non-Governmental Organization
NPV Net Present Value
NRM Natural Resources Management
OECD Organisation for Economic Co-operation and Development
OPV Open Pollinated Varieties
PARC Pan African Rinderpest Eradication Campaign
PETT The Peruvian Rural Land Titling Programme
PPIAF Public-Private Infrastructure Advisory Facility
Public-Private Partnerships in developing countries
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PPP Public-Private Partnership
SSA Sub-Saharan Africa
WB World Bank
WDR World Development Report
WFP World Food Programme
WSSD World Summit for Sustainable Development
Summary and conclusions
Public-Private Partnerships in developing countries
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Public-Private Partnerships (PPPs or 3P) are increasingly envisaged as an atractive
proposition for involving the private sector in international development cooperation. In
practice, however, PPPs include a wide variety of arrangements and are not always
uniformly defned. We therefore categorized developmental PPPs according to a set of
criteria related to the degree of cooperation in terms of shared goal, joint funding, resource
and activity sharing and risk distribution.
Since 2002 the Dutch Ministry of Foreign Afairs has been increasingly using PPPs for the
execution of development cooperation programs. In 2011, Dutch government spent 48.3
million on 54 PPPs mainly in sectors like healthcare, water and sanitation and food security.
Moreover, substantial funding is provided to worldwide strategic product development
coalitions as well as to thematic multi-donor trustfunds that operate in close alliance with
the private sector. Finally, also Dutch non-governmental organizations are engaged in
several partnerships with the private sector.
PPPs are generically defned as a form of cooperation between government and business
agents sometimes also involving voluntary organizations (NGOs, trade unions) or
knowledge institutes that agree to work together to reach a common goals or carry out a
specifc task, while jointly assuming the risks and responsibilities and sharing resources and
competences. While there are many conceptual studies available that provide insights in
the principles and potentials of PPPs in international development cooperation, empirical
evidence that highlights the (developmental) rationale and the actual outcomes for
stakeholders is still scarce.
This systematic review of the available evidence regarding the development impact of PPPs
is based on a careful search and selection process following the guidelines and procedures
of the Campbell protocol. From an initial collection of 1.433 studies derived from several
sources (i.e. articles from scientifc portals and development evaluation studies) fnally
remained 81 studies that qualifed as valid evaluative reports. Afer a further screening
regarding the reporting on PPP results, 47 studies fnally remained that provide empirical
evidence on PPP efectiveness, including 18 case studies and 29 reviews. We summarize the
main fndings and conclusions below:
1. Evaluation studies make diference between various types of PPPs that difer with
respect to the degree of sharing resources, responsibilities and risks.
Most evaluation evidence is available from PPP arrangements that are characterized as
joint ventures and management contracts. In addition, many PPPs rely on a
combination of various contractual principles. Subsidies and concessions to private
partners for the execution of development programs could also qualify as a PPP, since
these are usually assigned for outsourcing of activities. Otherwise, grants and revenue
subsidies (tax breaks) are considered as specifc incentives for enabling private sector
involvement in particular sectors that are economically viable (e.g. providing a net
beneft to society) but that are fnancially not yet sufciently atractive.
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Summary and conclusions
2. PPPs are currently used in diferent sectors, but evidence is mainly available for PPPs in
healthcare (insurance), infrastructure (including transport and energy), water supply
and agriculture.
Important areas for PPP development are found in sectors where substantial initial
capital investments are required and that ofer real opportunities for cost recovery
through payment of tarifs and fees. Notably few PPP evaluations are registered in the
felds of education and environment. PPPs seem to focus on activities that could
beneft from production and/or distribution technologies that are widely available
from private sector agents. Most evaluative evidence regarding PPPs is available from
Africa and Asia, particularly referring to setings of market failure.
3. Many PPP evaluations focus on resource sharing, while litle atention is usually given
to the risk-sharing and revenue distribution dimension of partnerships.
More than half of the PPP evaluative case studies pay no atention to the distribution of
risks between public and private partners. The partnership is usually conceived as a
cooperative agreement focusing on common goals and sharing inputs and resources.
Clear arrangements for the distribution of revenues and rules for assigning
responsibilities for potential losses are commonly absent. Moreover, rules for
distribution of public and private shares are defned mechanically or on an ad-hoc
base; bidding schemes are hardly used to identify appropriate private partners.
4. The rationale for relying on PPPs is mostly based on resource mobilization motives
rather than for efectiveness reasons.
In theory, PPPs can be considered a preferred option when market and/or institutional
failures exist that prevent the delivery of goods and services with a net development
impact. In practice, however, most PPPs are motivated for fnancial reasons in order to
mobilize additional resources that enable the execution of large public programs. Few
evaluation reports mention overcoming fnancial market failure and product/market
risks as a motive for public engagement. Market failures may be a relevant motive for
justifying PPPs in medicine research and agricultural product development where high
sunk costs inhibit private start-ups. Government failures can be equally relevant to
pursue PPPs if the adequate provision of public goods is at stake.
5. The goals perceived by PPPs are ofen defned in a very general way and criteria for
specifc, measurable, atainable, relevant and timely objectives are usually absent.
Many PPP evaluation studies mention perceived goals that are defned at a rather high
level of aggregation and that are difcult to assess empirically at the end of the
program. Process-type of goals (beter cooperation) are frequently forwarded, while
output-oriented goals are scarcely specifed. Especially the time dimension is usually
overlooked in PPP evaluations. An adequate time frame for evaluation is required,
since initially high transaction costs during the start-up phase of PPPs could be
compensated by lower costs during implementation.
Public-Private Partnerships in developing countries
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6. Reported efects of PPPs are rather positive at output level, but also weak, mixed and
negative efects are registered in several occasions.
In 15 of the 18 reviewed case studies there was reporting on the efect of the PPP on
output. The majority (13 out of 15) describes a positive efect, 2 studies fnd no efect
and 1 study registers a negative efect. A similar picture emerges from the review
studies. In most reports it remains unclear whether the efect can be atributed to the
PPP. Moreover, clients or benefciaries of PPPs are not always unambiguously defned.
No straightforward relationship has been found between the compliance on PPP
characteristics and the efect of PPPs on delivering output.
7. Development outcomes and efectiveness: some but rather weak evidence
The developmental outcome and impact of PPPs is assessed in half of the available case
studies (9 out of 18) and in 7 out of 9 cases positive efects are registered. However, the
robustness of these results is rather limited with low scores on the Maryland Scale of
Scientifc Methods (MSSM). Results were reported in terms of higher education scores,
beter treatment rates, lower consumer prices and adoption of new production
technologies, but no systematic relationship with PPP design features could be proven.
PPP projects focusing on privatization of public services (water, electricity) sometimes
cause tarif increases that may afect poorer households. Almost no evidence was found
regarding the cost-efectiveness and the environmental benefts of PPPs.
8. The evidence base on PPP evaluations is still scarce and hardly relies on sound and
robust empirical counterfactual analysis.
The large majority of the PPP evaluations are not based on robust impact analysis. Only
one study provides a counterfactual (e.g. situation without PPP intervention). This
implies that atribution of efects to particular PPP features is not possible. However,
some specifc pathways for generating PPP results could be discerned, with most
notable outcomes found in activities related to training and professional development,
R&D support, knowledge sharing and leverage of technical and managerial expertise,
work and participation incentives, and price controls and tarif ceiling measures.
9. Systematic analysis of PPP performance could provide more insights in the success and
failure factors underlying PPP efectiveness.
The professional literature provides several overviews of factors that infuence success
or failure of PPPs. Critical success factors refer to (a) standard seting and permanent
involvement of public agencies, (b) clear formation requirements (goals, inputs and
expectations), (c) sound regulatory framework regarding costs recovery and beneft
distribution, (d) adequate partner selection arrangements (based on compatibility,
capability, commitment and control), (e) common vision and mutual trustful
relationships and (f ) transparent negotiation on multiple interests of key participants.
The validity of these factors is confrmed from the case studies, but their mutual
interaction and relative importance remains subject to debate.
| 14 |
Summary and conclusions
10. Decision-making regarding the reliance on PPPs for development could be supported
with a clear framework for selecting and designing PPPs and should provide insights in
the rationale and intervention logic of PPPs in any specifc situation.
Since PPPs cannot be universally defned and they can include a variety of diferent
organizational features, their selection fnally depends in particular on a judgment
regarding appropriateness and expected results that can be reached in any particular
situation. Therefore, it might be useful to identify key constraints that hinder local
development and to outline whether or not PPPs can be considered as an adequate
strategy for addressing these constraints. For making such judgments, it is considered
particularly important to clearly defne PPP eligibility criteria and to compare the PPP
option with alternative implementation arrangements.
Public-Private Partnerships in developing countries
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1 Background
Growing role of private sector
Involving the private sector is a growing priority in Dutch development cooperation. Since
2002 the Dutch Ministry of Foreign Afairs (MFA) has increasingly used Public-Private
Partnerships (PPPs) for the execution of aid programs. The PPPs are designed to bring the
realization of the Millennium Development Goals (MDG) closer (MFA, 2010).
Dutch spending on developmental PPPs is concentrated in healthcare and water.
Currently the Dutch government is involved in PPPs in several African- (such as
Mozambique, Rwanda and Burundi) and Asian developing countries (such as Indonesia and
Mongolia). Examples of concrete projects are worldwide coalitions such as the so-called
Global Alliance for Vaccines and Immunization (GAVI), partnerships with individual
companies like the Dutch energy company Nuon in the Foundation for Rural Energy
Services (FRES) in Mali and product development partnerships (PDPs). In 2011, the Dutch
government spent 48,3 million on 54 PPPs. The projects were concentrated in the sectors
food security/PSD, water, sanitation & hygiene and healthcare, see Table 1.
Table 1 Dutch spending on PPPs in 2011
Theme Number of projects Spending (x mln.)
Food security/PSD 17 8,7
Water, sanitation & hygiene 15 13,5
Healthcare 13 24,5
Innovative fnance 6 0,3
Climate and energy 3 1,3
Total 54 48,3
Source: Tweede Kamer, 2011-2012 32 503 nr. 6
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Objective
2 Objective
Our main research question
The main research question of this review is: what is the evidence for the efectiveness and efciency
of Public-Private Partnerships (PPPs) in international development cooperation as derived from credible and
valid evaluative studies?.
covers fve key issues.
The specifc research questions can be divided across fve key issues:
1. Precise defnition of developmental PPPs
a. What are the criteria for an intervention to be considered developmental PPPs?
2. Categorization of diferent types of PPPs according to diferent intervention
strategies
a. Which types of developmental PPPs can be distinguished?
b. What is the intervention strategy of developmental PPPs?
c. Which pathways in developmental PPPs can be distinguished?
d. What is the relation between diferent types of PPPs and the intervention strategy?
3. Identifcation of results of PPPs pathways at outcome and possibly impact level
a. What are the outputs of PPPs in developing countries?
b. What are the outcomes PPPs in developing countries?
c. What are the impacts of PPPs in developing countries?
4. Analysis of the efectiveness of PPP pathways according to relevant evaluative studies
a. Why did a PPP produced the desired results or not?
b. Are there general paterns in success or failure factors?
5. Synthesis of the available information of PPP efciency.
a. What are the benefts of the PPPs compared to the costs?
Public-Private Partnerships in developing countries
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3 Defnition of key terms
Before answering the research question we defne the key terms in our research questions.
This entails the defnition of PPP, output, outcome, impact and intervention logic.
No broad accepted defnition of PPP
There is no universal accepted defnition of Public Private Partnership (PPP). Marin (2009)
illustrates this point: there is no single defnition of PPP. It covers a wide range of
transactions where the private sector is assigned some responsibility, including investment.
It ranges from management contracts with no investment obligations to concessions
contracts with signifcant investment obligations in addition to operational and
management obligations (Marin, 2009).
but defnitions do have common characteristics.
Although defnitions vary, they do have some common characteristics. Illustrative for this is
the analysis in a forthcoming paper of Da Rosa et al. (2012). Da Rosa et al. (2012) present an
extensive overview of 28 PPP defnitions which they score along 14 dimensions. They fnd
that most defnitions describe that PPPs: have diferent societal backgrounds (18 out of 28),
share objectives, goals and problems (17 out of 28), are for the provision of public goods
(14), beneft from complementary resources (14) and have partners which collaborate in an
interdependent and interactive way (Da Rosa et al., 2012).
We use the defnition of the Dutch MFA
Given the context of our review we use the PPP defnition from the Dutch Ministry of
Foreign Afairs (MFA, 2010): A form of cooperation between government and business (in
many cases also involving NGOs, trade unions and/or knowledge institutions) in which they
agree to work together to reach a common goal or carry out a specifc task, jointly assuming
the risks and responsibility and sharing their resources and competences.
and derive fve key criteria of developmental PPPs.
Based on the MFA defnition, defnitions from key developmental institutions (such as
OECD, World Bank and IMF) and the analysis of Da Rosa et al. (2012) we derive fve key
criteria of developmental PPPs, see Box 1. In our systematic review we will score the PPPs in
the case studies on these criteria.
Box 1 Five key criteria of developmental PPPs
# Characteristic
1 A cooperation between the public and private sector (also NGOs, trade organizations and
knowledge institutes) with a common (development) goal;
2 A clear agreement between the public and private party on the goal(s) of the PPPs;
3 A combination of Public and Private funding
4 A clear agreement between the public and private party on the sharing of resources and tasks;
5 Distribution of risks between the public and the private sector.
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Defnition of key terms
Types of developmental PPPs.
Within this framework there are several types of developmental PPPs. On a scale from
public to private we distinguish the following types of PPPs (ADB, 2008):
2
Service contract
Management contract
Afermage and lease contracts
Concession
Buildoperatetransfer (BOT) and similar arrangements (including BTO, BOO, DBO, DBFO)
Joint venture
These types are described in Box 2.
Box 2 Types of (developmental) Public Private Partnerships (PPPs)
Form Description (quoted from ADB, 2008)
Service
contract
The government (public authority) hires a private company or entity to carry
out one or more specifed tasks or services for a period, typically 13 years.
The government pays the private partner a predetermined fee for the service,
which may be based on a one-time fee, unit cost, or other basis.
Management
contract
A management contract expands the services to be contracted out to include
some or all of the management and operation of the public service (i.e., utility,
hospital, port authority, etc.). Obligation for service provision remains in the
public sector, while daily management control and authority is assigned to the
private partner or contractor.
The private contractor is paid a predetermined rate for labor and other anticipa-
ted operating costs. The contractor is paid an additional amount for achieving
prespecifed targets or the management contractor can be paid a share of
profts. The public sector retains the obligation for major capital investment.
Afermage or
Lease contracts
Under an afermage or a lease contract, the private partner is responsible for
the service in its entirety and undertakes obligations relating to quality and
service standards. Except for new and replacement investments, which remain
the responsibility of the public authority, the operator provides the service at
his expense and risk. The duration of the leasing contract is typically for 10
years and may be renewed for up to 20 years.
Under a lease contract the fnancial risk for operation and maintenance is
borne entirely by the private sector operator. The private sector retains
revenue collected from customers and makes a specifed lease payment to the
contracting authority.
An afermage allows the private sector to collect revenue from the customers
(typically an agreed rate per unit sold), pays the contracting authority an
afermage fee, and retains the remaining revenue.
2
In our opinion the ADB handbook on PPP provided the most broad and thorough overview of
developmental PPPs.
Public-Private Partnerships in developing countries
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Form Description (quoted from ADB, 2008)
Concession A concession makes the private sector operator (concessionaire) responsible for
the full delivery of services in a specifed area, including operation, maintenance,
collection, management, and construction and rehabilitation of the system. The
operator is responsible for all capital investment. The public sector is responsible
for establishing performance standards and ensuring that the concessionaire
meets them. A concession contract is typically valid for 2530 years.
The concessionaire collects the tarif directly from the system users.
Buildoperate
transfer (BOT)
and similar
arrangements
(including BTO,
BOO, DBO,
DBFO)
Under a BOT and similar arrangements a private frm or consortium fnances and
develops a new infrastructure project or a major component according to
performance standards set by the government. The private partner provides the
capital required to build the new facility. At the end of the contract, the ownership
is transferred to the public sector. Variations on the basic BOT structure are:
buildtransferoperate (BTO) where the transfer to the public owner takes
place at the conclusion of construction rather than at the end of the contract;
buildownoperate (BOO) where the developer constructs and operates the
facility without transferring ownership to the public sector;
design buildoperate (DBO) where the private sector provides design,
construction, and operation of the infrastructure project;
designbuildfnanceoperate (DBFO) where the responsibilities for designing,
building, fnancing, and operating are bundled together and transferred to
private sector partners.
Joint venture Under a joint venture, the public and private sector partners can either form a
new company or assume joint ownership of an existing company through a
sale of shares to one or several private investors. Both public and private
partners invest in the company and share risks.
Source: ABD (2008)
Output (immediate results)
We defne output as the number of goods or services produced by the PPP. For instance the
number of mosquito nets or malaria medicines. These are the most immediate results of
activities (OECD, 2001).
Outcome (intermediate efects)
We defne outcome as the intermediate (short term) efect of the PPP on the community.
Examples: since the PPP in water service more people have access to clean drinking water. Ofen
the time frame is such that outcomes can be achieved within the project life cycle (OECD, 2001).
Impact (fnal goal)
We defne impact as the causal efect (net efect) of the PPP intervention on the fnal goal. For
instance: less people die of water pollution because of the PPP intervention. The casual efect of
PPP should be indicated by counterfactual analysis, therefor a strong counterfactual is needed.
Intervention logic
Intervention logic we describe as all the activities and expected efects (outputs, results and
impacts) of an intervention, as well as the assumptions that explain how the activities will
lead to the efects in the context of the intervention (European Commission, 2006).
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Research steps
4 Research steps
Six research steps
In our systematic review we followed the guidelines and procedures mentioned in the
Campbell protocol for systematic reviews. We followed six research steps to fnd, select, and
analyze relevant studies:
Step 1: keyword search
Step 2: quick scan articles on title and abstract
Step 3: assessing general characteristics of studies
Step 4: check on quality (6 knock-out criteria)
Step 5: scoring of remaining case studies on counterfactual
Step 6: in depth analysis of remaining studies
An extensive description of the research steps can be found in Annex 2 (research
methodology).
resulted in 18 case studies and 29 reviews.
The search process resulted in 18 case studies and 29 reviews. In Figure 1 we visualize the
number of remaining studies afer each selection step.
Figure 1 Remaining number of studies afer each selection step
1433
studies found
81
afer title/
abstract check
47
afer quality
check
18
case studies
29 reviews
Public-Private Partnerships in developing countries
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5 Overview and classifcation
Majority of reviewed PPPs are in healthcare, infrastructure and agriculture
We reviewed PPP evaluations in a broad number of sectors. Most of them were in healthcare
(11), infrastructure (6) and water supply (5). See Table 2.
Table 2 Number of studies by sector
Case studies Reviews
(overview
studies)
Total
Agriculture 0 4 4
Education 2 0 2
Energy 2 1 3
Environment 1 1 2
Healthcare 6 5 11
Housing (construction) 1 2 3
Infrastructure 3 3 6
Transport 1 2 3
Water 0 5 5
Multiple sectors 0 3 3
Other 2 3 5
Total 18 29 47
Majority of reviewed PPP were in Asia and Africa
We reviewed evaluations from PPP in various developing countries. Most PPP were situated
in Asia (19) and Africa (11). See Table 3.
Table 3 Number of studies by region
Case studies Reviews
(overview
studies)
Total
Asia 10 9 19
Asia (various countries/regions) 1 3 4
China 2 0 2
India 2 3 5
Lebanon 1 0 1
Malaysia 0 1 1
Nepal 1 0 1
Pakistan 3 1 4
Yemen 0 1 1
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Overview and classifcation
Africa 4 7 11
Africa (various countries/regions) 3 4 7
Ghana 0 1 1
East Africa 0 1 1
Nigeria 1 0 1
Tanzania 0 1 1
Latin America 1 3 4
Latin America (various countries/
regions)
0 3 3
Peru 1 0 1
Various continents 3 10 13
Total 18 29 47
Majority of reviewed PPP are joint ventures and management contracts
We reviewed several diferent types of partnership contracts. Most PPP contracts are joint
ventures (11) and management contracts (9). See Table 4.
Table 4 Number of studies by type of PPP
Case studies Reviews
(overview
studies)
Total
Concession 1 0 1
Buildoperatetransfer (BOT) and similar
arrangements (including BTO, BOO, DBO, DBFO)
2 1 3
Joint Venture 8 3 11
Lease contract 1 0 1
Management contract 4 5 9
N/A 0 4 4
Various (combinations of above) 2 16 18
Total 18 29 47
Public-Private Partnerships in developing countries
| 23 |
6 Defnition and key criteria of
developmental PPPs
In this section we take a closer look at the defnition and characteristics of the PPPs in the 18
reviewed case studies. How is PPP defned in the reviewed studies and do these PPPs fulfll
the fve key criteria of developmental PPPs? In the next paragraph we discuss the defnitions
and we assess whether the reviewed PPPs fulfll the fve key criteria of developmental PPPs.
We fnish this section with a summary table on the key characteristics of the reviewed case
studies.
6.1 Defnition developmental PPPs
Most studies dont give an explicit defnition of PPP
A substantial amount of authors use the term Public Private Partnership without actually
explaining what the term means. This refects our fnding that there isnt a consistent
defnition of PPP. In only 4 out of the 18 case studies the defnition of PPP is explained (see
Annex 4 for these defnitions per case study). We have summarized these defnitions in a
so-called Word cloud (see Figure 2). The fgure shows that most defnitions contain the
words joint, government and collaborations.
Figure 2 Word cloud of PPP defnitions in reviewed case studies
Source: reviewed case studies
6.2 Five key criteria of developmental PPPs
Most studied PPP projects fulfll majority of the fve criteria of developmental PPPs
We looked whether the in the case studies described PPP projects fulflled each of the fve
PPP criteria (see Box 1). We found that a majority of these PPP projects fulfll three or more
of the fve PPP criteria. See Table 5 (an overview per study is presented in Annex 4).
| 24 |
Defnition and key criteria of developmental PPPs
Table 5 Five key criteria on developmental PPPs (case studies)
# Key criterion Yes No Total
1 Cooperation between public- and private party 18 0 18
2 Clear agreement on goal 16 2 18
3 Combination of public- and private funding 13 5 18
4 Agreement on sharing of resources and tasks 17 1 18
5 Distribution of risks between the public and the private sector 8 10 18
1. All (in the case studies reviewed) PPP projects fulfll criterion 1 (cooperation between public
and private sector). So in each PPP case study there is some form of cooperation between the
public and the private sector described. We expected this because we selected the studies on
this criterion. A few notable examples: The Chad-Cameroon petroleum development and
pipeline project, a collaborative venture between an oil consortium and the governments of
Chad and Camroon (Utzinger, 2005); Rescue-15, an Emergency Service Medical (EMS)
partnership between the Islamabads Police Department, NGOs and the private sector.
2. 16 out of 18 PPPs in the studies fulfll criterion 2 (clear agreement between public and
private party on the goals). For example the Womens Health Initiative (WHI), a PPP where
the parties agreed to improve reproductive and maternal health for woman and girls in
India. (Kruesmann and Timmermann, 2009).
3. 13 out of 18 case studies explicitly mention that the PPP goes with a combination of public
and private funding (criterion 3). However, the division of the budget (between the
public- and private party) is not always mentioned.
4. 17 out of 18 reviewed PPP projects fulfll criterion 4 (clear agreement on sharing of
resources and tasks). Notable example is the Lebanese network and telecom PPP
concession. The private sector became responsible for building and operating the network
and the public sector for regulation (Jamali, 2004).
5. The distribution of risks is addressed in 8 out of 18 of the studied PPP projects. A notable
example is presented by Shen et al. (2006) in the article on the partnership between the
Hong Kong
3
government and private sector (Walt Disney Company) on the development of
Disney Land. In this PPP project acquisition-, legal- and policy risks are allocated to the
public sector. While the design-, construction-, operation and industrial action risk are
allocated to the private sector. Developmental risk, market risk and fnancial risk are
shared between the partners (Shen et al., 2006).
6.3 Summary table (case studies)
In Annex 4 we present a summary table of the 18 reviewed case studies by sector. For each case
study we describe the subsector, region, exact defnition of PPP (quote), key characteristics, type
and budget. If we couldnt derive a characteristic from a study (because it was not available or
relevant) we noted this as NA. We have writen the most important fndings in bold.
3
Since 1997 Hong Kong isnt a developing country according to the IMF (IMF, 1998). However, we
decided to include this case study in our review because the partnership was set-up in the late
1990s. Thereby Hong Kong is part of China, which is a developing country.
Public-Private Partnerships in developing countries
| 25 |
7 Intervention logic
Before looking at the efects of PPPs in terms of output, outcome and impact it is important
to consider the so-called intervention logic of PPPs: what is the reason to implement PPP in
development countries? What are the goals for PPP and the expected results? We consider
the later questions in this section. In paragraph 7.1 we discuss the rationale of PPP in the
reviewed case studies. In paragraph 7.2 we discuss the goals and expected results of PPP in
the reviewed case studies.
7.1 Rationale of the PPP
PPPs can be implemented for (a combination of ) fnancial, developmental, efciency, ideological and
political reasons.
The rationale to implement the PPP is described in 12 of the 18 reviewed case studies. These
reasons can be grossly divided in: (1) fnancial reasons (including risk diversifcation), (2)
development reasons (3) efciency reasons and (4) ideological/political reasons
(see Annex 4 for details per case study):
Financial reasons (including risk diversifcation, 7 studies): in a substantial amount of the
reviewed case studies PPP is implemented because the local government doesnt have
enough resources to carry out a task alone: the government of Pakistan decided to
implement PPP in education because they did not have the resources to accomplish the
gigantic task of providing quality education and meeting the targets of the Millennium
Development Goals alone (Malik, 2010). The Lebanese government considered PPP in
telecom because they wanted to reform public enterprise but lacked fnancial resources
(Jamali, 2004). In their case studies on Chinese subway PPPs De Jong et al. (2010) state
that the use of PPP in (large) infrastructure projects has mainly risen because the
government has insufcient fnancial resources: In many cases local ofcials believe that
only funding from the private sector can fll the immense gap between the limited
presence of public resources and rapidly growing sustainable urban infrastructure needs.
(de Jong et al., 2010). Risk diversifcation is also mentioned as a motive to implement
PPP. For example the PSOM (Cooperation Emerging Markets) PPP which was
implemented to encourage investment project that would otherwise not have been
carried out because of the high product/market risks (Triodos Facet, 2010).
Development reasons (3 studies): the realization of (Millennium) development goals or
certain international standards is mentioned in 3 of the 18 studies as reason to implement
PPP: the government of India implemented ICTD to distribute the benefts of the IT
sector in rural regions and make more persons e-literate (Kuriyan and Ree, 2008). In their
review on PPPs in tuberculosis research (not in summary table) Dewan et al. (2006)
mention that collaborations between the public and private health sectors, or public-
private mix, may be an important solution to the problem that diagnosis, treatment, and
reporting practices ofen do not meet national or international standards for
tuberculosis.
| 26 |
Intervention logic
Efciency reasons (3 studies): in their extensive review on PPPs on East African Export-Oriented
Horticulture, Pfsterer et al., (2009) state the rationale of the horticulture PPP can be found in
market failure and government failure.
Market failure means that private frms fail to innovate and ensure continuous improvement in
product and process development (Pfsterer et al., 2009) because this is not proftable for
them. This kind of market failure is also addressed by Grace and Duce (2011). In their review on
drug development PPP in developing countries (not in summary table). They state that PPP is
implemented because the private parties on their own do not invest enough in diseases that are
especially occurring or have a diferent disease paterns in developing countries, because for these
medicine research [Aids, TB and malaria] is needed that is hardly relevant for developed countries
(Grace and Duce, 2011) See also Box 3.
Government failure means that the government fails to secure accountability between decision
makers and horticulture industry (Pfsterer et al., 2009). A PPP can efectively address these
failures.
Ideological/political reasons (3 studies): Kuriyan and Ree (2008) mention that PPPs has gained
support in the 1990s because of the international environment that strongly supported economic
liberalization and less state intervention. Kuriyan and Ree (2008) mention that ICTD-PPPs in India
were also enforced because the state was trying to make visible its atempts to accommodate the
rural electorate. Furthermore Kruesmann and Timmerman (2009) note (in their short review of the
Womens Health Initiative, a PPP to improve reproductive and maternal health for woman and girls
in India) that in India the government acknowledges that partnerships with the private sector
-both the for-proft and non-proft- are important to atain public health goals and to improve the
health delivery system (Kruesmann and Timmerman, 2009)
Box 3 Implement a PPP to increase efectiveness
In the past the public sector had the primary responsibility for the provision of
household waste management services but it was not very successful. In order to
increase efectiveness in the service delivery the Kwara State Government contracted a
private company in 2004 and was charged with the responsibility of keeping Iloring
clean, and to formalize the recycling process. Currently, the private company and the
Kwara State Waste Management Council (a government agency) are in charge of
household waste management services in Ilorin. The Waste Management Council plays
a supervisory role, while the private company is in charge of collection of household
waste. The challenge of efective and efcient household waste management strategy
has become a priority for policymakers in Kwara State. The people who are in support
of more private companies argue that if more private companies are involved in waste
management services it will lead to competition between the companies, increase
efectiveness and consequently improve environmental quality. Before involving more
private companies in the provision of household waste management services it is
important to have an overview of how Ilorin residents perceive the present household
waste management services. This is the aim of the study, as well as the examination of
some socio-economic factors infuencing their perceptions.
Source: Ezebilo and Animasaun (2012)
Public-Private Partnerships in developing countries
| 27 |
7.2 Goals and expected results of PPP
Goals of PPPs are ofen very general and not SMART formulated
The goal of the PPP is described in almost all reviewed case studies (see Annex 4). However
the described goals in the case study evaluations are ofen very general and not SMART
(specifc, measurable, atainable, relevant, timely) formulated especially the dimension
timely ofen isnt fulflled. Some typical examples:
The goal of Rescue-15 (an emergency service partnership between the Islamabad Police
Department NGOs and the private sector) was [to] boost public confdence and to
inculcate a spirit of citizen-friendly policing with community participation. (Ali, 2006).
This is an example of a goal that is neither measurable (because its not clear how public
confdence and a sense of citizen-friendly policing would be measured), nor atainable
(because its not clear how the goals will be achieved) or timely (because its not stated
when the goal should be reached).
The Hong Kong International Theme Parks Limited joint venture aimed to provide
recreational facilities for general public in Hong Kong and contribute to the Hong Kong
economy. The later goal is neither measurable (because it is not clear how the
contribution to the economy will be measured) nor timely (because it is not stated when
the goal should be reached).
The goal of the Lebanese telecom PPP was seting up an afordable telecommunication
network (Jamali, 2004). This goal is neither specifc (what is afordable?) nor measurable
or timely.
Ofen unclear on what expected results are based
The expected results of PPP are described in 11 of the 18 reviewed case studies. However its
not always clear on which arguments those expected results are based, see Annex 4.
| 28 |
Results of PPP
8 Results of PPP
In this section we present the results of the PPPs in the reviewed studies. In paragraph 8.1
we discuss the output of PPP in the reviewed case studies. In paragraph 8.2 we discuss the
outcome and in paragraph 8.3 the impact. Where applicable we complement these fndings
with the results in the overview studies. In paragraph 8.4 we discuss the pathways/strategies
of the PPPs in the reviewed case studies. We end this chapter with a discussion on
transaction costs (8.5), risk- (8.6) and proft sharing (8.7).
8.1 Output
Case studies
Most case studies present a positive efect of the PPP on output
We have defned output as the number of goods or services produced by the PPP. In 15 out of
18 reviewed case studies we were able to derive an efect of PPP on output. The majority of
those studies (13 out of 15) describes a positive efect of the PPP on output. 2 studies
describe no efect on output and zero studies describe a negative efect.
but the evidence is weak and limited.
The majority of studies has a no counterfactual. As we note in Annex 2, in the ideal situation
the study should compare the situation with PPP with the situation that would have
happened without PPP. So the outcome of PPP in a region should be compared with a
comparable region without PPP (a robust comparable control group while controlling for
external factors), MSSM level 5. In only 1 study the efect of the PPP intervention is
estimated with the use of a counterfactual on MSSM level 3 (output before/afer and control
group). The remaining counterfactuals are on level 2 (output before/afer) and 1 (only
output at 1 point in time), see Table 6.
Table 6 Efect of PPP intervention on output (case studies)
Efect on output
MSSM level (see box A-3 for description)
Total 1 2 3 4 5 NA
+ (positive efect in general) 13 4 8 1 - -
-
+/- (mixed efect) - - - - - -
-
- (negative efect in general) - - - - - -
-
0 (no efect in general) 2 2 - - - -
-
NA (not available/applicable) 3 1
2
Total 18 7 8 1 - -
2
Public-Private Partnerships in developing countries
| 29 |
Only one study presents a positive efect on output with a counterfactual on MSSM level 3.
The one study with a counterfactual on MSSM level 3 is about the provision of primary education
through PPP in Pakistan. This resulted in the so-called Promoting Low-Cost Private Schooling
in Rural Sindh (PPRS) program: Goal of the PPRS program was to take advantage of the local
knowledge and underutilized resources within [rural] communities to provide viable,
appropriate, and afordable education (Barrera-Osorio et al., 2011). Within the PPRS program
private entrepreneurs could start their own school and receive a per-child fee from the
government. The government selected these entrepreneurs within a random sample of 100
villages chosen from a sample of 163 qualifying [villages] (Barrera-Osorio et al., 2011). The
remaining 63 villages remained in the control group. Barrera-Osorio et al. (2011) estimate the
efect on school enrolment while controlling for child- and household characteristics and
district fxed efects. They fnd that the intervention had a signifcant positive efect on school
enrolment, (see also Box 4): enrolment increases by 51 percentage points in treated villages.
Thereby girls have a 4-5 points greater increase than boys (Barrera-Osorio et al., 2011).
4
Box 4 Evaluation methodology of PPRS program
In order to identify the causal impact of the intervention, the qualifying localities were
randomly assigned to the control and two treatment groups, thereby ensuring that
receipt of a school is uncorrelated with village characteristics that may infuence the
efcacy of the program. Insofar as randomization has established statistically indistin-
guishable groups across the control and treatment villages, any diferences between
them can be atributed to the intervention. The participating villages were chosen
according both to their need as well as the ability of the entrepreneur to secure an
adequate facility for conducting classes and qualifying teachers to lead them.
A baseline survey was conducted in all qualifying villages in February, 2009.
Following the survey, the villages were randomly assigned to the two treatments
and one control group. The schools were then established in the summer of 2009.
Because the new school term normally commences in spring, the students received
an abbreviated term their frst year. In anticipation of conducting the follow-up
survey, a census was conducted of treatment and control villages in June 2010. In
both the baseline survey and the census, socio-demographic information was
collected. The content of these two surveys was slightly diferent, however. While
they both included questions on the age, gender and enrollment status of all
children ages 5-9 in the household, the census also collected information about
children ages 10-15. The follow-up survey will include numeric and literacy tests for
all children between the ages of 5 and 10 in a randomly chosen sample of house-
holds from each village. In addition, reported enrollment will be verifed through
school surveys. This will allow us to establish the efectiveness of the intervention
in increasing enrollment and test scores.
Source: Barrera-Osorio et al., (2011)
4
Despite the success of the program, in 2012 100 schools were closed because they were within
within the radius of 1.5km of government schools. Now all these are declared in close proximity
of government schools (Dawn, 2012).
| 30 |
Results of PPP
8 case studies present positive efect on output with a counterfactual on MSSM level 2.
Utzinger (2005) fnds that afer implementation of the Chad/Camroon PPP on petroleum
development and pipeline project malaria rates amongst project workers in Chad decreased.
Ali et al. (2006) fnd that since the implementation of Rescue-15 the number of calls
requiring medical services has increased.
According to Newell (2004) the implementation of a public private partnership for control
of tuberculosis in Nepal has led to 1328 patients registered patients with tuberculosis: 210
(15.8%) of these were referrals from private practitioners, the remainder being self-referrals
to DOTS [direct observation of treatment] centers (Newell, 2004).
Jamali (2004) fnd that afer the implementation of the Lebanon telecom PPP the number
of cellular subscribers and international coverage increased. However it should be noted
that this PPP was not a success in qualitative terms. There was litle regulatory oversight
and poor communication between the partners: neither the public nor the private sector
approached the new project in a spirit of true partnership. There was suspicion from the
start in public circles about the inclination of the new operators to openly share and
disclose information (Jamali, 2004).
Triple value (2009) reports that afer implementation of the so-called Sustainable Trade
Agreement (Initiatief Duurzame Handel, IDH) partnership: (a) cacao productivity
increased and quality improved, (b) a code of conduct was implemented for the
improvement of labor standards in natural stone production and (c) an increase of RTRS
(Round Table of Responsible Soy) members by 42.
Triodos Facet (2010) reports that afer implementation of the Programme for Cooperation
with Emerging Markets (PSOM) 205 projects are complemented since the start of the
program [] 275 are ongoing and 176 have stopped, 120 of which prematurely. (Triodos Facet,
2010).
Bompart et al. (2011) report ASAQ Winthrop (a malaria medicine developed by a PPP) was
registered in 30 sub-Saharan African countries and in India, with over 80 million
treatments distributed in 21 countries. 6 million treatments in 2008, 25 million in 2009,
over 45 million in 2010 (Bompart et al., 2011).
Malik (2010) fnds that afer implementation of the Punjab Education Foundation (PEF, a
government organization in Pakistan that sponsors PPPs in education) the number of
schools and students rose, see Box 5.
Public-Private Partnerships in developing countries
| 31 |
Box 5 Punjabi Education Foundation
The PEF [Punjabi Education Foundation] was established through the Punjab
Education Foundation Act of 1991 by the Punjab Assembly. This legislation stipula-
ted that the PEF would advance loans and grants to private entrepreneurs for the
construction of schools as a way of promoting accessibility to education. Even afer
the passage of the Punjab Education Foundation Act of 2004, the PEFs mission
remained broadly the same: support the eforts of private schools to provide
education to the poor.
There was a sharp rise in the number of schools and a meteoric rise in the number
of students between 2005 and 2008. For starters, there was an increase of 720.5%
in the number of students in 2006 compared to 2005. The increases continued
every year: 264.6% in 2007, 75.4% in 2008, and 17.7% in 2009. By 2008 the PEF,
through the FAS program, supported 1,337 schools with 529,210 students. In
Pakistan, more than 40% of students drop out of school by the time they reach
Grade 4, but in FAS partner schools the dropout rate is zero.
Source: Malik (2010).
Is there a relationship between the output of PPPs and the design of PPPs? We address this
question in Figure 3. In this fgure we present the relationship between the output and the
key PPP characteristics. The fgure shows no relationship between the key PPP
characteristics and the efect of the PPP on output.
Figure 3 Relationship between PPP design and output (n=18)
c
-
e
s
1z
1s
nc yes nc yes nc yes nc yes nc yes
Chur.
(Cccperuticn)
Chur. z
(Agreement)
Chur.
(lunding)
Chur.
(Shuring)
Chur.
(Risks)
+ (pcsitive eect) o (nc eect) nA
Source: reviewed case studies
| 32 |
Results of PPP
Reviews
Positive efects of PPP on output are refected in the reviews (overview studies)
The positive fndings in the case studies are refected in the reviews, see Table 7 (in Annex 5
we present a table per review).
Table 7 Efect of PPP intervention on output (reviews)
Efect on output
+ (positive efect in general)
8
+/- (mixed efect)
3
- (negative efect in general)
1
0 (no efect in general)
1
NA (not available/applicable)
16
Total
29
Some notable examples of reviews that fnd a positive efect of PPP on output:
De Pinho Campos et al. (2011) studied the efect of product development (PD) PPPs for
disease control. They conclude that PD PPPs led to the creation of drugs or vaccines in
low and middle-income countries.
Dewan et al. (2006) looked at PPP in tuberculosis treatment. They fnd that in nine (75%)
of the 12 public-private mix projects, observed treatment met or exceeded the Indian
tuberculosis programme target of 85% treatment success. However: in two projects
where treatment outcomes of public sector administered and private provider
administered directly observed treatment were compared, no signifcant diferences were
found (Dewan et al. 2006).
but also some PPPs with weak, mixed or negative efects...
Finally, there are some PPPs with a weak or sometimes even negative efect on output. An
example of a PPP with a weak efect on output is the so-called WSSD (World Summit on
Sustainable Development) partnership, horticulture PPP in various African country, where
the output mostly consists of explorative studies en business plans, see Box 6.
Public-Private Partnerships in developing countries
| 33 |
Box 6 The weak output of the African horticulture partnership
The [WSSD] partnership aims to be a vehicle to address those botlenecks in and
around the export horticulture chain in both fowers and vegetables & fruits that
could only be tackled in a public-private partnership. The objective of the WSSD
partnership is twofold. First, market access to the European market is aimed
at through capacity building to comply with food safety regulations. Second,
strengthening structures and awareness is aimed at to contribute to sustainable
development, not only economic but also social and ecological.
The activities undertaken by the partners resulted in a variety of project outputs
such as products and services. One obvious criterion is the extent to which the
project objectives have been achieved. The fnalized projects under review largely
met their original objectives. For ongoing projects some frst outputs were
identifed When examining the results it demonstrated that most outputs are
results of explorative studies such as business plans, reports or frameworks. Almost
all projects plan to implement these outputs in project extension phases.
Source: Pfsterer et al. (2009)
and its not always clear if the efect is due to PPP
Thereby it isnt always clear if the positive efect of output is caused by the PPP or by another
reason - for instance a substantial increase in government spending. Tann (2012) looked at
water privatization in Malaysia and found that there was an increase in pipe length and
water production afer implementation of the PPP. However Tann (2012) notes: Based on
the evidence, it is not clear if increases in production capacity and pipe length were due to
PPI given that these corresponded with signifcant increases in government fnancing.
Moreover, large improvements were made by public and corporatized states in production
capacity while increases in pipe length were related to water distribution which remained in
the public sector for all states except Selangor (publicprivate) afer 2005 and Johor
(private) (Tann, 2012).
8.2 Outcome
Case studies
Most case studies present a positive efect of the PPP on outcome, but evidence is weak.
We have defned outcome as the intermediate (short term) efect of the PPP on the
community: 9 of the 18 reviewed case studies describe an efect of the PPP on outcome. In 7
of those 18 studies the result on outcome is positive. However as we noted when
discussing the efect on output the MSSM score in these studies is low: none of the studies
have a counterfactual on MSSM level 4 or higher. See Table 8.
| 34 |
Results of PPP
Table 8 Efect of PPP intervention on outcome (case studies)
Efect on outcome
MSSM level (see box A-3 for description)
Total 1 2 3 4 5 NA
+ (positive efect in general)
7 1 5 1 - - -
+/- (mixed efect)
1 1 - - - - -
- (negative efect in general)
1 1 - - - - -
0 (no efect in general)
- - - - - - -
NA (not available/applicable)
9 - - - - - 9
Total
18
3 5 1 - -
9
5 case studies present positive efect on outcome with a counterfactual on MSSM level 2
Malik (2010) fnds that afer implementation of the Punjab Education Foundation (PEF, a
government organization that sponsors PPPs in education) dropout rates decreased and
test scores increased.
Ali et al. (2006) fnd that since the implementation of Rescue-15 the mean response time
became approximately 10 minutes. This is close to international standards.
Newell (2004) notes that the establishment the public private partnership for control of
tuberculosis has led to an increase in case notifcation and treatment success rates
(>90%): more than exceeding international targets (Newell, 2004).
Triodos Facet (2010) fnds the establishment of the PSOM/PSI PPP generated 81 direct
jobs. In 17 projects new products were launched in the recipient country and in 23
projects a new technology for producing existing products was developed.
Bompart et al. (2011) fnd that ASAQ Winthrop (a new anti-malarian combination
implemented by a PPP) led to a decrease of the prices of so-called ACTs (Artesunate-based
Combination Therapy, malaria drugs), see Box 7.
Box 7 ASAQ Winthrop led to price reduction of ATCs
[The] partnership was initiated in 2004 between the Drugs for Neglected Diseases
initiative (DNDi) and sanof-aventis [a private frm] to develop together a fxed-
dose combination of artesunate and amodiaquine, one of the forms of ACT
recommended by the WHO, which at that time only existed as a non-fxed
combination of the two drugs.
The availability of a new medicine does not imply access in the feld. As such, the
partnership made two bold commitments. First, the product would receive no
patent protection. Second, the partners set a target price of one USD per treatment
for adults and 0.5 USD cents for children. Before ASAQ Winthrops introduction to
the marketplace, the price for most ACTs in public markets was approximately 2.50
USD for an adult treatment. Afer ASAQ Winthrops introduction, the global
reference price for ACTs on public markets decreased to approximately 1 USD
Source: Bompart et al. (2011)
Public-Private Partnerships in developing countries
| 35 |
Is there a relationship between the outcome of PPPs and the design of PPPs? We address
this question in Figure 4. In this we fgure present the relationship between the output and
the key PPP characteristics. The fgure shows no relationship between the key PPP
characteristics and the efect of the PPP on output.
Figure 4 Relationship between key PPP design and outcome (n=18)
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s
.
1
,
2
,
3
,
4
A
f
e
r
m
a
g
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)
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A
(
t
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f
P
P
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m
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y
)
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n
e
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g
y
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z
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t
a
l
.
(
2
0
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)
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a
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a
n
d
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a
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r
o
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n
.
1
,
2
,
3
,
4
,
5
C
o
n
c
e
s
s
i
o
n
3
,
7
b
i
l
l
i
o
n
Annexes
| 68 |
S
t
u
d
y
(
a
u
t
h
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a
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r
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5
)
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s
(
I
P
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)
.
1
,
2
,
3
,
4
,
5
C
h
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n
a
a
n
d
I
n
d
i
a
:
B
O
T
I
n
d
o
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s
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a
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d
P
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k
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:
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d
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6
1
6
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:
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7
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0
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:
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2
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a
n
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2
0
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m
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d
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M
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2
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3
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4
J
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N
A
Public-Private Partnerships in developing countries
| 69 |
S
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d
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(
a
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t
h
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a
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d
y
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N
A
Annexes
| 70 |
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N
A
Public-Private Partnerships in developing countries
| 71 |
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N
A
Annexes
| 72 |
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Public-Private Partnerships in developing countries
| 73 |
S
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2
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1
0
0
,
5
3
b
i
l
l
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n
(
t
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)
Annexes
| 74 |
T
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A
-
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Public-Private Partnerships in developing countries
| 75 |
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Annexes
| 76 |
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Annexes
| 78 |
S
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Public-Private Partnerships in developing countries
| 79 |
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Annexes
| 80 |
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8
N
A
Annexes
| 82 |
T
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| 83 |
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.
3
Annexes
| 84 |
S
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1
Public-Private Partnerships in developing countries
| 85 |
S
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1
5
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2
K
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m
a
n
n
a
n
d
T
i
m
m
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m
a
n
n
(
2
0
0
9
)
N
A
N
A
(
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v
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f
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:
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p
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s
.
N
A
N
A
N
A
Annexes
| 86 |
S
t
u
d
y
M
a
i
n
P
P
P
p
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w
a
y
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y
:
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&
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;
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C
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;
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m
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N
A
1
Public-Private Partnerships in developing countries
| 87 |
S
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u
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M
a
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n
P
P
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p
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A
1
Annexes
| 88 |
S
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N
A
2
Public-Private Partnerships in developing countries
| 89 |
S
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N
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1
Annexes
| 90 |
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2
Public-Private Partnerships in developing countries
| 91 |
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2
Annexes
| 92 |
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N
A
1
Public-Private Partnerships in developing countries
| 93 |
Annex 5 summary table reviews (overview studies)
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Annexes
| 94 |
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Public-Private Partnerships in developing countries
| 95 |
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Annexes
| 96 |
S
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Public-Private Partnerships in developing countries
| 97 |
S
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Annexes
| 98 |
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.
Public-Private Partnerships in developing countries
| 99 |
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Annexes
| 100 |
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A
Public-Private Partnerships in developing countries
| 101 |
S
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a
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Annexes
| 102 |
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A
Public-Private Partnerships in developing countries
| 103 |
S
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Annexes
| 104 |
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N
A
Public-Private Partnerships in developing countries
| 105 |
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N
A
Annexes
| 106 |
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Public-Private Partnerships in developing countries
| 107 |
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Annexes
| 108 |
Evaluation reports of the Policy and Operations
Evaluation Department (IOB) published 2008-2013
Evaluation reports published before 2008 can be found on the IOB website:
www.government.nl/foreign-policy-evaluations
No. Year Title evaluation report ISBN
378 2013 Public private partnerships in developing countries.
Systematic literature review
978-90-5328-439-1
377 2013 Corporate Social Responsibility: the role of public policy. A
systematic literature review of the efects of government
supported interventions on the corporate social responsibility
(CSR) behaviour of enterprises in development countries
978-90-5328-438-4
376 2013 Renewable Energy: Access and Impact. A systematic literature
review of the impact on livelihoods of interventions providing
access to renewable energy in developing countries
978-90-5328-437-7
375 2013 The Netherlands and the European Development Fund -
Principles and practices. Evaluation of Dutch involvement in
EU development cooperation (1998-2012)
978-90-5328-436-0
374 2013 Working with the World Bank. Evaluation of Dutch World Bank
policies and funding 2000-2011
978-90-5328-435-3
373 2013 Evaluation of Dutch support to human rights projects.
(2008-2011)
978-90-5328-433-9
372 2013 Relations, rsultats et rendement. valuation de la coopration
au sein de lUnion Benelux du point de vue des Pays-Bas
978-90-5328-434-6
372 2012 Relaties, resultaten en rendement. Evaluatie van de Benelux
Unie-samenwerking vanuit Nederlands perspectief
978-90-5328-431-5
371 2012 Convirtiendo un derecho en practica. Evaluacion de impacto
del programa del cancer cervico-uterino del centro de mujeres
lxchen en Nicaragua (2005-2009)
978-90-5328-432-2
371 2012 Turning a right into practice. Impact evaluation of the Ixchen
Centre for Women cervical cancer programme in Nicaragua
(2005-2009)
978-90-5328-429-2
370 2012 Equity, accountability and efectiveness in decentralisation
policies in Bolivia
978-90-5328-428-5
369 2012 Budgetsupport: Conditional results Policy review (2000-2011) 978-90-5328-427-8
369 2012 Begrotingssteun: Resultaten onder voorwaarden
Doorlichting van een instrument (2000-2011)
978-90-5328-426-1
368 2012 Civil Society, Aid, and Development: A Cross-Country Analysis 979-90-5328-425-4
367 2012 Energievoorzieningszekerheid en Buitenlandbeleid
Beleidsdoorlichting 2006-2010
979-90-5328-424-7
366 2012 Drinking water and Sanitation Policy review of the Dutch
Development Cooperation 1990-2011
978-90-5328-423-0
366 2012 Drinkwater en sanitaire voorzieningen Beleidsdoorlichting van
het OS-beleid 1990-2011
978-90-5328-422-3
Public-Private Partnerships in developing countries
| 109 |
365 2012 Tactische diplomatie voor een Strategisch Concept De
Nederlandse inzet voor het NAVO Strategisch Concept 2010
978-90-5328-421-6
364 2012 Efectiviteit van Economische Diplomatie: Methoden en
Resultaten van onderzoek.
978-90-5328-420-9
363 2011 Improving food security: A systematic review of the impact of
interventions in agricultural production, value chains, market
regulation, and land security
978-90-5328-419-3
362 2011 De Methodische kwaliteit van Programma-evaluaties in het
Medefnancieringsstelsel-I 2007-2010
978-90-5328-418-6
361 2011 Evaluatie van de Twinningfaciliteit Suriname-Nederland 978-90-5328-417-9
360 2011 More than Water: Impact evaluation of drinking water supply
and sanitation interventions in rural Mozambique
978-90-5328-414-8
359 2011 Regionaal en gentegreerd beleid? Evaluatie van het Nederlandse
beleid met betrekking tot de Westelijke Balkan 2004-2008
978-90-5328-416-2
358 2011 Assisting Earthquake victims: Evaluation of Dutch Cooperating
aid agencies (SHO) Support to Haiti in 2010
978-90-5328-413-1
357 2011 Le risque defets phmres: Evaluation dimpact des
programmes dapprovisionnement en eau potable et
dassainissement au Bnin
978-90-5328-415-5
357 2011 The risk of vanishing efects: Impact Evaluation of drinking
water supply and sanitation programmes in rural Benin
978-90-5328-412-4
356 2011 Between High Expectations and Reality: An evaluation of
budget support in Zambia
978-90-5328-411-7
355 2011 Lessons Learnt: Synthesis of literature on the impact and
efectiveness of investments in education
978-90-5328-410-0
354 2011 Leren van NGOs: Studie van de basic education interventies
van geselecteerde Nederlandse NGOs
978-90-5328-409-4
353 2011 Education maters: Policy review of the Dutch contribution to
basic education 19992009
978-90-5328-408-7
352 2011 Unfnished business: making a diference in basic education.
An evaluation of the impact of education policies in Zambia
and the role of budget support.
978-90-5328-407-0
351 2011 Confanza sin confnes: Contribucin holandesa a la educacin
bsica en Bolivia (2000-2009)
978-90-5328-406-3
350 2011 Unconditional Trust: Dutch support to basic education in
Bolivia (2000-2009)
978-90-5328-405-6
349 2011 The two-pronged approach Evaluation of Netherlands
Support to Formal and Non-formal Primary Education in
Bangladesh, 1999-2009
978-90-5328-404-9
348 2011 Schoon schip. En dan? Evaluatie van de schuldverlichting aan
de Democratische Republiek Congo 2003-2010 (Verkorte
samenvating)
978-90-5328-403-2
347 2011 Table rase et aprs? Evaluation de lAllgement de la Dete
en Rpublique Dmocratique du Congo 2003-2010
978-90-5328-402-5
346 2011 Vijf Jaar Top van Warschau De Nederlandse inzet voor
versterking van de Raad van Europa
978-90-5328-401-8
Annexes
| 110 |
345 2011 Wederzijdse belangen wederzijdse voordelen Evaluatie van
de Schuldverlichtingsovereenkomst van 2005 tussen de Club
van Parijs en Nigeria. (Verkorte Versie)
978-90-5328-398-1
344 2011 Intrts communs avantages communs Evaluation de l
accord de 2005 relatif l allgement de la dete entre le Club
de Paris et le Nigria. (Version Abrge)
978-90-5328-399-8
343 2011 Wederzijdse belangen wederzijdse voordelen Evaluatie van
de schuldverlichtingsovereenkomst van 2005 tussen de Club
van Parijs en Nigeria. (Samenvating)
978-90-5328-397-4
342 2011 Intrts communs avantages communs Evaluation de
laccord de 2005 relatif lallgement de la dete entre le Club
de Paris et le Nigria. (Sommaire)
978-90-5328-395-0
341 2011 Mutual Interests mutual benefts Evaluation of the 2005
debt relief agreement between the Paris Club and Nigeria.
(Summary report)
978-90-5328-394-3
340 2011 Mutual Interests mutual benefts Evaluation of the 2005
debt relief agreement between the Paris Club and Nigeria.
(Main report)
978-90-5328-393-6
338 2011 Consulaire Dienstverlening Doorgelicht 2007-2010 978-90-5328-400-1
337 2011 Evaluacin de las actividades de las organizaciones holandesas
de cofnanciamiento activas en Nicaragua
336 2011 Facilitating Resourcefulness. Synthesis report of the
Evaluation of Dutch support to Capacity Development.
978-90-5328-392-9
335 2011 Evaluation of Dutch support to Capacity Development. The
case of the Netherlands Commission for Environmental
Assessment (NCEA)
978-90-5328-391-2
- 2011 Aiding the Peace. A Multi-Donor Evaluation of Support to
Confict Prevention and Peacebuilding Activities in Southern
Sudan 2005 - 2010
978-90-5328-389-9
333 2011 Evaluacin de la cooperacin holandesa con Nicaragua
2005-2008
978-90-5328-390-5
332 2011 Evaluation of Dutch support to Capacity Development. The
case of PSO
978-90-5328-388-2
331 2011 Evaluation of Dutch support to Capacity Development. The
case of the Netherlands Institute for Multiparty Democracy
(NIMD)
978-90-5328-387-5
330 2010 Evaluatie van de activiteiten van de
medefnancieringsorganisaties in Nicaragua
978-90-5328-386-8
329 2010 Evaluation of General Budget Support to Nicaragua 2005-2008 978-90-5328-385-1
328 2010 Evaluatie van de Nederlandse hulp aan Nicaragua 2005-2008 978-90-5328-384-4
327 2010 Impact Evaluation. Drinking water supply and sanitation
programme supported by the Netherlands in Fayoum
Governorate, Arab Republic of Egypt, 1990-2009
978-90-5328-381-3
326 2009 Evaluatie van de Atlantische Commissie (2006-2009) 978-90-5328-380-6
Public-Private Partnerships in developing countries
| 111 |
325 2009 Beleidsdoorlichting van het Nederlandse exportcontrole- en
wapenexportbeleid
978-90-5328-379-0
- 2009 Evaluation policy and guidelines for evaluations No ISBN
324 2009 Investing in Infrastructure 978-90-5328-378-3
- 2009 Synthesis of impact evaluations in sexual and reproductive
health and rights
978-90-5328-376-9
323 2009 Preparing the ground for a safer World 978-90-5328-377-6
322 2009 Draagvlakonderzoek. Evalueerbaarheid en resultaten 978-90-5328-375-2
321 2009 Maatgesneden Monitoring Het verhaal achter de cijfers 978-90-5328-374-5
320 2008 Het tropisch regenwoud in het OS-beleid 1999-2005 978-90-5328-373-8
319 2008 Meer dan een dak. Evaluatie van het Nederlands beleid voor
stedelijke armoedebestrijding
978-90-5328-365-3
318 2008 Samenwerking met Clingendael 978-90-5328-367-7
317 2008 Sectorsteun in milieu en water 978-90-5328-369-1
316 2008 Be our guests (sommaire) 978-90-5328-372-1
316 2008 Be our guests (summary) 978-90-5328-371-4
316 2008 Be our guests (Main report English) 978-90-5328-371-4
316 2008 Be our guests (samenvating) 978-90-5328-370-7
316 2008 Be our guests (hoofdrapport) 978-90-5328-370-7
315 2008 Support to Rural Water Supply and Sanitation in Dhamar and
Hodeidah Governorates, Republic of Yemen
978-90-5328-368-4
314 2008 Primus Inter Pares; een evaluatie van het Nederlandse
EU-voorziterschap 2004
978-90-5328-364-6
313 2008 Explore-programma 978-90-5328-362-2
312 2008 Impact Evaluation: Primary Education Zambia 978-90-5328-360-8
311 2008 Impact Evaluation: Primary Education Uganda 978-90-5328-361-5
310 2008 Clean and Sustainable? 978-90-5328-356-1
309 2008 Het vakbondsmedefnancieringsprogramma Summary English 978-90-5328-357-8
309 2008 Het vakbondsmedefnancieringsprogramma Resumen Espaol 978-90-5328-357-8
309 2008 Het vakbondsmedefnancieringsprogramma 978-90-5328-357-8
308 2008 Het Nederlandse Afrikabeleid 1998-2006. Evaluatie van de
bilaterale samenwerking
978-90-5328-359-2
308 2008 Het Nederlandse Afrikabeleid 1998-2006. Evaluatie van de
bilaterale samenwerking (Samenvating)
978-90-5328-359-2
307 2008 Beleidsdoorlichting seksuele en reproductieve gezondheid en
rechten en hiv/aids 2004-2006
978-90-5328-358-5
If you would like to receive a publication in printed form, please send an e-mail to
IOB@minbuza.nl, mentioning the title and ISBN number.
| 112 |
Published by:
Ministry of Foreign Afairs of the Netherlands
Policy and Operations Evaluation Department (IOB)
Layout: VijfKeerBlauw, Rijswijk
Print: Zalsman BV
ISBN: 978-90-5328-439-1
Ministry of Foreign Afairs of the Netherlands | April 2013
Titel van het rapport | IOB Evaluatie | nr. 000 | Titel van het rapport | IOB Evaluatie | nr. 000 | Titel van het rapport | IOB Evaluatie | nr. 000 | Titel van het rapport | IOB Evaluatie | nr. 000 | Titel van het
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Public-Private Partnerships in developing countries | IOB Study | no. 378 | Public-Private Partnerships in developing countries | IOB Study | no. 378 Public-Private Partnerships in developing countries
Published by:
Ministry of Foreign Afairs of the Netherlands
Policy and Operations Evaluation Department (IOB)
P.O.Box 20061 | 2500 eb The Hague | The Netherlands
www.government.nl/foreign-policy-evaluations
Ministry of Foreign Afairs of the Netherlands | April 2013
13Buz616814 | E
Public-private partnerships (PPPs) are a
relatively recent phenomenon in international
development cooperation. Current policy
documents frequently refer to expectations
regarding their potential contributions to global
development goals. The growing international
atention was frmly backed by the Netherlands
government. However, there are still few
diagnostic tools available to determine when and
how PPPs represent a preferred institutional
arrangement. Moreover, the empirical evidence
on the efectiveness and efciency of PPPs is
notably scarce.
This IOB study provides insights in the variety of
PPP arrangements. A major conclusion derived
from this review is that PPP evaluations focus on
resource sharing but pay litle atention to the
risk-sharing and revenue distribution dimension
of partnerships.