الصحة العامة

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Browsing الصحة العامة by Author "Mohammad Mahmoud Mustafa Baniode"

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    Understanding the Determinants Influencing Decision-Makers’ Adoption of Public-Private Partnership Strategy in the Palestinian Healthcare Sector: A Mixed-Methods Study (PHD)
    (Al-Quds Univeersity, 2026-05-24) Mohammad Mahmoud Mustafa Baniode; محمد محمود مصطفى بني عودة
    Background: Public–Private Partnership (PPP) is increasingly recognized as a policy mechanism for improving efficiency, quality, and sustainability in healthcare systems, particularly in resource-constrained settings. Although PPPs are included in Palestinian health policy discourse, their implementation remains limited. This study examined the determinants of decision-makers’ intentions to adopt PPPs, as well as sectoral preferences and governance considerations influencing their implementation. Methods: A sequential exploratory mixed-methods design was conducted between 2023 and 2025. The formative phase involved 14 participants to refine the study focus and inform instrument development. The qualitative phase comprised 17 in-depth interviews with key informants from public, private for-profit, and private not-for-profit health sectors. Findings informed the development of a questionnaire grounded in the Theory of Planned Behavior (TPB). The quantitative phase included 163 senior decision-makers from 42 hospitals in the West Bank (71% response rate). Data were analyzed using thematic analysis, descriptive statistics, non-parametric tests, and Structural Equation Modeling (SEM). Results: The formative phase identified context-specific factors shaping PPP adoption and informed instrument development. Qualitative findings highlighted governance, financial, and operational challenges, including limited feasibility evidence, unclear stakeholder roles, weak coordination, and regulatory constraints. Sectoral differences were evident, with public-sector participants favoring regulated PPP models, private for-profit stakeholders preferring greater operational flexibility, and not-for-profit organizations emphasizing equity and access. Quantitative findings showed that Attitude toward the Behavior and Subjective Norm significantly predicted Behavioral Intention, whereas Perceived Behavioral Control and the mediating construct were not significant. The model explained 46.5% of the variance in Behavioral Intention (R² = 0.465). Policy analysis revealed broad support for management and service-operation PPP models in which government retains asset ownership while private partners manage service delivery. Full privatization was consistently rejected. Integration of findings indicated that PPP adoption is influenced by behavioral factors, governance arrangements, institutional readiness, and sector-specific preferences. Conclusion: PPP adoption intentions in the Palestinian health sector are primarily driven by attitudinal and normative factors, while implementation feasibility is shaped by governance and institutional conditions. Effective PPP development requires strengthened regulatory frameworks, improved inter-sectoral coordination, and context-sensitive partnership models aligned with stakeholder priorities.