Stakeholder's experience on financial incentive-based regulatory instruments for public-private partnership in developing countries: a study from Iran's primary health care delivery system.

backgroundRegulatory instruments are a key necessity to implement public-private partnership's strategy. This study aimed to explore the stakeholders' experience on financial incentive-based regulatory instruments for public-private partnership in Iran's primary health care (PHC) delivery system.

methodsThis qualitative study was involved face-to-face interviews with 18 stakeholders in primary health care partnership projects including employers, experts, contractors, and executive managers of contracted companies operating as a private health sector participant in primary health care services. The data were analyzed using the framework analysis method.

resultsTwenty-four codes were developed. Findings showed that the current state of financial incentive-based regulatory instruments in Iran's PHC delivery system faced some challenges despite existing capacities. These challenges include the lack of an independent trustee for access to capital, and a comprehensive regulatory program to facilitate private sector participants' access to capital, and partnership contracting mechanisms. Findings also showed main challenges of these instruments related to access to capital, tax incentives and subsidies, staff mobility control mechanisms, partnership contracting mechanisms, and provider payments.

conclusionThe presence of significant challenges in Iran's health care system can impact the private sector's motivation to participate in primary health care. By improvement the infrastructure, reforming legal processes, and providing financial incentives, the government can boost the private sector's motivation in primary health care and advance the health sector's goals.