Healthcare Infrastructure Development Finance: A Comparative Analysis of Direct Government Funding and Public Private Partnership Option

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Abstract

This study undertook a comparative analysis of direct government finance and public private partnership (PP) option for healthcare infrastructure development. The objective is to assess the cost, time and financing leverage effects of the two financing options. The Federal Medical Centre (FMC) Owerri was used as study location. Two identical building projects: Ward II funded through PPP and Ward 10 funded through direct government financing was used as case studies. A combination of secondary and primary data was used in the analysis. The secondary data was basically projects cost and time performance data of each of the sampled projects, while the primary data is made up responses of 72 project participants to our 5-point Lirkert structured questionnaire.Descriptive analysis and inferential statistics were carried out on the collected data. The results of our analysis shows that though the two projects experience 7months (28 weeks) time overruns, but ward 10 achieved 62% scope completion and recorded N793,910.83 time overruns, but ward 10 achieved 62% scope completion and recorded zero cost overruns. Also ward 10 created a public debt profile of N65,935,642.50, while ward II attracted private investment of N160,292,507.17 as opposed to public debt. Ward II recorded a high positive financing leverage level of +2.14, while that of ward 10 is negative and as low as – 0.39. The implication being that FMC Owerri is almost completing the development of a healthcare infrastructure (Ward II) worth N235,292,507.17 with investment of N75,000,000.00 using PPP option. On the other hand government has invested N170,150,776.00 through direct funding of Ward 10 as well is owing the contractor N65,935,642.50 without knowing the cost and time of completion. However, conflict within the project team, socio-economic instability and instability in government policies and programmes were found to have exerted the most significant effect on PPP funding of infrastructural projects. This is not significantly different from that faced by direct government funding. Equally, 97% of stakeholders are of the opinion that healthcare infrastructure development should be better funded by direct public sector budgetary provisions, while 86% disagreed with executing public health infrastructure using PP. sparingly, 87.5%; 97%; 87.5%; 66.67% and 63.89% are of the opinion that PPP is more advantageous for financing healthcare infrastructure development with respect to scope; time; cost; risk and quality managements of projects respectively. This contradiction in opinion confirms that the general aversion of public sector workers to the use of PPP option for public infrastructure development is due to reasons not based on cost and time efficiency and effectiveness in delivery.

Keywords: Public Private Partnership (PPP), Infrastructure, cost overruns, funding, quality management, time.

 CHAPTER ONE: INTRODUCTION

  1. 1.1  Background of study.............................................................1

  2. 1.2  Statement of Problem............ ...............................................4

  3. 1.3  Aim and Objectives... ..........................................................5

  4. 1.4  Research Questions...............................................................6

  5. 1.5  Research Hypotheses.............................................................7

  6. 1.6  Significance of the Study.................. ....................................7

  7. 1.7  Scope and Limitations............ .............................................10

CHAPTER TWO: LITERATURE REVIEW

2.1 Conceptual framework...........................................................12

  1. 2.1.1  Capital investment project............ ........................................12

  2. 2.1.2  Project finance ........................... .......................................15

  1. 2.2  Historical perspective of project finance......................................18

  2. 2.3  Project financing structure.......................................................22

  3. 2.4  Theoretical Framework ........................... ............................ 26

  4. 2.5  Project Financing and Its Benefits..............................................30

2.5 Characteristics of Project Financing .............................................33

2.6 Public Sector financing of Public infrastructure Project......... .............34

2.7 Financing Infrastructure project through Public - Private Partnership 37

  1. 2.8  Global perspectives on PPP infrastructure financing........................38

  2. 2.9  Framework for PPPs project financing ........................................43

  3. 2.10  Contracts Structure for PPPs Projects..........................................48

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Description of the Questionnaire...... .........................................59 
3.2 
Research Design................................................................. 55
3.3 
Types and Sources of Data Used................................. ............56
3.4
  Study population and sample size selection.................................. 57
3.4.1 
Study sample and size selection ... ..............................................57

3.5 Tools for Data Presentation and Analysis...... ...............................60

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

4.1 Primary Data............... .......................................................61

4.2 Secondary Data........................ ........................................71

4.3 Hypotheses Testing............................................................... 74


CHAPTER FIVE: CONCLUSIONS AND RECOMMENDATIONS

  1. 5.1  Summary of findings..............................................................76

  2. 5.2  Conclusions......... ...............................................................77

  3. 5.3  Recommendations..................................................................78

References..................... .............................................................80

Appendix....................................................................................85 

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APA

Chinyere, U (2021). Healthcare Infrastructure Development Finance: A Comparative Analysis of Direct Government Funding and Public Private Partnership Option. Afribary. Retrieved from https://afribary.com/works/healthcare-infrastructure-development-finance-a-comparative-analysis-of-direct-government-funding-and-public-private-partnership-option

MLA 8th

Chinyere, Uwakwem "Healthcare Infrastructure Development Finance: A Comparative Analysis of Direct Government Funding and Public Private Partnership Option" Afribary. Afribary, 22 Feb. 2021, https://afribary.com/works/healthcare-infrastructure-development-finance-a-comparative-analysis-of-direct-government-funding-and-public-private-partnership-option. Accessed 28 Mar. 2024.

MLA7

Chinyere, Uwakwem . "Healthcare Infrastructure Development Finance: A Comparative Analysis of Direct Government Funding and Public Private Partnership Option". Afribary, Afribary, 22 Feb. 2021. Web. 28 Mar. 2024. < https://afribary.com/works/healthcare-infrastructure-development-finance-a-comparative-analysis-of-direct-government-funding-and-public-private-partnership-option >.

Chicago

Chinyere, Uwakwem . "Healthcare Infrastructure Development Finance: A Comparative Analysis of Direct Government Funding and Public Private Partnership Option" Afribary (2021). Accessed March 28, 2024. https://afribary.com/works/healthcare-infrastructure-development-finance-a-comparative-analysis-of-direct-government-funding-and-public-private-partnership-option