Sustainable Health Care Public-Private Partnerships in Emerging Economies

This study examines the sustainability performance of health care Public-Private Partnerships (PPPs) in emerging economies across economic, social, and environmental dimensions. Using panel data from 148 projects in 22 countries (2005-2022) and a multilayer network framework, it compares PPPs with traditional procurement. Results show that PPPs improve financing, access, and patient satisfaction, with moderate environmental gains. Governance quality and macroeconomic stability enhance these effects, while interdependencies reveal how advances in one area reinforce those in others. The analysis links PPP outcomes to Sustainable Development Goals (SDGs 3, 9, 10, 12, 13, and 16) and confirms robustness through alternative indices and models. This is the first integrated evaluation of health care PPPs in emerging economies, offering guidance for embedding ESG standards, resilience clauses, and monitoring benchmarks.