Public-Private Partnership (ppp) Handbook

Figure 5: Structure of Management Contract
Source: Heather Skilling and Kathleen Booth. 007.
Government
Public Service Provider
Private Operator
Regulation: 
Tariff setting 
Service standards 
Environmental monitoring
Investment 
& Subsidy
Reporting
Approvals
Tariff
Management

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    Public–Private Partnership Handbook
Box 4: Cambodia—Contracting Out Primary Health Care to Nongovernment 
Organizations 
In addition to their uses in infrastructure, management contracts are used for other municipal 
services such as health care. In Cambodia, -year management contracts with nongovernment 
organizations were put in place in primary health care facilities in 1 districts. The contractor 
has full-line management responsibility and must respond to performance targets including 
achievements in immunization, antenatal care, family planning, and services to the poor. 
The contractor must provide certain services free of charge (emergency obstetrical care, 
minor surgery, inpatient treatment of serious illnesses). Compared with publicly managed 
facilities, the Government found that private management was more effective than public 
management in terms of performance and coverage achievements, and improvement in 
working conditions for staff.
Sources: Loevinsohn, Benjamin. 000. 
Contracting for the Delivery of Primary Health Care in Cambodia: Design 
and Initial Experience of a Large Pilot Test
. World Bank Institute Flagship Program Online Journal. Available: 
www.worldbank.org/wbi/healthflagship/ journal/index.htm; Bhushan, Indu, Sheryl Keller, and Brad Schwartz. 
00. Achieving the Twin Objectives of Efficiency and Equity: Contracting Health Services in Cambodia. 
Economic 
and Research Department Policy Brief
 No. 6. Manila: ADB.