Saudi Cultural Missions Theses & Dissertations

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Subject: search.filters.subject.Public-Private Partnerships (PPPs)

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    Trust in Healthcare Public-Private Partnerships in Delhi NCR: A Systematic Review of Stakeholder Perceptions and Governance Challenges
    (Saudi Digital Library, 2025) Alsaqabi, Dimah; Bhardwaj, Simran; Sultana, Parveen; Albariqi, Yazeed; Chichani, Sushant; Alshrari, Zeyad; Preethi, John
    Background: Trust is central to the success of healthcare public-private partnerships (PPPs) yet remains poorly understood in the Indian context. This review examines trust dynamics in PPPs within Delhi NCR, a region marked by complex governance and significant PPP activity. Objectives: To identify key trust factors and its dynamics discussed in the literature on healthcare PPPs across Delhi NCR; and to provide recommendations for building and sustaining trust in future healthcare PPPs. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Elsevier, institutional library repositories, and Google Scholar encompassing studies published between January 2000 – May 2025. Inclusion criteria targeted empirical studies, policy papers, and case reports on trust in Indian healthcare, particularly Delhi-NCR context. Data were thematically synthesised using Braun and Clarke’s Thematic Analysis method and analysed through McKnight’s and Institutional Trust frameworks. Case study analysis was conducted using Porter’s Value Chain. Results: Forty studies met inclusion criteria. Five interrelated trust factors were identified: transparency, accountability, stakeholder engagement, regulation, and payment. Transparency and accountability showed strong positive correlation (r = 0.72). A Delhi-based dialysis PPP case study validated thematic findings, highlighting systemic trust breakdowns. Limitations: This review's findings are limited by being sector specific, as trust dynamics in healthcare PPPs may not translate directly to other sectors. Geographic bias is evident, with limited representation of regions beyond Delhi NCR, reducing national applicability. Additionally, the cross-sectional nature of most studies restricts insight into how trust evolves over time. Conclusion: This review examined what builds and breaks trust in healthcare PPPs, with a focus on Delhi-NCR. Five interconnected trust factors: transparency, accountability, stakeholder engagement, regulation, and payment were consistently identified. Transparency emerged as the most foundational, enabling or disabling other trust mechanisms. Theoretical frameworks helped explain paradoxes, such as low trust in high-influence stakeholders. Ultimately, trust must be intentionally embedded into PPP design through inclusive, transparent, and accountable governance.
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    Public-Private Partnerships (PPP) in Sustainable Infrastructure Development in Saudi Arabia: A Risk-Reward Analysis from a Project Management and Contracting Perspective
    (Saudi Digital Library, 2025) Alanzi, Mashal Johim; Hasan, Fakhrul
    This study investigates the dynamics of risk and reward allocation, governance, and technological enablers in Saudi Arabia’s Public-Private Partnerships (PPPs) within the framework of Vision 2030. Using a qualitative methodology based on semi-structured interviews and thematic analysis in NVivo, the research identified 13 initial codes consolidated into four overarching themes: risk–reward mechanisms, project management and governance, institutional and technological enablers, and international best practices. Findings reveal that while PPPs are central to infrastructure delivery, risk allocation in Saudi Arabia remains highly government-centric, often undermined by opaque communication and weak project management capacity. Governance reforms, such as the PSP Law, provide a legal basis, yet institutional fragmentation and regulatory overlaps persist. Technology, including blockchain and AI, is recognised as a potential enabler of transparency but remains at a largely symbolic stage. Comparative analysis highlights that international best practices can inform Saudi PPPs only when adapted to the Kingdom’s socio-economic and institutional context. The study advances PPP scholarship by providing a context-specific understanding of governance and risk-sharing in emerging markets, integrating technology as a dual enabler, and offering practical recommendations for policymakers, investors, and project managers.
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