Bridging healthcare gaps through public-private partnerships in Nigeria: a scoping review.

Abstract

Nigeria's healthcare system faces several persistent structural challenges. Public-private partnerships (PPPs) have emerged as a strategy to address these gaps, although evidence on their implementation and impact remains fragmented. This scoping review mapped the implementation models, outcomes, challenges and future directions of PPPs in Nigeria's healthcare system, following the Arksey and O'Malley framework and PRISMA-ScR guidelines. Literature searches were conducted across PubMed, Scopus, Web of Science, Google Scholar and grey literature sources. Studies were screened using Rayyan, while eligibility was guided by the population-concept-context framework. Data were synthesized using descriptive and thematic analysis. Twenty-four studies were included, covering PPP applications across primary, secondary, tertiary and community healthcare systems. Identified models included service delivery, financing, infrastructure, supply chain and governance partnerships. The included evidence reported improvements in healthcare access, diagnostic capacity, immunization coverage, infrastructure development and system efficiency, particularly in tuberculosis diagnostics, radiology, dialysis and radiotherapy services. However, weak governance, poor stakeholder coordination, funding instability, affordability barriers and inequitable urban concentration of benefits persisted. Strengthening regulatory frameworks, sustainable financing, accountability and equitable access may enhance PPP implementation and enable appropriately governed PPPs to contribute to selected dimensions of healthcare access and service capacity relevant to universal health coverage in Nigeria.