As countries work toward stronger, more resilient health supply chains, private-sector engagement (PSE) often plays a critical role. Private companies bring expertise in many areas including transportation and warehousing, telecommunications, pharmaceutical distribution and information systems — capabilities that can expand reach and improve efficiency across health systems. But as VillageReach learned through the Supply Chain Integrators (SCI) investment, successful and sustainable PSE doesn’t happen simply by inviting the private sector in. It requires alignment, clarity, trust and attention to detail.
This is the theme of third lesson from the SCI Five-Year Report: Building Responsive, Integrated Health Supply Chains in Africa: Achievements and Lessons from the Supply Chain Integrators Investment.
The Promise—and the Complexity—of Public-Private Partnerships
PSE has long been part of global health strategies. But despite its potential, it often falls short when private sector strategies are misaligned or disconnected from government priorities or when government misunderstands the incentives needed for private sector involvement. VillageReach’s work under the SCI investment reinforced that governments must lead, and public private relationships must be built on shared goals, accountability and open communication.
We believe sustainable PSE impact that truly strengthens supply chain performance relies on these critical details:
- Understanding and addressing misperceptions;
- Creating alignment around “win-win” objectives;
- Measuring progress; and
- Establishing systems to hold all partners accountable.
Without attention to these details, PSE efforts will be short lived, misaligned or ineffective. But when partnerships are built thoughtfully, with countries in the lead, they can expand access, increase efficiency and cost-effectiveness and make health systems more responsive to community needs.
A Deeper Look: Private Transport Partnerships in Action
Trucks loading at provincial store, Mozambique. Photo Credit: John Beale
The complexity of PSE is best illustrated by the example of VillageReach’s private transport integration, where the details truly determined success. VillageReach provided technical assistance for outsourced transport to 15 African countries throughout the investment, supporting them at different stages of PSE readiness and implementation. The breadth of this support underscored a key finding: while PSE can improve efficiency and resilience, it succeeds only when built on long-term, trusted relationships — relationships rooted in details, not assumptions.
To help governments and private companies work together productively, VillageReach invested in tools, evidence and convenings designed specifically to support collaboration. Even in countries with proven outsourced transport models—such as Mozambique—replicating or scaling these models required careful attention to stakeholder perceptions, cost structures, contract quality, collaboration mechanisms, and performance monitoring systems.
Aligning stakeholder perceptions
VillageReach conducted an outsourced transport perception survey across five African countries — Mozambique, Zambia, Kenya, Democratic Republic of Congo and Malawi — to understand how government officials and private companies viewed integration of private transport into public health systems. The goal of the survey was not to immediately integrate outsourced transport, but to create mutual understanding and a willingness to partner, regardless of where each country stood in its journey towards stronger public health transport systems.
Each country participated in a multi-stakeholder workshop to review survey results, key insights and identify solutions collectively. These open conversations helped demystify the private sector’s strategies and capabilities, identify key government behaviors and actions needed for success and build trust across stakeholders that often have little experience working together. This collaborative approach, enabled by the survey and workshops, helped shift PSE from a transactional model to a strategic partnership, where all parties understand their roles and responsibilities, and developed a shared commitment to improving access to health products.
Sharing knowledge and tools that enable partnership
During the investment VillageReach also developed a resource library to support governments and private partners in building sustainable outsourced transport models. This included technical notes, tools and guidance on strategies and operations, including:
With these resources, governments and their partners were better equipped to manage partnerships, negotiate contracts and ensure joint quality and accountability from government managers and private transport providers.
The Lesson for the Future
As African governments adapt to this new funding environment and prioritize how to maintain and strengthen health systems, they must utilize all available in-country resources. While VillageReach’s approach is grounded in government sovereignty over their health systems, our view is that sovereignty does not mean government needs to do everything. The role of the local private sector in health supply chains, in particular logistics firms, will continue to grow. But success requires these partnerships to be grounded in clarity, trust and shared accountability.
Lesson three reminds us that the private sector has a critical role to play—but only when countries have the tools, evidence and confidence to develop and manage those partnerships on their own terms.
Through the SCI investment, flexible and catalytic funding allowed countries to test, adapt and institutionalize partnership models aligned with their priorities — supporting reforms that endure beyond any single project or grant. When donors invest in country‑led problem solving that leverage all available resources including the local private sector, rather than prescribed solutions, the result is stronger stewardship, more resilient systems and partnerships that delivers lasting impact.