Abstract
Background Saudi Arabia is considering increasing the role of the private sector's participation in financing and delivering healthcare services through the adoption of Public-Private Partnerships (PPPs). However, the adoption and successful implementation of PPPs in the Saudi healthcare sector requires careful attention to overcome potential obstacles. Objectives This study investigates and identifies potential barriers to the successful implementation of PPPs in the Saudi healthcare sector. Methods A pre-tested interviewer-administered questionnaire was used to collect data from 72 respondents over a two-month period. Respondents were asked to rate the degree of influence of potential key barriers using a five-point Likert scale. The collected data was analysed using descriptive and inferential statistics. Results The evidence showed that the top three barriers, as rated by the respondents, were legal barriers, including delays in receiving approval and permits and law and regulation changes, environmental barriers, including lack of transparency and accountability and technological barriers, including a shortage of professionals qualified to handle PPP projects. Conclusions The barriers identified suggested that the government should ensure that PPPs are implemented in a timely manner to ensure that private sector involvement yields the intended benefits. Furthermore, a stable legal and regulatory framework must be established that is properly and easily enforced to avoid confusing stakeholders with too many changes. It is also important to ensure that transparency and accountability measures are strengthened.