Tuberculosis (TB) is a major public health problem in many low- and middle-income countries, including Indonesia. To accelerate TB case detection, and to improve the quality of diagnosis and treatment provided by all providers, the Public-Private Mix for implementing Directly Observed Treatment Short-course (PPM DOTS) was introduced in 2000. However, previous studies on PPM DOTS have focused on private practitioners and there has been a scarcity of research on PPM DOTS in the hospital setting. This dissertation aims to capture the potential of the PPM DOTS strategy, and identify the barriers to its implementation in hospitals in Indonesia. This dissertation is based on four separate but interrelated studies: 1. A costeffectiveness analysis, comparing incremental cost per additional number of TB cases successfully treated under three strategies of PPM DOTS in four provinces. 2. An evaluation of the access to TB services by a cross-sectional study among 62 hospitals, by estimating the proportion of TB cases receiving standardised diagnosis and treatment according to the DOTS strategy. The data were analysed using poststratification analysis. 3. The quality aspect was explored in a multiple-case study, including eight selected hospitals. The data were analysed using cross-case analysis. 4. The process of partnership was explored through a qualitative study. In-depth interviews were conducted with 33 informants, who were actors involved in PPM DOTS in hospitals in Yogyakarta province. Content analysis was applied to the qualitative data. PPM DOTS in hospitals was shown to be a cost-effective intervention in this particular context. However, the quality of the implementation was commonly suboptimal. In addition, a substantial number of TB cases did not get standardised diagnosis and treatment as per the DOTS strategy. The process of creating partnership among hospitals and National TB Programme was shown to be complex and dynamic. Process factors, such as commitment to collaboration and interaction and trust among the actors, were shown to be important. The rapid scaling-up of PPM DOTS in hospitals at the national level in Indonesia should be revisited. Indeed, considering the importance of hospitals in TB control, the implementation should be continued and expanded. However, more attention needs to be given to process, context and governance.

Magistro baigiamajame darbe išanalizuotos viešosios ir privačiosios partnerystės formos ir jų taikymo galimybės viešųjų paslaugų sektoriuje. Taip pat pateikiamos rekomendacijos koncesijų taikymo kelių statybos srityje tobulinimui. Pirmoje darbo dalyje teoriškai išanalizuoti tradicinio ir modernių viešųjų paslaugų teikimo būdų teoriniai aspektai, ypatingai išryškinant specifinius jų bruožus, privalumus ir trūkumus. Antrajame skyriuje analizuojami praktiniai koncesijos taikymo kelių statyboje atvejai – Palangos ir Vilniaus aplinkkeliai. / Master's thesis analyzed the public-private partnership forms and applications for the public service sector. It also provides guidance on the application of concessions in the field of road construction development. The first part of the theoretical analysis of the traditional and the modern public service delivery methods of theoretical aspects, particularly highlighting their specific features, pros and cons. The second section discusses the practical application of the concession road construction cases - Palanga and Vilnius bypasses.

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