Collaboration in a public-private partnership (PPP) to strengthen primary health care services was accelerated by strong interpersonal relationships, nurtured through partners’ investment of time and effort, and encouraged by having formal governance structures.

Changes such as the introduction of new partners and the planned exit of the implementation partner disrupted collaboration in the PPP.

The Actor-Network Theory can assist PPPs in framing and reviewing collaborative processes and membership and can provide real-time opportunities for improvement and action.

Organizations participating in PPPs for PHC should engage in thoughtful and considered identification and review of stakeholders and ensure the roles and responsibilities of each stakeholder are understood.

Organizations implementing PPPs should recognize the factors that support and impede open communication and mutually beneficial collaboration.

Organizations implementing PPPs should seek national-level policies and guidelines that assist local-level partnerships with forming, operating, and exiting with sustainable outcomes.

In low- and middle-income countries, public-private partnerships (PPPs) are often used to support the delivery of primary health care (PHC). We explore the processes of collaboration in a corporate social responsibility investment in PHC that was delivered through a PPP model in Western Province, Papua New Guinea, in 2009–2018 to strengthen PHC services.

Qualitative interviews were conducted with stakeholders in the PPP (N=20). Key program documents were also reviewed. Data were coded using a general inductive approach, and Actor-Network Theory (ANT) was used to frame the analysis.

Four dominant themes emerged: (1) interpersonal relationships accelerate collaboration, (2) collaboration requires time, (3) formal governance structures encourage collaboration, and (4) internal change disrupts collaboration. The research provides insight into the role of collaboration for more efficient, effective, and impactful design and implementation of PPP for PHC. It makes suggestions for how ANT may be used when designing PPPs and for the ongoing management of relationships between partners. We found ANT to be a useful framework to conceptualize the complex dynamics between the “actors” within the PPP and to identify opportunities for improvement where structural changes may be made to circumvent issues that may compromise effective collaboration.

Collaboration is key to the success of PPPs for PHC. We found collaboration is not formulaic but is driven by actors, relationships, time, and governance. ANT can assist in designing, understanding, and managing the complex relationships between stakeholders of a PPP, who often come with diverse agendas, experiences, values, and perspectives.

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