Many people in developing countries are exposed to a greater risk to access essential healthcare services. The World Health Organization (WHO) and the World Bank estimate that more than half of the world’s 7.3 billion people do not obtain all of the essential needed healthcare services. To minimize this burden, Sub-Saharan African (SSA) countries have embraced the private sector through public-private partnership (PPP) as a mean to achieve Universal Healthcare Coverage (UHC). A number of publications have raised the importance of institutional setting for effectiveness of the PPP in the region. However, very few have outstretched persuasive requirements to examine the effectiveness of PPP considering SSA’s socio-economic context. This paper examines the applicable environment for PPP in healthcare systems in SSA and has observed a trend of decrease in resources allocated by developing countries to healthcare services; increasing participation of private sector in healthcare delivery; the effectiveness of PPP is determined, but not limited to, by the quality of institutions and additional variables such as cultural characteristics, community attributes, and physical or material conditions.