Global health partnerships, governance, and sovereign responsibility in western Kenya

Abstract

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Global health enabling systems

“…Thus we cannot suggest that unacknowledged inequities alone are forcing the (mis)use of the word 'partnership' even though 'partnership' is admittedly often invoked to defensively suggest equity (Brown 2015; Fourie this issue). Whilst I do not in any way dismiss these very real and common inequities, I would like to suggest that the term 'partnership' is also a convenient misnomer for transnational scientific endeavors that have other feature(s) in common that distinguish them from straightforward collaboration.…”

“…The most heavily criticized partnerships may be those that are cobbled together as 'postal' or 'parachute' projects (Costello and Zumla 2000;Wolffers, Adjei, and van der Drift 1998;Ross-Degnan et al 1992;Fullwiley 2011;Osseo-Asare 2014), but many modern partnerships aspire to an ongoing local presence and mid-term goals (Brown 2015;Crane 2013;Wendland 2016). Implementation science measures sustainability, but in the area of global health, it is less popular and credited than developing and testing brand new interventions (Madon et al 2007;Geng, Peiris, and Kruk 2017).…”

“…Ownerships evolve and at the end of the day -unless a partnership is lifelong -each partner should get to keep something. All of these features are aspirations of global health partnerships, irrespective of whether they are achieved (Brown 2015;Abrahamsen 2004;Elmusharaf et al 2016;Koplan et al 2009). …”

“…Often inefficient public services -such as water, electricity, and security -are overloaded, and artificial cadres and silos of staff and patients are created and must be managed (Brown 2015), all to test interventions that communities may or may not ever receive. We must therefore accept that the valuable immediate offerings made by partnerships could delay more permanent solutions.…”

NGOs, partnerships, and public-private discontent in Nepal’s health care sector

“…For example, scholars have studied how PPPs have injected large amounts of money into national budgets, generally for disease-specific and vertical health programming (Peters and Phillips 2004;Pfeiffer 2013;Ramiah and Reich 2005;Ravishankar et al 2009); created new modes of health governance, including taking on core responsibilities of the public sector (Brown 2015;Gerrets 2015;Kapilashrami and O'Brien 2012;Ruckert and Labonté 2014); and generated new standards and forms of evaluation and accountability (Adams 2016;Cueto 2013;Packard 2016;Taylor and Harper 2015;WHO 2008) that are typically unconcerned with community definitions of, or concerns over, notions of 'scale', 4 'success', or 'impact'.…”