What Makes International Global Health University Partnerships Higher-Value? An Examination of Partnership Types and Activities Favoured at Four East African Universities

Abstract

Background:There are many interuniversity global health partnerships with African universities. Representatives of these partnerships often claim partnership success in published works, yet critical, contextualized, and comparative assessments of international, cross-border partnerships are few.Objective:The objectives of this paper are to describe partnerships characterized as higher-value for building the capacity of four East African universities and identify why they are considered so by these universities.Methods:Forty-two senior representatives of four universities in East Africa described the value of their partnerships. A rating system was developed to classify the value of the 125 international partnerships they identified, as the perceived value of some partnerships varied significantly between representatives within the same university. An additional 88 respondents from the four universities and 59 respondents from 25 of the international partner universities provided further perspectives on the partnerships identified. All interviews were transcribed and analysed in relation to the classification and emergent themes.Findings:Thirty-one (25%) of the partnerships were perceived as higher-value, 41 (33%) medium-value, and 53 (42%) lower-value for building the capacity of the four focus universities. Thirteen (42%) of the higher-value partnerships were over 20 years old, while 8 (26%) were between 3 and 5 years old. New international partners were able to leapfrog some of the development phases of partnerships by coordinating with existing international partners and/or by building on the activities of or filling gaps in older partnerships. Higher-valued partnerships supported PhD obtainment, the development of new programmes and pedagogies, international trainee learning experiences, and infrastructure development. The financial and prestige value of partnerships were important but did not supersede other factors such as fit with strategic needs, the development of enduring results, dependability and reciprocity. Support of research or service delivery were also considered valuable but, unless education components were also included, the results were deemed unlikely to last.Conclusion:International partnerships prioritizing the needs of the focus university, supporting it in increasing its long-term capacity and best ensuring that capacity benefits realized favour the focus university are valued most. How best to achieve this so all partners still benefit sufficiently requires further exploration.

Reciprocity in international interuniversity global health partnerships

“…This study, conducted in three distinct phases, used multiple methods to explore the practice of reciprocity in 125 partnerships of four focus universities-see Yarmoshuk et al (2016Yarmoshuk et al ( , 2018 and Yarmoshuk et al (2019). The analysis reported here is a secondary qualitative analysis of data collected to examine how international interuniversity partnerships contribute to developing the health professional programmes (HPPs) of four East African universities.…”

“…Two participants declined permission for voice recording but allowed detailed notes to be taken. (More details on methods and other findings can be found in Yarmoshuk et al (2016), Yarmoshuk et al (2018) and Yarmoshuk et al (2019)). The interviews were semistructured, with guides for each type of respondent and follow-up probes (guides are part of the earlier three publications cited).…”

“…Previous analyses provided the elements for developing the analytic framework and arriving at the findings reported here (Yarmoshuk et al 2016(Yarmoshuk et al , 2018Yarmoshuk et al 2019). All 125 partnerships were classified using the three types of reciprocity discussed above-(i) specific, (2) diffuse bilateral and (3) diffuse multilateral.…”

“…Their overall stated objective is to address health inequities between populations and also often between the participating institutions, especially between higher-income countries (HICs) and lower-and middle-income countries (LMICs). Inequalities in terms of the existing capacities and access to resources (Gaillard 1994;Mulvihill and Debas 2011;Leng 2016) can result in power imbalances between the partners to such an extent that some partnerships can be considered disempowering or neo-colonial (Canto and Hannah 2001;Yarmoshuk et al 2018).…”

“…Nineteen of the 21 activities were stated to be particularly significant for capacity development at their institutions, by at least some representatives. A second paper (Yarmoshuk et al 2018) reported that 25% of the partnerships were judged to be higher-value by the senior representatives of the four East African universities. Thematic analysis revealed that all higher-value partnerships shared three general characteristics: the outputs and outcomes addressed a priority need of the university; the long-term capacity of the focus university to fulfil its mandate was increased; and the overall capacity building benefits realized by the focus university were perceived to be fair when compared to the benefits realized by the international partner (i.e.…”