Towards a simple typology of international health partnerships

Abstract

Background: International health partnerships are one approach to capacity building in health systems. The evidence base for institutional partnerships for health service development remains weak and evaluation of the process and outcomes of health partnerships is a priority. The variability of partnerships contributes to the challenge of understanding their effectiveness and a typology of partnerships could aid evaluation. We analysed the proposals for all of the partnerships that received funding from the Tropical Health and Education Trust in 2012-2013 to develop such a typology. Methods: Our data consisted of 54 successful project proposals for health partnerships funded by THET in 2012-2013. A coding strategy was developed and modified through five rounds of coding, discussion, modification of the coding strategy and re-coding. The final coding strategy classified partnerships according to impact, approach and relationships between partners. Results: All 54 (100%) of the partnerships in our sample planned to deliver training and 30 (56%) aimed to deliver infrastructure strengthening in addition to training. 24 (44%) aimed to build generic skills and 30 (56%) specialist skills. 33(61%) of the partners based in low and middle income countries had a scope of influence at national or international level and 33 (61%) partnerships were between partners with an equal scope of influence. We suggest that those partnerships that focus on infrastructure strengthening and the development of generic skills might have more sustainable impacts in situations of high health care worker mobility and 12/54 partnerships met these criteria. Conclusion: We classified partnerships by their impact (scope of influence of LMIC partner and focus on individual/organisational development); approach to health systems strengthening (training/infrastructure; generic/specialist) and relationships (relative scope of influence between partners; mode of delivery - with an NGO partner or not). This is a first step in generating questions about partnership effectiveness that may be answered through evaluation.