Towards a simple typology of international health partnerships.

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.

All Health Partnerships, Great and Small: Comparing Mandated With Emergent Health Partnerships Comment on "Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda".

The plurality of healthcare providers and funders in low- and middle-income countries (LMICs) has given rise to an era in which health partnerships are becoming the norm in international development. Whether mandated or emergent, three common drivers are essential for ensuring successful health partnerships: trust; a diverse and inclusive network; and a clear governance structure. Mandated and emergent health partnerships operate as very different models and at different scales. However, there is potential for sharing and learning between these types of partnerships. Emergent health partnerships, especially as they scale up, may learn from mandated partnerships about establishing clear governance mandates for larger and more complex partnerships. By combining social network analysis, which can detect key actors and stakeholders that could add value to existing emergent partnerships, with Brinkerhoff 's comprehensive framework for partnership evaluation, we can identify a set of tools that could be used to evaluate the effectiveness and sustainability of emergent health partnerships.

The value of health partnerships: a practical approach to evidence.

Your April editorial(1) points out that there is little strong evidence of the effectiveness and impact of health links - or health partnerships, as they are often known - in terms of the processes and particularly the outcomes of health care. We believe this reflects the inherent complexity of the health systems and the consequent challenges for robust measurement. However, health partnerships use a range of evaluation methods that provide valuable, qualitative and descriptive information about change and performance management, which can help demonstrate the effectiveness of health partnerships.