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Glob Health Action. 2017;10(1):1367161. doi: 10.1080/16549716.2017.1367161.

Power, potential, and pitfalls in global health academic partnerships: review and reflections on an approach in Nepal.

Citrin D1,2,3,4, Mehanni S1,5,6,7, Acharya B1,5,6,8,9, Wong L1,5,6,10, Nirola I1,5, Sherchan R1,5, Gauchan B1,5, Karki KB11, Singh DR12, Shamasunder S5,6, Le P5,6, Schwarz D1,13,14, Schwarz R1,13,15,16, Dangal B1, Dhungana SK1, Maru S1,17,18,19, Mahar R1, Thapa P1, Raut A1, Adhikari M20, Basnett I1, Kaluanee SP1,21, Deukmedjian G1,5,6,22, Halliday S1,4, Maru D1,13,14,16,23.

Author information

1
a Possible , Kathmandu , Nepal.
2
b Department of Anthropology , University of Washington , Seattle , WA , USA.
3
c Department of Global Health , University of Washington , Seattle , WA , USA.
4
d Henry M. Jackson School of International Studies , University of Washington , Seattle , WA , USA.
5
e Health Equity Action Leadership Initiative , University of California, San Francisco , San Francisco , CA , USA.
6
f Division of Hospital Medicine , University of California, San Francisco , San Francisco , CA , USA.
7
g Gallup Indian Medical Center , Gallup , NM , USA.
8
h Department of Psychiatry , University of California, San Francisco , San Francisco , CA , USA.
9
i Shared Minds , Boston , MA , USA.
10
j Tuba City Regional Health Care , Tuba City , AZ , USA.
11
k Nepal Health Research Council , Ministry of Health , Kathmandu , Nepal.
12
l Public Health Monitoring & Evaluation Division , Ministry of Health , Kathmandu , Nepal.
13
m Department of Medicine, Division of Global Health Equity , Brigham and Women's Hospital , Boston , MA , USA.
14
n Department of Medicine, Division of General Pediatrics , Boston Children's Hospital , Boston , MA , USA.
15
o Department of Medicine, Division of General Internal Medicine , Massachusetts General Hospital , Boston , MA , USA.
16
p Department of Medicine , Harvard Medical School , Boston , MA , USA.
17
q Department of Obstetrics and Gynecology , Boston Medical Center , Boston , MA , USA.
18
r Department of Obstetrics and Gynecology , Boston University School of Medicine , Boston , MA , USA.
19
s Department Medicine, Division of Women's Health , Brigham and Women's Hospital , Boston , MA , USA.
20
t District Health Office, Department of Health Services , Ministry of Health , Mangalsen , Achham , Nepal.
21
u School of Leadership and Development , Eastern University , St. Davids , PA , USA.
22
v Tséhootsooí Medical Center , Fort Defiance , AZ , USA.
23
w Department of Global Health and Social Medicine , Harvard Medical School , Boston , MA , USA.

Abstract

BACKGROUND:

Global health academic partnerships are centered around a core tension: they often mirror or reproduce the very cross-national inequities they seek to alleviate. On the one hand, they risk worsening power dynamics that perpetuate health disparities; on the other, they form an essential response to the need for healthcare resources to reach marginalized populations across the globe.

OBJECTIVES:

This study characterizes the broader landscape of global health academic partnerships, including challenges to developing ethical, equitable, and sustainable models. It then lays out guiding principles of the specific partnership approach, and considers how lessons learned might be applied in other resource-limited settings.

METHODS:

The experience of a partnership between the Ministry of Health in Nepal, the non-profit healthcare provider Possible, and the Health Equity Action and Leadership Initiative at the University of California, San Francisco School of Medicine was reviewed. The quality and effectiveness of the partnership was assessed using the Tropical Health and Education Trust Principles of Partnership framework.

RESULTS:

Various strategies can be taken by partnerships to better align the perspectives of patients and public sector providers with those of expatriate physicians. Actions can also be taken to bring greater equity to the wealth and power gaps inherent within global health academic partnerships.

CONCLUSIONS:

This study provides recommendations gleaned from the analysis, with an aim towards both future refinement of the partnership and broader applications of its lessons and principles. It specifically highlights the importance of targeted engagements with academic medical centers and the need for efficient organizational work-flow practices. It considers how to both prioritize national and host institution goals, and meet the career development needs of global health clinicians.

KEYWORDS:

Global health; Nepal; health equity; partnership; training support

PMID:
28914185
PMCID:
PMC5645653
DOI:
10.1080/16549716.2017.1367161
[Indexed for MEDLINE]
Free PMC Article

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