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Prioritization and Resource Allocation in Academic Global Health Partnerships

  • John Kulesa
    Correspondence
    Address correspondence to (Present Address): John Kulesa, Division of Hospital Medicine, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, Phone: 202-476-3088.
    Affiliations
    George Washington University School of Medicine and Health Sciences, Department of Pediatrics, 2300 I St NW, Washington, District of Columbia, 20010, USA

    Children's National Hospital, Division of Hospital Medicine, 111 Michigan Ave NW, Washington, District of Columbia, 20010, USA
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  • Ian Chua
    Affiliations
    George Washington University School of Medicine and Health Sciences, Department of Pediatrics, 2300 I St NW, Washington, District of Columbia, 20010, USA

    Children's National Hospital, Division of Hospital Medicine, 111 Michigan Ave NW, Washington, District of Columbia, 20010, USA

    Stanford University School of Medicine, Department of Pediatrics, 291 Campus Drive, Stanford, California, 94305, USA
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  • Kathy Ferrer
    Affiliations
    George Washington University School of Medicine and Health Sciences, Department of Pediatrics, 2300 I St NW, Washington, District of Columbia, 20010, USA

    Children's National Hospital, Division of Hospital Medicine, 111 Michigan Ave NW, Washington, District of Columbia, 20010, USA
    Search for articles by this author
  • Terry Kind
    Affiliations
    George Washington University School of Medicine and Health Sciences, Department of Pediatrics, 2300 I St NW, Washington, District of Columbia, 20010, USA

    Children's National Hospital, Division of General and Community Pediatrics, 111 Michigan Ave NW, Washington, District of Columbia, 20010, USA
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  • Jeremy Kern
    Affiliations
    George Washington University School of Medicine and Health Sciences, Department of Pediatrics, 2300 I St NW, Washington, District of Columbia, 20010, USA

    Children's National Hospital, Division of Hospital Medicine, 111 Michigan Ave NW, Washington, District of Columbia, 20010, USA
    Search for articles by this author
Published:October 21, 2022DOI:https://doi.org/10.1016/j.acap.2022.10.012

      Abstract

      Objective

      US-based academic institutions involved in global health (GH) partnerships can have a positive impact on healthcare systems in low/middle-income countries but lack a consistent approach. Existing priority setting and resource allocation (PSRA) frameworks do not adequately capture the interpersonal and sociopolitical complexity of decision-making in GH work. The authors explored how US-based GH practitioners prioritize and allocate resources for different types of support in academic GH partnerships.

      Method

      In 2020-2021, the authors invited 36 US-based GH practitioners from the 2015 Pediatric GH Leadership Conference to participate in individual one-hour semi-structured interviews. Using an iterative and inductive grounded theory approach, the study team analyzed interview transcripts through the lens of Heyse's framework on decision-making in humanitarian aid.

      Results

      The authors interviewed 20 GH practitioners and reached thematic sufficiency. A descriptive conceptual framework, capturing 18 distinct themes in four major categories, emerged from the data. In this framework, categories included: 1) stakeholders: those who influence and are influenced by the partnership; 2) goals: vision, mission, aims, and scope of the partnership; 3) implementation strategy: approach to accomplishing goals, categorized as relationship-oriented, task-oriented, context-oriented, or nonprescriptive; and 4) approach to conflict: response when goals and strategies do not align among stakeholders.

      Conclusion

      Themes revealed a dynamic process for PSRA. Using our study findings, and building on existing literature, our framework highlights the complex interpersonal relationships, resource limitations, and sociopolitical and economic constraints that affect PSRA in GH partnerships. Finally, themes point to the field's evolution towards a more decolonized approach to GH.

      What's new

      This work outlines a process-oriented descriptive framework for prioritization and resource allocation in global health partnerships. The framework provides a tool to help global health practitioners critically interrogate partnerships.

      Key Words

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      References

        • UNICEF
        Levels and Trends in Child Mortality.
        September 8, 2020 (PublishedAccessed March 17, 2021)
        • Denno D.
        Global child health.
        Pediatrics in review. 2011; 32: e25
        • Samoff J
        • Carrol B.
        The promise of partnership and continuities of dependence: External support to higher education in Africa.
        African Studies Review. 2004; (Published online): 67-199
        • Caines K.
        Global Health Partnerships and Neglected Diseases’.
        2004 (London)
        • Steenhoff AP
        • Crouse HL
        • Lukolyo H
        • et al.
        Partnerships for global child health.
        Pediatrics. 2017; 140
        • Nelson BD
        • Lee AC
        • Newby PK
        • Chamberlin MR
        • Huang CC.
        Global health training in pediatric residency programs.
        Pediatrics. 2008; 122: 28-33
        • Goldberg J
        • Bryant M.
        Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development?.
        BMC public health. 2012; 12: 531
      1. World Health Organization. Everybody's business–strengthening health systems to improve health outcomes: WHO's framework for action. Published online 2007.

        • Bloom DE
        • Cadarette D
        • Dayalu R
        • Sullivan J.
        Introduction: priority setting in global health.
        Cost Effectiveness and Resource Allocation. 2018; 16: 1-5
        • Seixas BV
        • Dionne F
        • Mitton C.
        Practices of decision making in priority setting and resource allocation: a scoping review and narrative synthesis of existing frameworks.
        Health Economics Review. 2021; 11: 1-11
        • Marsh K
        • Lanitis T
        • Neasham D
        • Orfanos P
        • Caro J.
        Assessing the value of healthcare interventions using multi-criteria decision analysis: a review of the literature.
        Pharmacoeconomics. 2014; 32: 345-365
      2. Cromwell I, Peacock SJ, Mitton C. ‘Real-world'health care priority setting using explicit decision criteria: a systematic review of the literature. BMC health services research. 2015;15(1):1-11.

        • Polisena J
        • Clifford T
        • Elshaug AG
        • Mitton C
        • Russell E
        • Skidmore B.
        Case studies that illustrate disinvestment and resource allocation decision-making processes in health care: a systematic review.
        International journal of technology assessment in health care. 2013; 29: 174-184
        • Sibbald SL
        • Singer PA
        • Upshur R
        • Martin DK.
        Priority setting: what constitutes success? A conceptual framework for successful priority setting.
        BMC health services research. 2009; 9: 1-12
        • Diamantopoulos A
        • Sawyer LM
        • Lip GY
        • et al.
        Cost-effectiveness of an insertable cardiac monitor to detect atrial fibrillation in patients with cryptogenic stroke.
        International Journal of Stroke. 2016; 11: 302-312
        • Byskov J
        • Marchal B
        • Maluka S
        • et al.
        The accountability for reasonableness approach to guide priority setting in health systems within limited resources–findings from action research at district level in Kenya, Tanzania, and Zambia.
        Health research policy and systems. 2014; 12: 1-19
        • Wiseman V
        • Mitton C
        • Doyle-Waters MM
        • et al.
        Using economic evidence to set healthcare priorities in low-income and lower-middle-income countries: a systematic review of methodological frameworks.
        Health Economics. 2016; 25: 140-161
        • Glassman A
        • Chalkidou K
        • Giedion U
        • et al.
        Priority-setting institutions in health: recommendations from a center for global development working group.
        Global heart. 2012; 7: 13-34
        • Hipgrave DB
        • Alderman KB
        • Anderson I
        • Soto EJ.
        Health sector priority setting at meso-level in lower and middle income countries: lessons learned, available options and suggested steps.
        Social science & medicine. 2014; 102: 190-200
        • Chi YL
        • Bump JB.
        Resource allocation processes at multilateral organizations working in global health.
        Health policy and planning. 2018; 33 (i4-i13)
        • Hall W
        • Smith N
        • Mitton C
        • Urquhart B
        • Bryan S.
        Assessing and improving performance: a longitudinal evaluation of priority setting and resource allocation in a Canadian health region.
        International journal of health policy and management. 2018; 7: 328
        • Moon S
        • Szlezák NA
        • Michaud CM
        • et al.
        The global health system: lessons for a stronger institutional framework.
        PLoS Medicine. 2010; 7e1000193
        • Affun-Adegbulu C
        • Adegbulu O.
        Decolonising global (public) health: from Western universalism to global pluriversalities.
        BMJ Global Health. 2020; 5e002947
        • Beaglehole R
        • Bonita R.
        What is global health?.
        Global Health Action. 2010; : 3
        • Heyse L.
        From agenda setting to decision making: Opening the black box of Non-Governmental Organizations.
        The Ashgate Research Companion to Non-State Actors. 2011; (Published online): 277-290
        • Creswell JW
        • Poth CN.
        Qualitative Inquiry and Research Design: Choosing among Five Approaches.
        Sage publications, 2016
        • Varpio L
        • Ajjawi R
        • Monrouxe LV
        • O'Brien BC
        • Rees CE
        Shedding the cobra effect: problematising thematic emergence, triangulation, saturation and member checking.
        Medical education. 2017; 51: 40-50
        • Tufford L
        • Newman P.
        Bracketing in qualitative research.
        Qualitative social work. 2012; 11: 80-96
        • Corbin J
        • Strauss A.
        Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory.
        Sage publications, 2014
        • Saldana J.
        Fundamentals of Qualitative Research.
        OUP USA, 2011
        • Merriam SB
        • Tisdell EJ.
        Qualitative Research: A Guide to Design and Implementation.
        John Wiley & Sons, 2015
        • Levi D
        • Askay DA.
        Group Dynamics for Teams.
        Sage Publications, 2020
        • Eichbaum QG
        • Adams LV
        • Evert J
        • Ho MJ
        • Semali IA
        • van Schalkwyk SC.
        Decolonizing Global Health Education: Rethinking Institutional Partnerships and Approaches.
        Academic Medicine. 2020; (Published online)
        • Cancedda C
        • Farmer PE
        • Kerry V
        • et al.
        Maximizing the impact of training initiatives for health professionals in low-income countries: frameworks, challenges, and best practices.
        PLoS medicine. 2015; 12e1001840
        • Büyüm AM
        • Kenney C
        • Koris A
        • Mkumba L
        • Raveendran Y.
        Decolonising global health: if not now, when?.
        BMJ Global Health. 2020; 5e003394
        • Larson CP
        • Plamondon KM
        • Dubent L
        • et al.
        The Equity Tool for Valuing Global Health Partnerships.
        Global Health: Science and Practice. 2022; 10
      3. 2022 Global Health Education Course - Virtual Only - AAP. Accessed October 2, 2022. https://shop.aap.org/2022-Global-Health-Education-Course/

        • Rent S
        • North K
        • Diego E
        • Bose C
        Global Health Education and Best Practices for Neonatal-Perinatal Medicine Trainees.
        NeoReviews. 2021; 22: e795-e804