Abstract
Background: Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework – the partnership framework – and analytic approach for evaluating the perceptions of partnerships’ added value as well as the results from an application to one case in Uganda. Methods: We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE) to test the partnership framework on Uganda’s human papillomavirus (HPV) vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes). Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership’s role in this process. Results: Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE) may have had downstream consequences if this study’s results had not been shared with the Ministry of Health (MoH) and acted upon. The partnership was not perceived to have increased the efficiency of the process, perhaps as a result of unclear or absent guidelines around roles and responsibilities. Conclusion: The health and functioning of global health partnerships can be evaluated using the framework and approach presented here. Network theory and methods added value to the conceptual and analytic processes and we recommend applying this approach to other global health partnerships to ensure that they are meeting the complex challenges they were designed to address.
Highlights
As the size and scope of the global health agenda has grown in the past decades, so too has the need to leverage a greater number and type of actors and their resources, leading to the rise of “Global Health Public-Private Partnerships,” (GHPPPs) or “Global Health Initiatives.” The World Health Organization (WHO) Maximizing Positive Synergies Collaborative Group counted 100 such entities that participate in a range of activities related to global health decision-making, funding, implementation and technical assistance at global, national, and sub-national levels.[1]
This is certainly true for the case of Uganda, whose immunization system performance is gradually improving following the re-introduction of Gavi support in 2012 and the reorganization of its immunization program and partnership, and where the efficient allocation and coordination of partners’ comparative advantages will be essential to supporting national and global goals.[13]
Through the snowball sampling approach we identified a total of 39 individuals who participated in the human papillomavirus (HPV) vaccine application process
Summary
As the size and scope of the global health agenda has grown in the past decades, so too has the need to leverage a greater number and type of actors and their resources, leading to the rise of “Global Health Public-Private Partnerships,” (GHPPPs) or “Global Health Initiatives.” The World Health Organization (WHO) Maximizing Positive Synergies Collaborative Group counted 100 such entities that participate in a range of activities related to global health decision-making, funding, implementation and technical assistance at global, national, and sub-national levels.[1]. As the Gavi strategy has evolved to include strategic goals related to coverage and equity as opposed to new vaccine introductions,[9,10] so too has the recognition that partners must bring a growing diversity of skills and approaches to the partnership.[11,12] This is certainly true for the case of Uganda, whose immunization system performance is gradually improving following the re-introduction of Gavi support in 2012 and the reorganization of its immunization program and partnership, and where the efficient allocation and coordination of partners’ comparative advantages will be essential to supporting national and global goals.[13] Gavi’s 2015 announcement of a new structure for coordinating and managing Gavi Alliance partners — the Partners’ Engagement Framework14 — will replace the Gavi Business Plan in an effort to ensure country-centric processes and increase the relevance of partners’ activities; it is a reflection of the broader growth in the diversity and decentralization of partnerships and networks for global health.[5,14] This paper presents a case study of an Alliance partnership in Uganda prior to the introduction of the Partners’ Engagement Framework, but which may serve as a useful baseline. The paper closes with a discussion of the implications of the partnership evaluation approach for other global health partnerships and partnerships more generally
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
