Abstract
Interuniversity global health partnerships are often between parties unequal in organizational capacity and performance using conventional academic output measures. Mutual benefit and reciprocity are called for but literature examining these concepts is limited. The objectives of this study are to analyse how reciprocity is practiced in international interuniversity global health partnerships and to identify relevant structures of reciprocity. Four East African universities and 125 of their international partnerships were included. A total of 192 representatives participated in key informant interviews and focus group discussions. Interviews were transcribed and analysed thematically, drawing on reciprocity theories from international relations and sociology. A range of reciprocal exchanges, including specific, unilateral and diffuse (bilateral and multilateral), were observed. Many partnerships violated the principle of equivalence, as exchanges were often not equal based on tangible benefits realized. Only when intangible benefits, like values, were considered was equivalence realized. This changed the way the principle of contingency—an action done for benefit received—was observed within the partnerships. The values of individuals, the structures of organizations and the guiding principles of the partnerships were observed to guide more than financial gain. Asymmetry of partners, dissimilar perspectives and priorities, and terms of funding all pose challenges to reciprocity. In an era when strengthening institutions is considered crucial to achieving development goals, more rigorous examination and assessment of reciprocity in partnerships is warranted.
Highlights
Within global health and higher education literature, the concept of reciprocity has been discussed to a limited degree
We review how reciprocity has been discussed in the literatures on international relations and sociology, before examining the practice of reciprocity in the global health partnerships of four East African universities
The analysis reported here is a secondary qualitative analysis of data collected to examine how international interuniversity partnerships contribute to developing the health professional programmes (HPPs) of four East African universities
Summary
Within global health and higher education literature, the concept of reciprocity has been discussed to a limited degree. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) suggests that sponsors of global health training programmes “consider” reciprocity and that “mutual and reciprocal benefit, geared to achieving the program goals of all parties and aiming for equity, should be the goal” [(Crump et al 2010), p. WEIGHT did not define reciprocity or provide specific examples of reciprocity or mutual benefits. In a study examining undergraduate and graduate medical education programmes between institutions, Umoren et al (2012) defined reciprocity as “actions that show mutual respect and seek mutual benefit between the institutional partners” [p. Bozinoff et al (2014) examined mutual benefit within a medical student international elective programme. Others have discussed reciprocity and mutuality without clarifying or discussing their nature in detail (Ilieva et al 2014; Issa et al 2017)
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