Introduction
Background
Methods
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the partnership is between northern and southern institutions (single or multiple);
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the partnership extends beyond a single project;
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the partnership undertakes activities with a health focus;
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the literature refers to effectiveness of partnership, not just the activities and/or intervention.
Peer-reviewed literature
Grey literature
Final selection and citation mapping
Evidence assessment
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Level 0: Expert opinion/advocacy.
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Level 1: Coherent description of what was done and with clear rationale (logical and convincing).
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Level 2: Includes data that shows change, but attribution not proven.
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Level 3: Demonstrate causality through use of control or comparison group.
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Level 4: At least one replication studied independently (shows repeatability).
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Level 5: Systematic review.
Data analysis
Results
Quality and quantity of evidence
Level 0 | Level 1 | Level 2 | Level 3 | Level 4 | Level 5 | Total | |
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Grey literature | 2 | 1 | 14 | 0 | 0 | 0 | 17 |
Journal article | 8 | 6 | 10 | 0 | 0 | 3 | 27 |
Total | 10 | 7 | 24 | 0 | 0 | 3 | 44 |
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Health outcomes (Smith [20]): concludes that there is a lack of high quality research in this area but that broad trends appear to demonstrate improved health outcomes as a consequence of health links.
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Reverse innovation (Syed et al. [21]): concludes that benefits were largely soft (employee morale, learning, better information sharing, personal development, improved patient relationships). The study did not find evidence for the broader ‘impact’ of these benefits on health systems.
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Benefits to UK partners (Jones et al. [22]): concluded that there is little published or unpublished literature on the impact of volunteering and the existing evidence base was primarily descriptive. The review identified six domains of individual benefit to the UK and adapted them into an existing framework (developed by Wales for Africa) to show how the experience of overseas volunteering could impact on individuals, institutions and health care services.
Discussion
Strengths and limitations of the review
Main findings of the review
Implications for future monitoring and evaluation and research
Definition and differentiation
Health links are long term partnerships between UK health institutions and their counterparts in developing countries. …. Links are typically small partnerships that work in areas such as capacity building or clinical service delivery. Whereas some links are set up as small charities with expenses covered by the individuals involved, others are funded directly by the NHS. Ultimately, one of the main objectives of health links is to improve the health of the population in the corresponding developing country.” | … international partnerships, … lead, stimulate, and facilitate action on health challenges through programming, advocacy and technical support. …. Partners increasingly seek mutuality of benefits, including two way flow of energies, expertise and knowledge to justify investment.” | Partnerships to share learning and resources between UK institutions and collaborators in Low and Lower Middle Income Countries are one model to improve health care delivery. It has been proposed that such links promote genuine understanding and respect for different societies and cultures, offer a more sustainable, locally led model of development, build capacity and strengthen health systems in developing countries.” |
Smith [9] | Syed et al. [1] | Jones et al. [1] |
What do we mean by effectiveness?
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the level of individual partnerships;
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the level of organisations that facilitate and manage a portfolio of partnerships;
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the level of health service delivery and systems.
The effectiveness of individual partnerships
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how these values and standards relate to effectiveness;
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to what extent they are best practice in development cooperation or reflect something specific to the partnership model;
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and to what extent they link to some of the additional benefits ascribed to working in partnership.
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The intervention or activities undertaken within the partnership through monitoring and evaluation.
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The quality of the partnership through adherence to principles or charters and increasingly through self-assessment tools.
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The degree to which the partnership has delivered additional benefits beyond the project log frame such as sustainability or mutual benefit, usually through research studies.
The effectiveness of organisations that facilitate and manage a portfolio of institutional health partnerships
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Their effectiveness at providing guidance and support to individual IHPs particularly in those areas which may be outside their usual professional expertise.
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Their effectiveness at creating and strengthening networks for coordination, collaboration and funding at national and international levels.
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Their effectiveness at providing a portfolio of IHPs that ultimately meets the donor objectives for this mode of development cooperation.
The effectiveness of IHPs in improving health service delivery and systems
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health workforce strengthening;
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institutional strengthening;
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peer mentoring;
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innovation;
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supporting frontline services;
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supporting clinical areas which traditionally do not get much attention from donors eg epilepsy, non-communicable diseases, surgery, mental health.