Title

Prioritization and Resource Allocation in Academic Global Health Partnerships

Authors

John Kulesa, 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. Electronic address: kulesaj@gmail.com.
Ian Chua, 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. Electronic address: ichua@childrensnational.org.
Kathy Ferrer, 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. Electronic address: kferrer@childrensnational.org.
Terry Kind, 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. Electronic address: tkind@childrensnational.org.
Jeremy Kern, 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. Electronic address: jkern@childrensnational.org.

Document Type

Journal Article

Publication Date

10-21-2022

Journal

Academic pediatrics

DOI

10.1016/j.acap.2022.10.012

Keywords

Decolonization; Global Health; Grounded Theory; Priority Setting and Resource Allocation

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.

Department

Pediatrics

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