Mayhew Susannah H, Doherty Jane, Pitayarangsarit Siriwan
Centre for Population Studies, London School of Hygiene and Tropical Medicine, London, UK.
Health Res Policy Syst. 2008 Aug 1;6:8. doi: 10.1186/1478-4505-6-8.
Over the past ten years, calls to strengthen health systems research capacities in low and middle income countries have increased. One mechanism for capacity development is the partnering of northern and southern institutions. However, detailed case-studies of north-south partnerships, at least in the domain of health systems research, remain limited.This study aims to evaluate the partnerships developed between the Health Economics and Financing Programme of the London School of Hygiene and Tropical Medicine and three research partners in South Africa and Thailand to strengthen health economics-related research capacity.
Data from programme documents were collected over five years to measure quantitative indicators of capacity development. Qualitative data were obtained from 25 in-depth interviews with programme staff from South Africa, Thailand and London.
Five years of formal partnership resulted in substantial strengthening of individual research skills and moderate instituonalised strengthening in southern partner institutions. Activities included joint proposals, research and articles, staff exchange and post-graduate training. In Thailand, individual capacities were built through post-graduate training and the partner institution developed this as part of a package aimed at retaining young researchers at the institution. In South Africa, local post-graduate teaching programs were strengthened, regular staff visits/exchanges initiated and maintained and funding secured for several large-scale, multi-partner projects. These activities could not have been achieved without good personal relationships between members of the partner institutions, built on trust developed over twenty years. In South Africa, a critical factor was the joint appointment of a London staff member on long-term secondment to one of the partner institutions.
As partnerships mature the needs of partners change and new challenges emerge. Partners' differing research priorities (national v international; policy-led v academic-led) need to be balanced and equitable funding mechanisms developed recognising the needs and constraints faced by both southern and northern partners. Institutionalising partnerships (through long-term development of trust, engagement of a broad range of staff in joint activities and joint appointment of staff), and developing responsive mechanisms for governing these partnerships (through regular joint negotiation of research priorities and funding issues), can address these challenges in mutually acceptable ways. Indeed, by late 2005 the partnership under scrutiny in this paper had evolved into a wider consortium involving additional partners, more explicit mechanisms for managing institutional relationships and some core funding for partners. Most importantly, this study has shown that it is possible for long-term north-south partnership commitments to yield fruit and to strengthen the capacities of public health research and training institutions in less developed countries.
在过去十年中，加强低收入和中等收入国家卫生系统研究能力的呼声日益高涨。能力发展的一种机制是北方和南方机构建立伙伴关系。然而，至少在卫生系统研究领域，南北伙伴关系的详细案例研究仍然有限。本研究旨在评估伦敦卫生与热带医学院卫生经济与筹资项目与南非和泰国的三个研究伙伴建立的伙伴关系，以加强卫生经济相关的研究能力。
收集了五年期间项目文件中的数据，以衡量能力发展的量化指标。通过对来自南非、泰国和伦敦的项目工作人员进行25次深入访谈获得定性数据。
五年的正式伙伴关系使个人研究技能得到大幅提升，南方伙伴机构在机构层面也有适度加强。活动包括联合提案、研究和文章撰写、人员交流和研究生培训。在泰国，通过研究生培训培养了个人能力，伙伴机构将其作为留住年轻研究人员的一揽子计划的一部分。在南非，加强了当地的研究生教学项目，启动并维持了定期的工作人员访问/交流，并为几个大型多伙伴项目获得了资金。如果没有伙伴机构成员之间基于二十多年建立起来的信任而形成的良好个人关系，这些活动是无法实现的。在南非，一个关键因素是伦敦的一名工作人员长期借调到其中一个伙伴机构任职。
随着伙伴关系的成熟，伙伴的需求会发生变化，新的挑战也会出现。需要平衡伙伴不同的研究重点（国家与国际；政策主导与学术主导），并建立公平的筹资机制，同时认识到南方和北方伙伴面临的需求和限制。将伙伴关系制度化（通过长期建立信任、让广泛的工作人员参与联合活动以及联合任命工作人员），并建立应对这些伙伴关系的管理机制（通过定期联合协商研究重点和资金问题），可以以双方都能接受的方式应对这些挑战。事实上，到2005年底，本文所审视的伙伴关系已发展成为一个更广泛的联盟，包括更多的伙伴、更明确的机构关系管理机制以及为伙伴提供的一些核心资金。最重要的是，本研究表明，长期的南北伙伴关系承诺有可能取得成果，并加强欠发达国家公共卫生研究和培训机构的能力。
