Katisi Masego, Daniel Marguerite, Mittelmark Maurice B
Department of Health Promotion and Development, University of Bergen, PO Box 7807, 5020, Bergen, Norway.
Global Health. 2016 Jul 28;12(1):42. doi: 10.1186/s12992-016-0179-3.
International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume and Efficiency to strengthen delivery of the service and push the target. The objective of this paper is to use a systems model to establish how the functioning of the partnership on Safe Male Circumcision in Botswana contributed to the outcome.
Data were collected using observations, focus group discussions and interviews. Thirty participants representing all three partners were observed in a 3-day meeting; followed by three rounds of in-depth interviews with five selected leading officers over 2 years and three focus group discussions.
Financial resources, "ownership" and the target influence the success or failure of partnerships. A combination of inputs by partners brought progress towards achieving set program goals. Although there were tensions between partners, they were working together in strategising to address some challenges of the partnership and implementation. Pressure to meet the expectations of the international donors caused tension and challenges between the in-country partners to the extent of Development Partners retreating and not pursuing the mission further.
Target achievement, the link between financial contribution and ownership expectations caused antagonistic outcome. The paper contributes enlightenment that the functioning of the visible in-country partnership is significantly influenced by the less visible global context such as the target setters and donors.
国际捐助方支持博茨瓦纳政府与两个国际组织之间的伙伴关系，这两个组织分别是美国疾病控制与预防中心以及非洲综合防治艾滋病伙伴关系，目的是实施自愿男性包皮环切术，目标是在5年内为80%的艾滋病毒阴性男性进行包皮环切。当国际伙伴引入优化服务量和效率的模式以加强服务提供并推动目标实现时，博茨瓦纳政府已开始将该项目纳入其卫生系统。本文的目的是使用系统模型来确定博茨瓦纳男性安全包皮环切伙伴关系的运作如何促成了这一成果。
通过观察、焦点小组讨论和访谈收集数据。在为期3天的会议中观察了代表所有三个伙伴的30名参与者；随后在2年时间里对5名选定的主要官员进行了三轮深入访谈，并开展了三次焦点小组讨论。
财政资源、“自主权”和目标影响着伙伴关系的成败。伙伴们的共同投入推动了既定项目目标的实现。尽管伙伴之间存在紧张关系，但他们共同制定战略以应对伙伴关系和实施过程中的一些挑战。满足国际捐助方期望的压力在国内伙伴之间造成了紧张关系和挑战，以至于发展伙伴退缩，不再进一步推进该任务。
目标的实现、财政贡献与自主权期望之间的联系导致了对立的结果。本文提供了启示，即国内可见的伙伴关系的运作受到诸如目标设定者和捐助方等不太明显的全球背景的显著影响。
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