Jobson Geoffrey A, Grobbelaar Cornelis J, Mabitsi Moyahabo, Railton Jean, Peters Remco P H, McIntyre James A, Struthers Helen E
Anova Health Institute, 12 Sherborne Rd, Park Town, Johannesburg, 2190, South Africa.
School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
Global Health. 2017 Jan 13;13(1):3. doi: 10.1186/s12992-016-0228-y.
The involvement of Global Health Initiatives (GHIs) in delivering health services in low and middle income countries (LMICs) depends on effective collaborative working at scales from the local to the international, and a single GHI is effectively constructed of multiple collaborations. Research is needed focusing on how collaboration functions in GHIs at the level of health service management. Here, collaboration between local implementing agencies and departments of health involves distinct power dynamics and tensions. Using qualitative data from an evaluation of a health partnership in South Africa, this article examines how organisational power dynamics affected the operation of the partnership across five dimensions of collaboration: governance, administration, organisational autonomy, mutuality, and norms of trust and reciprocity.
Managing the tension between the power to provide resources held by the implementing agency and the local Departments' of Health power to access the populations in need of these resources proved critical to ensuring that the collaboration achieved its aims and shaped the way that each domain of collaboration functioned in the partnership.
These findings suggest that it is important for public health practitioners to critically examine the ways in which collaboration functions across the scales in which they work and to pay particular attention to how local power dynamics between partner organisations affect programme implementation.
全球卫生倡议（GHIs）在低收入和中等收入国家（LMICs）提供卫生服务方面的参与，依赖于从地方到国际层面的有效协作，而且单个全球卫生倡议实际上是由多个合作构成的。需要开展研究，聚焦于全球卫生倡议在卫生服务管理层面的协作如何发挥作用。在此，地方实施机构与卫生部门之间的合作涉及独特的权力动态和紧张关系。本文利用对南非一项卫生伙伴关系评估的定性数据，考察组织权力动态如何在协作的五个维度——治理、管理、组织自主性、相互性以及信任和互惠规范——上影响该伙伴关系的运作。
管理实施机构拥有的提供资源的权力与地方卫生部门接触有需求人群的权力之间的紧张关系，对于确保协作实现其目标并塑造伙伴关系中每个协作领域的运作方式至关重要。
这些发现表明，公共卫生从业者批判性地审视他们工作范围内不同层面协作的运作方式，并特别关注伙伴组织之间的地方权力动态如何影响项目实施，这一点很重要。
