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The Evolution of Trust Within a Global Health Partnership With the Private Sector: An Inductive Framework

BACKGROUND

Public-private partnerships (PPPs) in global health are increasingly common to support sustainable development and strengthen health systems in low- and middle-income countries. Since the release of the Sustainable Development Goals (SDGs) in 2015 culminating in a discrete goal "to revitalize the global partnership for sustainable development," public health scholars have sought to understand what makes PPPs successful in different contexts. While trust has long been identified as a key component of successful strategic alliances in the private sector, less is known about how trust emerges between public- and private- sector partners, particularly in global health. Therefore, we investigated how trust between partners evolved in the context of Project Last Mile (PLM), a global health partnership that translates the business acumen of The Coca-Cola Company to strengthen public health systems across Africa.

METHODS

This study draws upon secondary analysis of qualitative data generated as part of the longitudinal, mixed-methods evaluation of PLM across country settings. Seventy-seven interviews with a purposeful sample of key stakeholders were conducted in Mozambique, South Africa and eSwatini between August 2016 and July 2018. Trained qualitative interviewers followed a standard discussion guide, and audio-recorded interviews with participants' consent. In this secondary analysis, we analyzed qualitative data to understand how trust between partners was cultivated across settings.

RESULTS

We drew upon stakeholder experiences to inform an inductive framework for how trust develops over time. Our analysis revealed five domains that were foundational to building trust: (1) reputational context, (2) team composition, (3) tangible outputs, (4) shared values, and (5) effective communication.

CONCLUSION

The framework may be useful for private and public sector entities seeking to establish and sustain trust within their global health partnerships.

Partnership evaluation: An application of a developmental framework to the Governance and Local Development project in Senegal

This study explores the valued-added of USAID/Senegal's Governance for Local Development (GOLD) project's integrated approach to working with four sector projects: two in health, one in water and sanitation, and one in nutrition. The study builds on a partnership evaluation framework that identifies practices related to preconditions, factors linked with success, implementation structures and processes, contribution of collaboration to performance, and collaboration outcomes. A survey instrument developed statements of positive practices and asked respondents to agree or disagree with each one. The analysis includes exploration of differences in perception. Respondents generally expressed agreement with the statements in the survey instrument associated with the various dimensions of effective partnerships. All projects mentioned the presence of partnership champions. Problems with joint action (e.g., planning, budgeting, managing) were the most frequently cited constraints. The study confirms most of the hypotheses embedded in the evaluation framework regarding partnership's potential for creating synergies and improved outcomes and affirms the framework's usefulness as a developmental evaluation tool. Positive outcomes result from intentional efforts to build relationships, cultivate champions, and design systems and processes that support a partnership culture and contribute to each partners' success as well as the success of the partnership itself.

A Case Study on the Utility of Sustained Evaluation Practice in Public Health Partnership

This article explores a case study of the potential influence of a capacity building investment toward public health partnerships (PHPs) targeting asthma. This case study explores what factors were salient among PHPs who were indirect recipients of a funder’s capacity building. Our case study suggests that a funder’s capacity building efforts may be linked to evaluation practice guidelines and decisions toward individual and organizational level use of evaluation use within partnerships. Moreover, examining the contextual factors that were associated with the evaluation of these PHPs explicates where adjustments may be needed in applying capacity building to the PHP setting. This case study has implications for future health planning policies.

Process evaluation of knowledge transfer across industries: Leveraging Coca-Cola's supply chain expertise for medicine availability in Tanzania

Persistent gaps in the availability of essential medicines have slowed the achievement of global health targets. Despite the supply chain knowledge and expertise that ministries of health might glean from other industries, limited empirical research has examined the process of knowledge transfer from other industries into global public health. We examined a partnership designed to improve the availability of medical supplies in Tanzania by transferring knowledge from The Coca-Cola system to Tanzania’s Medical Stores Department (MSD). We conducted a process evaluation including in-depth interviews with 70 participants between July 2011 and May 2014, corresponding to each phase of the partnership, with focus on challenges and strategies to address them, as well as benefits perceived by partners. Partners faced challenges in (1) identifying relevant knowledge to transfer, (2) translating operational solutions from Coca-Cola to MSD, and (3) maintaining momentum between project phases. Strategies to respond to these challenges emerged through real-time problem solving and included (1) leveraging the receptivity of MSD leadership, (2) engaging a boundary spanner to identify knowledge to transfer, (3) promoting local recognition of commonalities across industries, (4) engaging external technical experts to manage translation activities, (5) developing tools with visible benefits for MSD, (6) investing in local relationships, and (7) providing time and space for the partnership model to evolve. Benefits of the partnership perceived by MSD staff included enhanced collaboration and communication, more proactive orientations in managing operations, and greater attention to performance management. Benefits perceived by Coca-Cola staff included strengthened knowledge transfer capability and enhanced job satisfaction. Linking theoretical constructs with practical experiences from the field, we highlight the challenges, emergent strategies, and perceived benefits of a partnership across industry boundaries that may be useful to others seeking to promote the transfer of knowledge to improve global health.