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Kulesa J, Chua I, Ferrer K, Kind T, Kern J. Prioritization and Resource Allocation in Academic Global Health Partnerships. Acad Pediatr 2022; 23:829-838. [PMID: 36280039 DOI: 10.1016/j.acap.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/14/2022] [Accepted: 10/15/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE US-based academic institutions involved in global health (GH) partnerships can have a positive impact on health care 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 to 2021, the authors invited 36 US-based GH practitioners from the 2015 Pediatric GH Leadership Conference to participate in individual 1-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 4 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 toward a more decolonized approach to GH.
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Affiliation(s)
- John Kulesa
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Kulesa, I Chua, K Ferrer, T Kind, and J Kern), Washington, DC; Division of Hospital Medicine, Children's National Hospital (J Kulesa, I Chua, K Ferrer, and J Kern), Washington, DC.
| | - Ian Chua
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Kulesa, I Chua, K Ferrer, T Kind, and J Kern), Washington, DC; Division of Hospital Medicine, Children's National Hospital (J Kulesa, I Chua, K Ferrer, and J Kern), Washington, DC; Department of Pediatrics, Stanford University School of Medicine (I Chua), Stanford, Calif
| | - Kathy Ferrer
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Kulesa, I Chua, K Ferrer, T Kind, and J Kern), Washington, DC; Division of Hospital Medicine, Children's National Hospital (J Kulesa, I Chua, K Ferrer, and J Kern), Washington, DC
| | - Terry Kind
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Kulesa, I Chua, K Ferrer, T Kind, and J Kern), Washington, DC; Division of General and Community Pediatrics, Children's National Hospital (T Kind), Washington, DC
| | - Jeremy Kern
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences (J Kulesa, I Chua, K Ferrer, T Kind, and J Kern), Washington, DC; Division of Hospital Medicine, Children's National Hospital (J Kulesa, I Chua, K Ferrer, and J Kern), Washington, DC
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