Global Health Partnerships: The UK Contribution to Health in Developing Countries

This 180-page resource shares the insights of Lord Nigel Crisp, former Chief Executive of the National Health Service (NHS) in England, who set off on a quest to understand how the strategy of forging partnerships between the United Kingdom (UK) and individuals and organisations in developing countries can contribute to improvements in global health. Collaboration is characterised here as an approach for: increasing the quality of health worker training and helping countries retain their health workers; responding more effectively to humanitarian disasters; and sparking the exchange of experiences and best practices. The core finding of Crisp's report, which was commissioned by the Prime Minister of the UK, is that partnerships that are respectful and responsive to specific needs can be crucial in the effort to support developing countries in achieving the health-related Millennium Development Goals (MDGs) on reducing maternal and child deaths, and combating AIDS, tuberculosis (TB), and malaria.

The process of the review was participatory in nature; from the outset, it was agreed that it would be based on countries' needs as identified and expressed by people from those countries. Specifically, Crisp met with numerous local people and 15 ministers of health in a number of countries - with a concentration on Africa and India, but including contact with people from other parts of Asia, such as China, and the Caribbean. What emerged from these stories were 16 key recommendations.

Among the communication-centred lessons to emerge is Crisp's finding that, in building co-ordinated collaborations, participants must be attuned to cultural issues - "You cannot simply apply UK methods and behaviours. This is not about giving people a UK product but about a process of working together to meet a need....there is resentment of uncoordinated aid and the burdens it brings, and anger at some high-handed 'northern' behaviour and assumptions." In short, the idea is that "developing countries are able to take the lead and own the solutions - and are supported by international, national and local partnerships based on mutual respect."

Crisp makes the case that such partnerships can help address areas of crisis such as staffing. (The World Health Report 2006 demonstrated both the scale of the problem and the link between poor health - and unnecessary death - and low levels of trained staff. This shortcoming is particularly evident when it comes to efforts to manage migration and mitigate the effects on developing countries of the reduction in training and employment opportunities in the UK - examined in depth here). Crisp argues that the UK can play a leading role in what he envisions as a "powerful and coordinated international response to this" problem, such as by funding efforts by the Global Health Workforce Alliance (GHWA) to raise awareness about the need for health care worker training, as well as to bring together and maximise current efforts of governments, donors and agencies to tackle the staff shortages. Established in May 2006, this international partnership has, as of this writing, started work in 8 countries, including 5 in the most severely affected region of sub-Saharan Africa, helping to train and support a new generation of local leaders who will develop and put in place health work force plans for their countries.

In tune with the above, one of Crisp's recommendations is that a global health partnership centre should be established - preferably in an existing organisation - as a "one-stop-shop" source of information for governments and health organisations. As he envisions it, such a centre would actively seek to make connections and promote and share good practice and learning. Crisp indicates that such a global health exchange could be facilitated by use of information and communication technology (ICT). He notes that "[i]nternational agencies in developing countries are already working with commercial organisations in 'emerging markets' to provide investment in, for example, medicines, technology and infrastructure", and he shares examples indicating that ICT and telemedicine are already beginning to have some impact in developing countries (one example cited is Swinfen Charitable Trust, which offers free medical advice based on images they receive from a digital camera in a medical centre).

Training people in developing countries to understand the benefits technology can bring for health is described here as beneficial, even though it may not obviate concerns about limitations on the use of ICT (e.g., broadband is still not widespread and is frequently of low density, suitable only for text and not images. Computers are not robust, maintenance is difficult, satellite expensive, etc.). Nonetheless, Crisp still believes that drawing on ICT as a tool can be a key strategy for making evidence and best practice available to health workers, policy makers, and the public. In short, "e-health" - in its myriad uses - can enhance partnership.

Click here to access a related peer-reviewed summary on the Health e Communication website, and to participate in peer review.