Evaluating the process of partnership and research in global health: reflections from the STRIPE project

The paper highlights the increasing importance of partnerships between global north and south academic institutions in global health research. These collaborations aim to improve efficiency, address health disparities, and leverage large datasets. However, successful partnerships require thoughtful engagement and equitable collaboration. Existing frameworks for evaluating partnerships emphasize aspects like social justice, contextual understanding, and shared goals. Challenges include unpredictable funding, trust issues, and capacity limitations. The STRIPE project, a consortium of eight institutions mapping lessons learned from polio eradication, provides a case study to understand best practices in establishing and evaluating such partnerships. The paper focuses on a process evaluation of this partnership during its first year, emphasizing knowledge mapping activities. The aim is to identify effective strategies, challenges encountered, and implemented solutions.

The authors review existing literature on partnership evaluation frameworks in global health research. They cite the CIOMS guidelines, which emphasize equitable partnerships and capacity building, and discuss other frameworks that focus on participatory research, shared governance in consortia, and transdisciplinary teamwork. These frameworks highlight common themes: social justice principles, contextual understanding, shared vision, and the significant impact of contextual factors (such as political instability and funding delays). The reviewed works generally lack prospective evaluations conducted during project implementation, a gap the current study aims to fill.

The study employed Blackstock et al.'s framework for evaluating participatory research, adapting it to assess the STRIPE consortium's partnership process. The evaluation was prospective, formative, and participatory. Data collection methods included written reflections from JHU team members (n=9), individual calls with consortium members (n=7), and a process evaluation working group meeting (n=8). Preliminary analyses of the written reflections and call notes identified themes, which informed the final evaluation criteria. The working group refined these criteria, adding capacity building, and combining related criteria, resulting in 12 evaluation criteria. These criteria were then applied to the STRIPE project's first year, with each member of the consortium reflecting on their experiences. Challenges and solutions were documented and compiled for each criterion.

Twelve criteria emerged to evaluate STRIPE's partnership and research process: access to resources, expectation setting, organizational context, external context, quality of information, relationship building, transparency, motivation, scheduling, adaptation, communication, and capacity building. Challenges related to resource access included financial delays, difficulties recruiting qualified staff, and technical issues with online tools. Expectation setting was challenged by insufficient detail in task descriptions, difficulties communicating timeline changes, and managing expectations of in-country stakeholders. Organizational context issues included competing priorities, staff turnover, and varying levels of coping capacity. External context challenges comprised outbreaks, elections, and insecurity. Information quality issues involved an imbalance in data collection across aspects, the complexity of data collection tools, and limited opportunities for feedback. Relationship building was hindered by trust issues, weak networks, and institutional power dynamics. Transparency concerns focused on project development processes, data analysis, and publication. Motivation decreased due to lengthy processes and tools. Scheduling was affected by holidays and time zone differences. Adaptation challenges stemmed from misunderstandings about timeline changes and workload distribution. Communication difficulties involved confusion about contact points and the use of numerous communication channels. Finally, capacity building was hampered by a lack of familiarity with tools and processes. The study proposed numerous solutions for each challenge to improve the research process, including providing additional time and training, improving communication strategies, implementing better project management tools, and strengthening institutional support for capacity building.

The findings indicate that successful multi-country research requires comprehensive communication strategies, clear expectation setting, and robust institutional support. The study highlights a gap in readily available project management tools that cater to the diverse contexts and needs of international collaborations. The importance of early collaboration and expectation alignment is emphasized, as is the necessity of aligning institutional capacity with project demands. Capacity building needs to address both individual skills and institutional structures, requiring significant resource allocation. Funding agencies should incorporate organizational capacity building into their requirements and provide sufficient funding.

This collaborative process evaluation underscores the crucial role of clear communication, early expectation alignment, and comprehensive capacity-building activities tailored to both individual researchers and their institutions. The study highlights the need for improved project management tools to enhance communication and collaboration in multi-country research settings. Future research should focus on developing and evaluating such tools and further exploring the impact of institutional support on partnership success in global health research.

The evaluation's participatory nature, conducted within a subcontracted partnership with JHU as the lead organization, may have influenced responses and introduced power dynamics that impacted data collection and analysis. The reliance on shared experiences and tools for capturing cross-country themes might have resulted in information being withheld. Future evaluations could benefit from employing an independent third-party evaluator and collecting more individualized data.