Do International Health Partnerships contribute to reverse innovation? a mixed methods study of THET-supported partnerships in the UK.
Do International Health Partnerships contribute to reverse innovation? a mixed methods study of THET-supported partnerships in the UK.
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DOI：
10.1186/s12992-017-0248-2
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发表时间：
2017-04-18
影响因子：
10.8
通讯作者：
Harris M
中科院分区：
文献类型：
--
作者：
Kulasabanathan K;Issa H;Bhatti Y;Prime M;Del Castillo J;Darzi A;Harris M
国际卫生伙伴关系正在发生变化，日益强调高收入国家和低收入或中等收入国家伙伴之间的相互问责和共同议程制定。现在有一个重要的重点是学习的双向性，然而对于英国的合作伙伴来说，这通常侧重于个人层面的学习，通过个人和专业发展。我们试图评估这种学习是否也采取了“反向创新”的形式--即在低收入国家构思的想法随后被高收入国家采用。这项混合方法研究使用了对热带健康教育信托基金(THET)支持的国际卫生伙伴关系(n = 114)的所有英国牵头机构的初始范围调查，以确定国际卫生计划在多大程度上是或曾经是反向创新的工具。这项调查构成了进一步深入访谈的样本框架，重点关注志愿者向LMIC学习的经历和态度。对国际水文计划领导人员(n = 12)的访谈被录音并逐字转录。对调查数据进行描述性分析。面试记录是按主题编码的，采用归纳法。调查应答率为27%(n = 34)。大多数人(70%)强烈同意支持LMIC合作伙伴最能描述伙伴关系的使命，但只有13%的受访者强烈同意学习新的创新和模式是其伙伴关系的主要使命。尽管一半以上的答复者报告了在LMIC中观察到的创新做法，但只有一位国际水文计划答复者表示，这导致了反向创新。对调查受访者的抽样调查揭示了主要围绕学习是如何概念化的主题，但也揭示了英国和LMIC合作伙伴之间的核心权力失衡。家长式的知识观念可以追溯到伙伴关系、权力动态和对LMIC的潜在态度。考虑到创新的全球流动，如果高收入国家(HIC)要从LMIC实践中受益，最重要的是对这种学习从哪里来持开放态度。使学习的潜力更加明确，并促进返回后的创新传播，最终将为采用的成功奠定基础。
International health partnerships (IHPs) are changing, with an increased emphasis on mutual accountability and joint agenda setting for both the high- and the low- or middle-income country (LMIC) partners. There is now an important focus on the bi-directionality of learning however for the UK partners, this typically focuses on learning at the individual level, through personal and professional development. We sought to evaluate whether this learning also takes the shape of ‘Reverse Innovation’ –when an idea conceived in a low-income country is subsequently adopted in a higher-income country. This mixed methods study used an initial scoping survey of all the UK-leads of the Tropical Health Education Trust (THET)-supported International Health Partnerships (n = 114) to ascertain the extent to which the IHPs are or have been vehicles for Reverse Innovation. The survey formed the sampling frame for further deep-dive interviews to focus on volunteers’ experiences and attitudes to learning from LMICs. Interviews of IHP leads (n = 12) were audio-recorded and transcribed verbatim. Survey data was analysed descriptively. Interview transcripts were coded thematically, using an inductive approach. Survey response rate was 27% (n = 34). The majority (70%) strongly agreed that supporting LMIC partners best described the mission of the partnership but only 13% of respondents strongly agreed that learning about new innovations and models was a primary mission of their partnership. Although more than half of respondents reported having observed innovative practice in the LMIC, only one IHP respondent indicated that this has led to Reverse Innovation. Interviews with a sample of survey respondents revealed themes primarily around how learning is conceptualised, but also a central power imbalance between the UK and LMIC partners. Paternalistic notions of knowledge could be traced to partnership power dynamics and latent attitudes to LMICs. Given the global flow of innovation, if High-income countries (HICs) are to benefit from LMIC practices, it is paramount to keep an open mind about where such learning can come from. Making the potential for learning more explicit and facilitating innovation dissemination upon return will ultimately underpin the success of adoption.