Prioritization and Resource Allocation in Academic Global Health Partnerships

John Kulesa; Ian Chua; Kathy Ferrer; Terry Kind; Jeremy Kern

doi:10.1016/j.acap.2022.10.012

Prioritization and Resource Allocation in Academic Global Health Partnerships

Acad Pediatr. 2023 May-Jun;23(4):829-838. doi: 10.1016/j.acap.2022.10.012. Epub 2022 Oct 21.

Authors

John Kulesa¹, Ian Chua², Kathy Ferrer³, Terry Kind⁴, Jeremy Kern³

Affiliations

¹ 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. Electronic address: kulesaj@gmail.com.
² 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.
³ 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.
⁴ 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.

PMID: 36280039
DOI: 10.1016/j.acap.2022.10.012

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.

Keywords: decolonization; global health; grounded theory; priority setting and resource allocation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Delivery of Health Care
Global Health*
Humans
Resource Allocation*