Activities and Benefits of International Health Partnerships

AUTHOR: BERNARD OKEAH

A recent report by the UK Tropical Health Education Trust (THET) noted that a significant proportion of UK-based IHPs tend to be largely managed by volunteer healthcare professionals who devote their expertise to realise the mandate of their respective organisations (2). Though volunteers help minimise the staff-related costs of the IHPs, their commitment to the partnerships can be limited by other competing priorities such as their main jobs thus impacting on the management of IHPs.  

IHPs partnerships work across four main sectors namely academic institutions, the National Health Service (NHS), within life sciences or commercial sector organisations, and non-governmental institutions including charities. Some IHPs provide international placement opportunities for healthcare professionals as well as students pursuing health-related courses (5). They involve a UK-based institution collaborating with organisations domiciled in other countries across the globe to achieve a global health objective. Despite the triple challenge of the coronavirus, pandemic, Brexit, and cuts by the UK government to overseas development assistance (ODA) that have significantly affected global health activities, UK international health partnerships have shown great resilience and have adapted to innovative working approaches during the post-COVID-19 period with increased elements of remote working now in place for volunteers (3,6).

Activities of International Health Partnerships

IHPs engage in various activities including conducting research, delivering healthcare services, training and capacity building of healthcare workers, implementing community based global health interventions such as hygiene and sanitation programmes, providing technical support to healthcare organisations, and consultancy in global health. Training of healthcare professionals is a significant contribution made by UK-based academic institutions to both the local and international health workforce that improves universal health coverage in line with the United Nations Sustainable Development Goals (7,8), because many international students return to their home countries to take up roles as healthcare workers. 

Health-related programmes offered by UK universities are world-renowned, attracting healthcare professionals from across the globe to pursue full-time, part-time, and distance-learning professional courses. These programmes include medicine, nursing, pharmacy, dentistry, public health, psychology, sociology, and other life sciences. Partner institutions in resource-limited settings also provide placement opportunities for UK healthcare professionals making it possible for them to gain international health experience. Moreover, universities and other academic institutions offer professional development opportunities through short courses available to healthcare workers globally either virtually or through face-to-face sessions. UK-based institutions, specifically universities, provide an excellent research base that supports innovation and boosts productivity across industries largely funded by the UK government and its partners.

The NHS contributes to international health working by providing training opportunities for the global health workforce, research and innovation, as well as engagement in voluntary / humanitarian activities through NHS-based charities / organisations. Professional courses delivered by NHS organisations attract professionals from other countries while some NHS organisations provide attachment opportunities for the health professionals. These partnerships are equally beneficial to developing the workforce of the NHS  such as the Global Fellowship programme for GP trainees which is useful in bringing learning back to the NHS. NHS-based charities provide opportunities for NHS staff to work as volunteers in charities of their interest with some staff working as international health volunteers supporting capacity building activities in partner organisations. NHS organisations also work closely with international partners in conducting collaborative research such as trials on new treatments and interventions that are useful in improving access to quality, safe, and affordable healthcare.

Life science / commercial companies are engaged in manufacturing and distribution of health products to global markets, training and capacity building healthcare workers, international research collaborations, and delivering healthcare services. Some products manufactured by the life sciences or commercial companies include diagnostics and imaging equipment, medical and surgical equipment, pharmaceutical products, providing digital support solutions, and sterilisation as well as cleaning products. Though largely driven by profit, the work of commercial sector organisations may increase access to life-saving technologies and products such as vaccines and affordable medicines. They create potential opportunities for knowledge exchange between healthcare professionals, thus contributing to the development of the global health workforce. Moreover, the commercial sector plays a role in funding research activities in their countries of operation allowing for international collaboration between global health experts. 

Charities and trusts, some of which are registered as part of public sector organisations or as independent organisations, engage in a wide range of activities including training of healthcare workers, implementation of specific projects in maternal and neonatal health, supply of medical equipment, provision of clean water, sanitation and hygiene products, sexual and menstrual health projects, as well as development of healthcare infrastructure. Some charities such as Cancer Research UK provide funding opportunities for international health partners though this is comparatively lower compared to other funding streams for overseas development assistance.

Benefits of International Health Partnerships

Some international health partnerships working in marginalised communities with limited access to healthcare services have a far-reaching impact on the overall health and wellbeing of those communities (10). The partnerships complement mainstream healthcare services and create unique knowledge exchange opportunities for healthcare professionals in both resource-limited and highly resourced countries as they apply their knowledge and skills to improve the health of communities (11). This further strengthens ethical partnerships between resource-constrained and highly resourced countries and facilitates ongoing needs assessment tailored to the respective communities.

IHPs support education of the global health workforce by providing opportunities for knowledge exchange and skills acquisition that may not be available in the healthcare professional’s country. Furthermore, healthcare professionals are exposed to different models of teaching and patient care through their involvement in IHPs to become global health workforce agents of change in their home institutions. IHPs promote bidirectional learning and provide opportunities for reverse innovation (12,13) where learning from a low-income setting could be adapted and implemented in a high income setting e.g. effective models of community health working (14). IHPs also allow for new collaborations in education and research through exchange programmes that are useful in developing the global health workforce while providing opportunities for global health experts to undertake collaborative research (15). The intercultural learning gained through involvement with IHPs broadens the scope of healthcare professionals in providing person-centred care to patients from different cultures which mutually benefits individuals from all involved partner organisations. 

Personal experience in International Health Partnerships

I have worked as a volunteer in an international health partnership providing technical expertise to the Betsi-Kenya Health link in my previous role within the NHS as an infection prevention practitioner. During the COVID-19 pandemic, the partnership implemented a COVID-19 surveillance project in the rural parts of western Kenya through a community health working model that proved beneficial in managing the spread of coronavirus in a resource-limited setting. The intervention involved developing the capacity of community health workers through training in identifying risk events that could trigger outbreaks within their communities and reporting to public health authorities for appropriate actions to limit the spread of the virus. While working remotely, we were able to share key lessons and experiences in managing the pandemic which was very satisfying, especially when the World Health Organisation declared that the COVID-19 pandemic was eventually under control.

International Health Partnerships : Key points

International health partnerships work across four major sectors namely academic institutions, the NHS, life sciences / commercial sector, and charities that are geared towards improving the health and well-being of communities (7). They tend to be mainly managed by volunteer healthcare professionals who work above and beyond their contracted job requirements to achieve the objectives of the IHPs (16–18). The IHPs improve access to services especially within marginalised communities. The work undertaken by IHPs is beneficial to both health care professionals and partnering institutions in the following ways:

• It improves the international profile of NHS bodies which is useful in the recruitment of international talent through available opportunities attracting high quality staff thus strengthening the diversity in the NHS.
• It allows staff to access innovative educational and cultural experiences, promoting intercultural learning and communication
• It improves the skills of healthcare professionals as agents of change within their respective organisations.
• It increases the opportunities for shared learning and knowledge transfer of skills through participation in studies and exposure to other health care systems. This gives opportunities for healthcare professionals to experience working in resource-poor environments, and to develop training competencies and confidence. This has also been useful in building resilience in the NHS.
• It promotes retention of staff through increased opportunity for education and career progression; an interest in international initiatives can also promote job satisfaction and retention.
• It boosts the workforce morale and mobility across the international health partners
• It increases the opportunities for multidisciplinary working with great insight into different cultures, equality, global citizenship awareness.

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