Collaborating on a Memorandum of Understanding
Partnership documents outlining the principles and governance structures for setting up and maintaining a North-South partnership are found in Europe’s ESTHER Alliance, the UK’s THET International Health Link Manual and the WHO-African Partnership for Patient Safety. These bodies share the view that the ‘how’ of partnerships is as important as the ‘what’. Shared and joint planning are key. Shared decision-making and responsibility can only take place if the partners are equal and respectful towards each other. This requires vigilance to ensure that traditional hierarchical relationships that have historically marked North-South partnerships do not inadvertently develop.
Reciprocity, another core principle, means there are benefits for both northern and southern partners. For the northern partner, these can include operational and organisational cost-effectiveness in health service delivery and professional development for individuals in the organisation. Adherence to country national policies and strategies makes sense; the people of the land and their representatives know best how to implement health interventions tailored to the values, cultures and socio-economic circumstances of the population. Ethical considerations including evaluation, communications, scalability and sustainability of initiatives with judicious use of limited resources must also be taken into account.
In our own case the five parties worked together over nine months drafting an MOU on the objectives, governance and principles which will underpin all partnership activities. A special thanks to Ms Nadine Ferris France and Dr David Weakliam of ESTHER Ireland who met with the Irish (in person) and Kenyan (virtually) parties during the MOU process and emphasised the explicit inclusion of governance processes and partnership principles in the document. This was extremely helpful. A signing ceremony has been postponed due to the Covid-19 pandemic, but despite this, a number of successful collaborations have taken place to date.