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International Journal of Health Policy and Management
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Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda

Article 5, Volume 6, Issue 6, June 2017, Page 327-338  XML PDF (849 K)
Document Type: Original Article
DOI: 10.15171/ijhpm.2016.137
Authors
Carol Kamya1 ; Jessica Shearer 2 ; Gilbert Asiimwe1 ; Emily Carnahan2 ; Nicole Salisbury2 ; Peter Waiswa3 4 5 ; Jennifer Brinkerhoff6 ; Dai Hozumi7
1Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
2PATH Seattle, WA, USA
3Makerere University School of Public Health, Kampala, Uganda
4Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
5The INDEPTH Network, Maternal, Newborn and Child Health Working Group, Accra, Ghana
6George Washington University, Washington, DC, USA
7Management Sciences for Health, Arlington, VA, USA
Abstract
Background
Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework – the partnership framework – and analytic approach for evaluating the perceptions of partnerships’ added value as well as the results from an application to one case in Uganda.
 
Methods
We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE) to test the partnership framework on Uganda’s human papillomavirus (HPV) vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes). Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership’s role in this process.
 
Results
Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE) may have had downstream consequences if this study’s results had not been shared with the Ministry of Health (MoH) and acted upon. The partnership was not perceived to have increased the efficiency of the process, perhaps as a result of unclear or absent guidelines around roles and responsibilities.
 
Conclusion
The health and functioning of global health partnerships can be evaluated using the framework and approach presented here. Network theory and methods added value to the conceptual and analytic processes and we recommend applying this approach to other global health partnerships to ensure that they are meeting the complex challenges they were designed to address.
Keywords
Immunization; Social Network Analysis (SNA); Partnership; Global Health; Uganda; Gavi
Main Subjects
Health Policy Analysis
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