Abstract
BACKGROUND: Effective global health partnerships can strengthen and improve health and healthcare systems across the world; however, establishing and maintaining effective partnerships can be challenging. Principles of Partnerships have been developed to improve the quality and effectiveness of health partnerships. It is unclear how principles are enacted in practice, and current research has not always included the voices of low-income and middle-income country partners. This study aimed to explore how The Tropical Health and Education Trust's nine Principles of Partnership are enacted in practice, from the points of view of partners from low-income, middle-income and high-income countries, to help improve partnerships' quality and sustainability. METHODS: People who had been a part of previous and/or ongoing health partnerships were interviewed virtually. Participants were purposefully sampled and interviews were conducted using an appreciative inquiry approach. Audio recordings were transcribed and deductive framework analysis was conducted. RESULTS: 13 participants from 8 partnerships were interviewed. Six participants were based in the low-income or middle-income countries and seven in the UK. Key findings identified strategies that enacted 'successful' and 'effective' partnerships within the Principles of Partnerships. These included practical techniques such as hiring a project manager, managing expectations and openly sharing information about the team's expertise and aspirations. Other strategies included the importance of consulting behavioural science to ensure the partnerships consider longevity and sustainability of the partnership. DISCUSSION: Core principles to effective partnerships do not work in isolation of each other; they are intertwined and are complimentary to support equitable partnerships. Good communication and relationships built on trust which allow all partners to contribute equally throughout the project are core foundations for sustainable partnerships. Recommendations for established and future partnerships include embedding behavioural scientists/psychologists to support change to improve the quality and sustainability of health partnerships.