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Globalization and Health
Published in: Globalization and Health 1/2016

Open Access 01-12-2016 | Research

Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana

Authors: Masego Katisi, Marguerite Daniel, Maurice B. Mittelmark

Published in: Globalization and Health | Issue 1/2016

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Abstract

Background

International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume and Efficiency to strengthen delivery of the service and push the target. The objective of this paper is to use a systems model to establish how the functioning of the partnership on Safe Male Circumcision in Botswana contributed to the outcome.

Methods

Data were collected using observations, focus group discussions and interviews. Thirty participants representing all three partners were observed in a 3-day meeting; followed by three rounds of in-depth interviews with five selected leading officers over 2 years and three focus group discussions.

Results

Financial resources, “ownership” and the target influence the success or failure of partnerships. A combination of inputs by partners brought progress towards achieving set program goals. Although there were tensions between partners, they were working together in strategising to address some challenges of the partnership and implementation. Pressure to meet the expectations of the international donors caused tension and challenges between the in-country partners to the extent of Development Partners retreating and not pursuing the mission further.

Conclusion

Target achievement, the link between financial contribution and ownership expectations caused antagonistic outcome. The paper contributes enlightenment that the functioning of the visible in-country partnership is significantly influenced by the less visible global context such as the target setters and donors.
Footnotes
1
“Parental states” is not proper English, but is a direct translation from Setswana language phrase used by Government officers to show that the Government is the leader/the host /he owner/the one responsible for the program and other partners fall under their authority. That is why one of the officers referred to Government as a “parent” in one of the quotations below.
 
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Metadata
Title
Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana
Authors
Masego Katisi
Marguerite Daniel
Maurice B. Mittelmark
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2016
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-016-0179-3

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