Do International Health Partnerships contribute to reverse innovation? a mixed methods study of THET-supported partnerships in the UK

Abstract

BackgroundInternational health partnerships (IHPs) are changing, with an increased emphasis on mutual accountability and joint agenda setting for both the high- and the low- or middle-income country (LMIC) partners. There is now an important focus on the bi-directionality of learning however for the UK partners, this typically focuses on learning at the individual level, through personal and professional development. We sought to evaluate whether this learning also takes the shape of ‘Reverse Innovation’ –when an idea conceived in a low-income country is subsequently adopted in a higher-income country.MethodsThis mixed methods study used an initial scoping survey of all the UK-leads of the Tropical Health Education Trust (THET)-supported International Health Partnerships (n = 114) to ascertain the extent to which the IHPs are or have been vehicles for Reverse Innovation. The survey formed the sampling frame for further deep-dive interviews to focus on volunteers’ experiences and attitudes to learning from LMICs. Interviews of IHP leads (n = 12) were audio-recorded and transcribed verbatim. Survey data was analysed descriptively. Interview transcripts were coded thematically, using an inductive approach.ResultsSurvey response rate was 27% (n = 34). The majority (70%) strongly agreed that supporting LMIC partners best described the mission of the partnership but only 13% of respondents strongly agreed that learning about new innovations and models was a primary mission of their partnership. Although more than half of respondents reported having observed innovative practice in the LMIC, only one IHP respondent indicated that this has led to Reverse Innovation. Interviews with a sample of survey respondents revealed themes primarily around how learning is conceptualised, but also a central power imbalance between the UK and LMIC partners. Paternalistic notions of knowledge could be traced to partnership power dynamics and latent attitudes to LMICs.ConclusionsGiven the global flow of innovation, if High-income countries (HICs) are to benefit from LMIC practices, it is paramount to keep an open mind about where such learning can come from. Making the potential for learning more explicit and facilitating innovation dissemination upon return will ultimately underpin the success of adoption.

Outcome of uncomplicated ureteric calculi managed with medical expulsive therapy in the outpatient clinic of a urology unit in Sri Lanka

“…This type of pragmatic observational studies would allow better clinical trial planning and promote equity of health care services among populations of different socioeconomic strata [ 6 ]. Even developed countries can benefit as these results contribute to reverse innovation [ 19 ].…”

Review of the reverse innovation series in globalization and health – where are we and what else is needed?

“…Second, the series has also provided theoretical contributions examining models of Reverse Innovation, knowledge diffusion and the role of international health partnerships [11][12][13][14][15]. There have been empirical studies of the barriers to Reverse Innovation [16][17][18] including the use of Implicit Association Tests (IATs) to identify unconscious associations between rich countries and good research, and poor countries and bad research [17].…”

An innovation platform for diffusing public health practices across a global network

“…At the core of these hospital and health system partnerships are opportunities for reciprocal exchange of ideas, approaches, and expertise. Often referred to as international health partnerships, examples in the literature include collaborative trainings, research activities, capacity development, and service delivery [1]. Determining how to move medicine to places where there are logistical challenges, how to educate a diverse array of caregivers in professional and lay contexts, how to build the capacity of medical researchers, and how to leverage social support structures to overcome stigma about medical conditions are only a handful of examples that demonstrate innovation flow from high-income countries (HIC) to low-and middle-income countries (LMIC), a process we refer to as 'high-low innovation.'…”