Perceived roles, benefits and barriers of virtual global health partnership initiatives: a cross-sectional exploratory study

Abstract

Background Virtual global health partnership initiatives (VGHPIs) evolved rapidly during the COVID-19 pandemic to ensure partnership continuity. However the current landscape for VGHPI use and preference is unknown. This study aimed to increase understanding of GH partners’ perspectives on VGHPIs. Methods From 15 October to 30 November 2020, An online, international survey was conducted using snowball sampling to document pandemic-related changes in partnership activities, preferences for VGHPIs, and perceived acceptability and barriers. The survey underwent iterative development within a diverse author group, representing academic and clinical institutions, and the non-profit sector. Participants from their professional global health networks were invited, including focal points for global health partnerships while excluding trainees and respondents from the European Economic Area. Analysis stratified responses by country income classification and partnership type. Authors used descriptive statistics to characterize responses, defining statistical significance as α = 0.05. Results A total of 128 respondents described 219 partnerships. 152/219 (69%) partnerships were transnational, 157/219 (72%) were of > 5 years duration, and 127/219 (60%) included bidirectional site visits. High-income country (HIC) partners sent significantly more learners to low- to middle-income country (LMIC) partner sites (p < 0.01). Participants commented on pandemic-related disruptions affecting 217/219 (99%) partnerships; 195/217 (90%) were disruption to activities; 122/217 (56%) to communication; 73/217 (34%) to access to professional support; and 72/217 (33%) to funding. Respondents indicated that VGHPIs would be important to 206/219 (94%) of their partnerships moving forward. There were overall differences in resource availability, technological capacity, and VGHPI preferences between LMIC and HIC respondents, with a statistically significant difference in VGHPI acceptability (p < 0.001). There was no significant difference between groups regarding VGHPIs’ perceived barriers. Conclusions The pandemic disrupted essential partnership elements, compounding differences between LMIC and HIC partners in their resources and preferences for partnership activities. VGHPIs have the potential to bridge new and existing gaps and maximize gains, bi-directionality, and equity in partnerships during and after COVID-19.

Access, interest and equity considerations for virtual global health activities during the COVID-19 pandemic: a cross-sectional study

“…Strict infection control practices and unprecedented travel restrictions during the COVID-19 pandemic disrupted in-person GHAs and bidirectional activities [ 11 , 24 – 27 ], and overall communication between GH partners, typically facilitated and reinvigorated by in-person site visits, likewise declined but in a disparate fashion for those is LMIC versus HIC settings [ 11 , 27 , 28 ]. Meanwhile GH inequities worsened at a time when knowledge sharing in the form of GHAs was most needed between all regions of the world, regardless of baseline resource levels, to acquire expertise in addressing pandemic-related healthcare and educational issues [ 26 , 29 ].…”

“…Meanwhile GH inequities worsened at a time when knowledge sharing in the form of GHAs was most needed between all regions of the world, regardless of baseline resource levels, to acquire expertise in addressing pandemic-related healthcare and educational issues [ 26 , 29 ]. Even as travel restrictions subside, shifting testing and vaccination requirements and ongoing funding cuts have continued to limit in-person GHAs in a post-COVID world, especially for those in LMIC settings [ 11 , 25 , 28 , 30 ].…”

“…Due to pandemic-related travel challenges, GHAs conducted virtually online (VGHAs) became a critical element of GH collaboration and have tremendous potential to address challenges to GH engagement and equity. While there is substantial literature describing GH trainee competencies, preparation activities for short-term experiences in GH in resource-constrained settings, and sustaining GHAs during periods of disrupted in-person activities [ 9 – 11 , 23 , 24 , 28 , 31 – 34 ], few studies have explored successes and challenges to VGHAs from HIC and LMIC viewpoints. While the growing use of virtual platforms allowed for more participation in GHAs by those residing in LMICs, recent evidence documenting barriers, enablers, and preferences for VGHAs highlight the existence of new inequalities [ 23 , 28 ].…”

“…While there is substantial literature describing GH trainee competencies, preparation activities for short-term experiences in GH in resource-constrained settings, and sustaining GHAs during periods of disrupted in-person activities [ 9 – 11 , 23 , 24 , 28 , 31 – 34 ], few studies have explored successes and challenges to VGHAs from HIC and LMIC viewpoints. While the growing use of virtual platforms allowed for more participation in GHAs by those residing in LMICs, recent evidence documenting barriers, enablers, and preferences for VGHAs highlight the existence of new inequalities [ 23 , 28 ]. Barriers to VGHA implementation included cost, lack of technological infrastructure, unilateral project ownership, and an absence of mutual learning and goal setting, and while challenges have been identified, solutions are still forthcoming.…”

“…While seeking to disrupt the status quo of inequitable and HIC-based GH practices, referred to as the decolonization of GH [ 20 , 22 , 35 , 36 ], more research is needed to understand the benefits and detriments of VGHAs to build more equitable partnerships and to capitalize on an underutilized mode of bidirectional exchange. This mixed methods study aimed to follow up on preliminary descriptive data [ 28 ] by further characterising access to and interest in VGHAs by both LMIC and HIC partners before and during the COVID-19 pandemic.…”