A Study Of The Characteristics, Participant Perceptions And Predictors Of Effectiveness In Community Partnerships In Health Personnel Education
: The Case Of South Africa

  • Walid El Ansari

    Student thesis: Doctoral Thesis


    A community coalition is a formal alliance of organisations, groups and agencies that have come together for a common goal. Collaborative partnerships between the health professionals and the communities they serve have received attention as a strategy for achieving health gain and are spreading globally. This partnership approach has a potential for a synergistic maximization of impact and has been advocated as a means to increase citizen participation and ownership among under-privileged groups. Despite the popular appeal and theoretical promise of this approach, the precise domains that need to be fostered by the stakeholders to implement this complex model remain unclear.

    The aim of this study was to investigate and compare the characteristics and perceptions of the CPs' stakeholders as regards the structural characteristics and operational parameters of the partnerships, as well as the correlates of effectiveness and impact for each participant group. Of particular interest was to identify the characteristics which enable partnerships to fulfill their organizational tasks and goals, regardless of the scope or complexity of purpose.

    The five CPs were located across South Africa and aimed at Health Professions Education reforms. Quantitative data was collected from 668 coalition members and qualitative data from 46 strategic participants. The partnerships' documents were also scrutinized and ample participant observations were undertaken. The data was then pooled and the comparison groups were constructed: the professionals, comprising of staff from the academic institutions and the health service providers, the community members and the full-time paid employees of the partnerships, the core staff.

    The analyses of the partner's opinions and views as well as the predictors of accomplishment of diverse stakeholders hold lessons for managers concerned with health coalitions. Generally, training and development seem to be the main thrust of the partnerships' missions. The observation is that clarity of roles, procedures and responsibilities is imperative. Clarity requires transparency to each others agendas. Although there was an under-representation of the youth, there seemed to exist a mixture of various levels of satisfaction in the partnerships, with the community members in need for more sense of ownership. The findings also point to that consultation in decision making seem to be lacking with unilateral decision making taking place. This might lead to power struggles and hidden agendas between the partners that could hamper the advancement of the partnerships.

    Explanation of why stakeholders are satisfied or committed or what explains their views on effectiveness and activity levels of their partnerships may inform efforts in other settings. With diverse partners, it is important to be somewhat cautious in the consideration of the stakeholders engaged in these collaborative efforts. Partners working together need not be considered homogenous entities. The groups come from different backgrounds, organizations and cultures. The attitude to be created in collaborative interventions is one of a clear understanding that embraces the different origins and aspirations of the stakeholders and recognises the mutual roles, responsibilities, resources and limits. Only by paying due attention to their individual values and weaving it into a common vision can the partnership process be taken forward.
    Date of AwardSept 1999
    Original languageEnglish
    SupervisorCeri J. Phillips (Supervisor) & Anthony Zwi (Supervisor)


    • Personnel
    • Management
    • Partnerships
    • Collaborative Partnerships
    • health professionals
    • South Africa

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