Global health research case studies: lessons from partnerships addressing health inequities

Inspiration for compiling this collection of case studies comes from the Global Health Research Initiative’s (GHRI) commitment to conceptualizing and supporting global health research as a practice with increasingly discernable core characteristics. Through an exploration of these characteristics, the collection highlights practical, relevant and transferable lessons for consideration by researchers, their research-user partners, and donors working to address health inequities through global health research partnerships. The value of global health research partnerships is illustrated through the achievements of the collaborations featured in this collection. The ten case studies included in this collection do not describe individual research projects. Instead, they each provide an in-depth account of a defined program of research that acts as a platform for theoretically linked research projects. The programs are an integrated blend of knowledge generation, capacity building, and knowledge translation activities that have evolved towards increasing complexity and sophistication. In particular, attention to capacity building and knowledge translation increases as the programs mature over time. The programs of research are animated by a core alliance of individuals whose international partnerships are rooted in mutual trust and the articulation of a common goal: health equity. The cases presented in this collection are concerned with health inequities experienced by certain population groups. For example, the two cases set in South Asia (Haddad et al., Mumtaz et al.) are both concerned with the persistent health inequities that are experienced by lower-caste women belonging to marginalized indigenous groups. Another disadvantaged population group highlighted twice in this collection is people living with HIV/ AIDS in rural Sub-Saharan Africa (Kipp et al., Sodhi et al.). A third group, Ecuadorians with limited resources who are vulnerable to environmental degradation and to acute pesticide poisoning, is also highlighted twice in this collection (Spiegel et al., Cole et al.). All of these groups face persistent social and health inequities that have “both historical roots and present day causes” (Cole et al.). This collection features partnerships that include Canadian researchers. This is in part not accidental given that these cases were compiled by Canada’s Global Health Research Initiative (GHRI), a partnership between five Canadian government agencies that are responsible for health, health research and international development (the International Development Research Centre, the Canadian Institutes of Health Research, Health Canada, the Canadian International Development Agency, and the Public Health Agency of Canada). Over the past ten years, GHRI has sought to understand the characteristics of effective global health research and to create an environment that is conducive to its successful conduct. While the programs described in this collection are not all directly supported by GHRI, they share characteristics that are common to the programs of research supported by GHRI. We emphasize these characteristics here because we believe that they are core to the practice of global health research. The practice of global health research as described in these case studies and as supported by GHRI is characterized by: 1) long-term and sustainable North-South partnerships; 2) interdisciplinary responses to complex issues; 3) participatory action research that grounds the research in its context; and 4) research with a policy or practice impact orientation. In this introductory essay we elaborate on each of these characteristics. We also take this opportunity to highlight some of the commendable achievements of the partnerships. At the same time, we do not neglect to expand on the challenges that face global health research partnerships, nor fail to recognize the systemic barriers that too often confine researchers, research-users, and donors.