title: Application of a partnership model for transformative and sustainable international development.
abstract: There are differences of intent and impact between short-term and long-term engagement of U.S. academic institutions with communities of need in developing nations. Global health programs that produce long-term transformative change rather than transient relief are more likely to be sustainable and in ethical harmony with expressed needs of a region or community. This article explores characteristics of successful ethical partnerships in global health and the challenges that threaten them, introducing a consensus community engagement model as a framework for building relationships, evolving an understanding of needs, and collaboratively developing solutions and responses to priority health needs in underserved regions of the world. The community engagement model is applied to a case study of an initiative by a U.S. school of nursing to establish long-term relationships with the nursing community in the Caribbean region with the goal of promoting transformative change through collaborative development of programs and services addressing health care needs of the region's growing elderly population and the increasing prevalence of noncommunicable chronic diseases. Progress of this ongoing long-term relationship is analyzed in the context of the organizational, philosophical, ethical, and resource commitments embodied in this approach to initiation of transformative and sustainable improvements in public health.
authors.affiliation: Office of Global and Community Health Initiatives, Duke University School of Nursing, Durham, North Carolina 27710, USA. dorothy.powell@duke.edu
authors.forename: Dorothy L
authors.initials: DL
authors.lastname: Powell
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Gilliss
authors.forename: Hermi H
authors.initials: HH
authors.lastname: Hewitt
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Flint
mesh_terms: D017691:Caribbean Region; D003256:Community Participation; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D054521:Cultural Competency / Q000941:ethics / Q000458:organization & administration; D003906:Developing Countries; D014943:Global Health; D006301:Health Services Needs and Demand; D006801:Humans; D007393:International Educational Exchange; D016294:Models, Nursing; D009657:North Carolina; D015399:Nursing Research / Q000941:ethics / Q000458:organization & administration; D019982:Organizational Case Studies; D010175:Pan American Health Organization / Q000458:organization & administration; D011209:Power, Psychological; D028662:Principle-Based Ethics; D016730:Program Development; D012579:Schools, Nursing / Q000941:ethics / Q000458:organization & administration*; D012922:Social Change