title: Global health partnerships: building multi-national collaborations to achieve lasting improvements in maternal and neonatal health.
abstract: In response to health care challenges worldwide, extensive funding has been channeled to the world's most vulnerable health systems. Funding alone is not sufficient to address the complex issues and challenges plaguing these health systems. To see lasting improvement in maternal and infant health outcomes in the developing world, a global commitment to the sharing of knowledge and resources through international partnerships is critical. But partnerships that merely introduce western medical techniques and protocols to low resource settings, without heeding the local contexts, are misguided and unsustainable. Forming partnerships with mutual respect, shared vision, and collaborative effort is needed to ensure that all parties, irrespective of whether they belong to resource rich or resource poor settings, learn from each other so that meaningful and sustained system strengthening can take place.
  
  
  
  In this paper, we describe the partnership building model of an international NGO, Kybele, which is committed to achieving childbirth safety through sustained partnerships in low resource settings. The Kybele model adapts generic stages of successful partnerships documented in the literature to four principles relevant to Kybele's work. A multiple-case study approach is used to demonstrate how the model is applied in different country settings.
  
  
  
  The four principle of Kybele's partnership model are robust drivers of successful partnerships in diverse country settings.
  
  
  
  Much has been written about the need for multi-country partnerships to achieve sustainable outcomes in global health, but few papers in the literature describe how this has been achieved in practice. A strong champion, support and engagement of stakeholders, co-creation of solutions with partners, and involvement of partners in the delivery of solutions are all requirements for successful and sustained partnerships.
authors.affiliation: Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina, 4107, McGavran-Greenberg Hall, Chapel Hill, NC, USA. ramaswam@email.unc.edu.
authors.forename: Rohit
authors.initials: R
authors.lastname: Ramaswamy
authors.affiliation: Kybele, Inc., Winston-Salem, NC, USA.
authors.forename: Brianne
authors.initials: B
authors.lastname: Kallam
authors.affiliation: Department of Anesthesiology, University Hospital, Split, Croatia.
authors.forename: Dragica
authors.initials: D
authors.lastname: Kopic
authors.affiliation: Department of Anesthesiology, Clinical Center Volvodina, NoviSad, Serbia.
authors.forename: Borislava
authors.initials: B
authors.lastname: Pujic
authors.affiliation: Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Medge D
authors.initials: MD
authors.lastname: Owen
mesh_terms: D057191:Capacity Building / Q000379:methods*; D014943:Global Health / Q000639:trends; D006801:Humans; D000068104:Infant Health / Q000592:standards; D007391:International Cooperation; D000068097:Maternal Health / Q000592:standards; D017146:Models, Organizational; D009938:Organizations / Q000458:organization & administration* / Q000639:trends; D015397:Program Evaluation / Q000639:trends
keywords: Global health partnerships; Low and middle income countries; Maternal and child health; Obstetric anesthesia