Best Practices of Partnership
It is beneficial to follow many practices for successfully planning, implementing and sustaining a partnership:
- Identify appropriate partners
- Have a shared vision, mission and goals
- Delineate roles and responsibilities and maintain accountability
- Communicate with partners
- Establish a governance structure
- Sustain the Partnership
I. Identify appropriate partners
The experience of partnerships has shown that it is critical to identify appropriate partners so that those that will add the most value are identified, and so that the partnership can function smoothly. Some factors to consider regarding potential partners are6:
- History of collaboration: Their experience in the particular field or what value they will add; which organizations have they collaborated with in the past; what have been the outcomes of those partnerships
- Reputation in their fields: How long have they been engaged in the topic of interest; what achievements have been made in area; what is the impact of those achievements on the field
- Business processes: How the potential partner promotes its goods and services; who will control the data analysis, publication, and dissemination of results; and who will control the communication of public statements and findings related to the project
- Compatibility: How the potential partner's mission aligns with your own; will the partnership have a reasonably large impact relative to the resources required
II. Have a shared vision, mission and goals
- Participants in partnerships cannot have divided loyalties and accountabilities and maintain optimal functionality. Community health centers within the Bureau of Primary Health Care Initiatives discovered in their partnership experience that having a shared vision to expand care to all those in need was necessary for the success of these partnerships. Furthermore, a shared governance structure through which an agenda for health care access was truly owned by its partners rather than by the health center was seen to be essential for the success of the partnership7.
- Designing concrete and attainable long and short term goals is essential for the success of partnerships. The partnership model created by Business and Public Health in Georgia resonated with both partners alike, because it was based on identifying shared objectives, assets, and liabilities, and on implementing manageable and measurable objectives that fit the missions of all partners8.
III. Delineate roles and responsibilities and maintain accountability
- Setting expectations for roles and responsibilities of each organization in the partnership is critical. Formal mechanisms aid partnerships in establishing expectations for roles and responsibilities. A public-private partnership to promote hand washing with soap in Central America, consisting of the USAID, the ministries of health and education, the soap industry, media, donors, and NGOs found that drawing up a memorandum of understanding helped to define the roles and responsibilities of the partners, the goals of the initiative, and the expected outcomes 9.
- Another effective strategy to improve performance and mutual accountability is the adoption of standard operating procedures. This includes articulating SMART (i.e., specific, measurable, achievable, realistic, and timely) objectives, defined roles, responsibilities and decision rights, and regularly engaging in consolidated partnership-wide planning10.
IV. Communicate with partners
- Creating the right environment for the partnership includes ensuring open communication, respect, and participation by all. The Federal Highway Administration's U.S. and foreign public-private partnerships as well as the Safe USA Alliance's partnership with Browning Ferris Industries recommend that partners should communicate with each other from the start with regular meetings at both the managerial and technical levels11,5.
- The African Comprehensive HIV/AIDS Partnerships (ACHAP) concluded that establishing formal or informal mechanisms for regular information sharing within the organization and between the partners is essential. This enables timely corrective action and changing course as needed to keep to the objectives of the program12,13
V. Governance in Partnerships
Having a governance structure is another important principle in the success of partnerships. A review of several public-private partnerships recommended that identification of a governance structure should be based on the partnership's objectives, existing governance structures of the potential partners, and the principles of good governance. Four possible governance structures include the elite committee model, the nongovernmental organizational model, the quasi public authority model, and the catalyst model.9.
Examples of Governance Models:
Elite Committee Model
In this model, a committee is set up with members from partner organizations. Equal partners negotiate and arrive at consensus decisions. The committee does not implement decisions but influences their respective organizations to achieve goals. For example, the Global Alliance for Vaccines and Immunization (GAVI) program, which consists of various partners including the Bill and Melinda Gates Children's Vaccine Program, International Federation of Pharmaceutical Manufacturers Associations, public health and research institutions, national governments, the Rockefeller Foundation, UNICEF, the World Bank Group, and the World Health Organization (WHO), set up a steering committee with influential members from each partner organization. A board of directors consisting of top officials from its members and chaired by the Director of the WHO governs the initiative.
Non Governmental Organization Model
In this model, the public partner provides organizational, material, and financial resources and enables the private partner to implement the program. For example, in USAID's HAPP program for social marketing of condoms in Indonesia, FUTURES works with the Consortium of Concerned Condom Manufacturers to promote behavior change and implement a social marketing campaign in which USAID HAPP is responsible for overall coordination.
Quasi Public Authority Model
A hybrid organization with features of both public and private partner organizations is created by the public sector partners, to act in public interest. It provides goods and services and enables the private sector partners to enter the market. The Medicines for Malaria Venture (MMV) is a public-private drug research partnership that was based on the agreement that the organization should run as a not-for-profit business and be based on operational paradigms of industry, not the public sector. MMV provides public resources to private drug companies to develop promising drug candidates.
Catalyst Model
A catalyst organization acts as a bridge between the public and private sectors. The catalyst facilitates, coordinates, and conducts meetings, designs strategy, and employs a local coordinator. For example, the USAID-funded projects, Basic Support for Institutionalizing Child Survival (BASICS) and the Environmental Health Project (EHP), bring together partners like the soap industry, ministries of health and education, media organizations, donors, and NGOs to increase awareness of the health benefits and market opportunities of hand washing with soap. BASICS and EHP, playing the role of catalysts for the partnership, also act as mediators between the public and private sectors.
VI. Sustain the partnership
- Ensuring benefits for partners for belonging to the partnership, documenting outcomes, and communicating successes are important factors in sustaining a partnership. Many of the factors associated with planning and implementation, such as leadership roles, membership responsibilities, and organizational contributions, also affect the maintenance of the partnership.6
- In planning for the long-term future of a partnership, having a long-term funding structure as well as resources is a key consideration2,6,14,15. While some partnerships are dependent upon external funding sources that tend to be finite, ideally, renewable resourcing arrangements should be put into place.2 The Safe USA Alliance learned that fundraising efforts by partners should be continuous and can help to sustain the project and the partnership once the original funding sources end. Sites in the Safe USA Alliance raised their own funding through coalitions.5 The National Aids Fund (NAF) recognizes that finding innovative ways of supporting partnerships to conduct HIV work in communities is key to the sustainability of these partnerships and their efforts. NAF, besides providing a leadership grant to communities, provides a $75,000 Challenge Grant to communities in the ratio of 1:2, that is, the community raises two dollars for every dollar of NAF support. The NAF has been very successful in sustaining these programs through these mechanisms in the years since they were established in 198816. The Healthy Communities Access Program (HCAP) was federally funded from 2003-06. A review of HCAP determined it was vital for the consortia that were funded under HCAP to identify an active, viable financial collaborative structure to continue the work.7 A review of 23 global health partnerships concluded that financing gaps can be minimized by setting realistic targets and ensuring that plans identify specific partners responsible for filling funding gaps related to the cost of implementing a partnership. A work plan that includes the commitment of all partners is essential so that they remain accountable to providing the funding needs of the partnership.10,7. Having a budget and having multiple partners contribute financially to the partnership, in addition to having a broad array of partners, contributed to the success of partnerships, according to a survey of partnerships between the local health departments in Wisconsin and various private partners including hospitals, community-based organizations, schools, etc.17
- Other areas of focus for sustainability include team building, decision making, consensus development, maintaining lines of authority, monitoring partner contributions and fulfillment of roles and responsibilities, and tracking progress through the evaluation of objectives.2
2 Tennyson R. 2003. The Partnering Tool book. Published by the International Business Leaders Forum and the Global Alliance for Improved Nutrition. Access online:
http://www.toolkitsportdevelopment.org/html/resources/E1/E1585B25-8A8A-44A9-BC6C-F519987AD2CE/pt-en.pdf
5 Public Private Partnerships - A Tool for Success, August 2000 (Draft)
6 CDC Guidance for Collaboration with the Private Sector, CDC Partnership Tool Kit-Draft Version 1.1 - September 2006, Division of Partnerships and Strategic Alliances, National Center for Health Marketing, CCHIS, CDC
7 Shi L, Collins PB., Public-private partnerships in community health centers: addressing the needs of underserved populations. Organ Ethic. 2007 Spring-Summer; 4(1):35-42.)
8Buehler JW, Whitney EA, Berkelman RL, Business and public health collaboration for emergency preparedness in Georgia: a case study, , BMC Public Health. 2006 Nov 20; 6:285
9 Water and Sanitation Program, The World Bank, Health in Your Hands, Public Private Partnerships for Health: A Review of the Best Practices in the Health Sector, July 2003
10 Buse K and Harmer AM. October 2007. Seven habits of highly effective global public-private health partnerships: Practice and potential. Social Science & Medicine. 64(2007): 259-271.
11 Federal Highway Administration, 2007, User Guidebook on Implementing Public-Private Partnerships for Transportation Infrastructure Projects in the United States
http://www.fhwa.dot.gov/PUBLIC PRIVATE PARTNERSHIP/resources_guidebooks.htm
12 Ramiah I, Reich MR., Public-private partnerships and antiretroviral drugs for HIV/AIDS: lessons from Botswana. Health Affairs, Vol 24, Number 2, March/April 2005
13 Ramiah, Ilavenil, Reich, Michael R, Building effective public-private partnerships: Experiences and lessons from the African Comprehensive HIV/AIDS Partnerships (ACHAP). Social Science & Medicine. Vol 63(2) Jul 2006, 397-408.
14 Comprehensive Cancer Control, CDC. December 2006. Partnership Tool Kit: Program Version. Access online:
http://www.msdh.state.ms.us/msdhsite/index.cfm/43,2766,292,410,pdf/PartnershipToolsforPrograms.pdf
15 Lopez R, Campbell R, Jennings J., The Boston schoolyard initiative: a public-private partnership for rebuilding urban play spaces, J Health Polit Policy Law. 2008 Jun; 33(3):617-38.
16 Public-Private Partnerships: A New Model for Community Mobilization against AIDS. November 21, 2002.
http://www2a.cdc.gov/phtn/webcast/hiv11-21/default.asp#
7 Zahner S.J., Local public health system partnerships, Local public health system partnerships.
