Mapping synergy and antagony in North-South partnerships for health: a case study of the Tanzanian women's NGO KIWAKKUKI.

North-South partnerships for health aim to link resources, expertise and local knowledge to create synergy. The literature on such partnerships presents an optimistic view of the promise of partnership on one hand, contrasted by pessimistic depictions of practice on the other. Case studies are called for to provide a more intricate understanding of partnership functioning, especially viewed from the Southern perspective. This case study examined the experience of the Tanzanian women's NGO, KIWAKKUKI, based on its long history of partnerships with Northern organizations, all addressing HIV/AIDS in the Kilimanjaro region. KIWAKKUKI has provided education and other services since its inception in 1990 and has grown to include a grassroots network of >6000 local members. Using the Bergen Model of Collaborative Functioning, the experience of KIWAKKUKI's partnership successes and failures was mapped. The findings demonstrate that even in effective partnerships, both positive and negative processes are evident. It was also observed that KIWAKKUKI's partnership breakdowns were not strictly negative, as they provided lessons which the organization took into account when entering subsequent partnerships. The study highlights the importance of acknowledging and reporting on both positive and negative processes to maximize learning in North-South partnerships.

Scaling-up and rooting-down: a case study of North-South partnerships for health from Tanzania.

BACKGROUND: North-South Partnership (NSP) is the mandated blueprint for much global health action. Northern partners contribute funding and expertise and Southern partners contribute capacity for local action. Potential Northern partners are attracted to Southern organizations that have a track record of participating in well-performing NSPs. This often leads to the rapid 'scaling up' of the Southern organization's activities, and more predictable and stable access to resources. Yet, scaling up may also present challenges and threats, as the literature on rapid organization growth shows. However, studies of the impact of scaling up within NSPs in particular are absent from the literature, and the positive and negative impact of scaling up on Southern partners' functioning is a matter of speculation. OBJECTIVE: The purpose of this study is to examine how scaling up affects a Southern partner's organizational functioning, in a Southern grassroots NGO with 20 years of scaling up experience. DESIGN: A case study design was used to explore the process and impact of scaling up in KIWAKKUKI, a women's grassroots organization working on issues of HIV and AIDS in the Kilimanjaro region of Tanzania. Data included documents, observation notes and in-depth interviews with six participants. The data were analyzed by applying an established systems framework of partnership functioning, in addition to a scaling up typology. RESULTS: KIWAKKUKI has experienced significant scale-up of activities over the past 20 years. Over time, successful partnerships and programs have created synergy and led to further growth. As KIWAKUKKI expanded so did both its partnerships and grassroots base. The need for capacity building for volunteers exceeded the financial resources provided by Northern partners. Some partners did not have such capacity building as part of their own central mission. This gap in training has produced negative cycles within the organization and its NSPs. CONCLUSIONS: Northern partners were drawn to KIWAKKUKI because of its strong and rapidly growing grassroots base, however, a lack of funding has led to inadequate training for the burgeoning grassroots. Opportunity exists to improve this negative result: Northern organizations that value community engagement can purposefully align their missions and funding within NSP to better support grassroots efforts, especially through periods of expansion.

Health worker motivation in the context of HIV care and treatment challenges in Mbeya Region, Tanzania: a qualitative study.

BACKGROUND: Health worker motivation can potentially affect the provision of health services. The HIV pandemic has placed additional strain on health service provision through the extra burden of increased testing and counselling, treating opportunistic infections and providing antiretroviral treatment. The aim of this paper is to explore the challenges generated by HIV care and treatment and their impact on health worker motivation in Mbeya Region, Tanzania. METHODS: Thirty in-depth interviews were conducted with health workers across the range of health care professions in health facilities in two high HIV-prevalence districts of Mbeya Region, Tanzania. A qualitative framework analysis was adopted for data analysis. RESULTS: The negative impact of HIV-related challenges on health worker motivation was confirmed by this study. Training seminars and workshops related to HIV contributed to the shortage of health workers in the facilities. Lower status workers were frequently excluded from training and were more severely affected by the consequent increase in workload as seminars were usually attended by higher status professionals who controlled access. Constant and consistent complaints by clients have undermined health workers' expectations of trust and recognition. Health workers were forced to take responsibility for dealing with problems arising from organisational inefficiencies within the health system. CONCLUSION: HIV-related challenges undermine motivation among health workers in Mbeya, Tanzania with the burden falling most heavily on lower status workers. Strained relations between health workers and the community they serve, further undermine motivation of health workers.

We also have Cases of the Disease that you are researching about. Small-scale Enterprises and the Challenges of HIV/AIDS-Related Stigma and Discrimination in Kabale; Uganda

At the workplace; the HIV epidemic has brought about loss of productivity; staff turnover and increased labour costs among others. HIV stigma presents barriers to HIV prevention in different settings including the workplace. Unlike large scale enterprises; small-scale enterprises have received less attention in the fight against HIV/AIDS. This study employed a qualitative case study design. Data were collected from eighteen participants in three small-scale enterprises in Kabale; Uganda. Findings indicate that although there are effectively no workplace policies in small-scale enterprises; employees in the visited workplaces do not fear HIV/AIDS testing and disclosing their HIV/AIDS status as main sources of HIV-stigma although their perceptions remain hypothetical. Integrating clear anti-discriminatory HIV/AIDS policies may empower some small-scale enterprises with related HIV knowledge and skills in an effort to overcome the challenges of HIV-related stigma and discrimination