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SummaryRacism is a public health crisis. Black communities (including Africans, the African diaspora and people of African descent) experience worse health outcomes as demonstrated by almost any measure of health and wellbeing—e.g. life expectancy; disease prevalence; maternal mortality rates. While health promotion has its foundation in promoting equity and social justice, it is clear that however well-intended, we are not affecting meaningful change for Black communities quickly enough. Through this article, we outline the intersection of social determinants of health and anti-Black racism. We describe how in the first 8 months of 2020 Black communities around the globe have been disproportionately affected by COVID-19, while also having to respond to new instances of police brutality. We assert that the time has come for health promotion to stop neutralizing the specific needs of Black communities into unspoken ‘good intentions’. Instead, we offer some concrete ways for the field to become outspoken, intentional and honest in acknowledging what it will take to radically shift how we promote health and wellbeing for Black people.

Several health research organisations whose work focuses on international collaboration outline guidelines that support ethical practice in health research partnerships including building consensus around good collaborative research practice. This paper explores researcher's perspectives, experiences, and reflections on the elements of successful health research partnerships between Northern and Southern countries/institutions. The study adopted a qualitative research approach using in-depth interviews to explore what an authentic partnership is as experienced and aspired by stakeholders in health research partnerships in Zambia. Interviews were conducted with stakeholders implementing various health research activities in the country. Our findings revealed that Southern partners aspired for equal status and participation, transparency, and accountability, interdependency, and reciprocity, commitment to shared goals, open dialogue and sustainability in partnerships. While to some extent these aspirations overlap with the categories covered throughout the different partnership guidelines, some key aspects go beyond what is included in existing recommendations such as status and recognition which are salient in the broader guidelines. An important aspect in dismantling power structures that causes inequality in partnerships is through generating knowledge and innovation using local resources in the South to address local needs which can be subsequently re-used to address challenges at the global level.

Background The late 1990s and early 2000s have seen a growth in north–south health research partnerships resulting from scientific developments such as those in genetic studies and development of statistical techniques and technological requirements for the analysis of large datasets. Despite these efforts, there is inadequate information representing the voice of African researchers as stakeholders experiencing partnership arrangements, particularly in Zambia. Furthermore, very little attention has been paid to capturing the practice of guidelines within partnerships. In this paper, we present achievements and highlight challenges faced by southern partners in north–south health research partnerships. Methods A qualitative inquiry was employed using in-depth interviews developed using the Bergen Model of Collaborative Functioning with 20 key informants in Lusaka district in Zambia purposively sampled from a wide range of health research partnerships. Results Partnerships produce benefits for southern partners, including evidence generation to influence policy, improved service delivery, infrastructure development and designing interventions to improve the healthcare of populations in greatest need. Most importantly, through partnerships, there is availability of financial resources to accomplish partnership goals. For success to be achieved, there must be effective communication and leadership, values and accountability that go into the process of partnership functioning. Trust interacts with different elements that create partnerships where there is co-ownership of study rewards. Challenging aspects of the interaction are largely due to funding mechanisms where 90% of the funding for health research is from northern partners. This funding mechanism results in power imbalances that lead to publication challenges, dictation of research agenda and ownership of samples and data leading to a general lack of motivation to collaborate. Conclusion Mistrust has implications on joint working such that partners find it difficult to work together and produce results greater than their individual efforts. Property rights and resource sharing must be resolved early in the partnership and each partner’s contributions recognised. These findings highlight areas that partnerships need to focus on to make the most of guidelines on research partnership with developing countries.

The Sustainable Development Goals (SDGs) lay the foundations for supporting global health and international development work for the next 15 years. Thirty years ago, the Ottawa Charter defined health promotion and outlined key principles for global action on health, including the importance of advocating, enabling and mediating for health equity. Advocacy underscores a human right to health and suggests political action to support its attainment. Enabling speaks to health promotion’s focus on the empowerment of people and communities to take control over their health and aspirations. Mediation draws attention to the critical intersectoral partnerships required to address health and social inequities. Underpinned by this approach, the aim of this paper is to consider how key health promotion principles, namely, rights, empowerment and partnership feature (and are framed) within the SDGs and to consider how these framings may shape future directions for health promotion. To that end, a critical frame analysis of the Transforming Our World document was conducted. The analysis interrogated varying uses and meanings of partnerships, empowerment and rights (and their connections) within the SDGs. The analysis here presents three framings from the SDGs: (1) a moral code for global action on (in)equity; (2) a future orientation to address global issues yet devoid of history; and (3) a reductionist framing of health as the absence of disease. These framings raise important questions about the underpinning values of the SDGs and pathways to health equity – offering both challenges and opportunities for defining the nature and scope of health promotion.

Palliative care is specialized health care to improve quality of life for patients with serious illness and their families through prevention and relief of suffering. A Palliative Care Institute was held in western Washington to capture community voices about diverse needs, strengths, and opportunities for improvement of palliative care. Researchers employed qualitative methods to obtain thematic data, provide real-time analysis, and engage in a multivoting technique to reflect stakeholder interest in individual themes and prioritize larger group interests. Bronfenbrenner's ecological systems framework was used to explore caregiver experiences. Within the microsystem, caregivers reported difficulties in interactions with medical providers as a key challenge. Within the mesosysytem, interactions between patients and medical providers and the impact on caregivers were explored. Within the exosystem, caregivers reported lack of control over the schedules of personal care staff. Macrosystem influences included impact of local culture on the development of palliative care services. Chronosystem influences include de-medicalization of childbirth and its impact on perceptions of palliative care. Implications include the need for social workers to be proactive in fostering trust and effective communication between care providers and caregivers, and the demand for health care provider training in communication with patients and families.

En 1978, sous la direction de l'Organisation mondiale de la sante (OMS) et du Fonds des Nations Unies pour l'enfance (UNICEF), 134 ministres de la sante a travers le monde ont signe une declaration par laquelle ils s'engageaient a atteindre « la Sante pour tous d'ici l'an 2000 ». Aujourd'hui, malheureusement, « la Sante pour tous » reste un reve lointain. Le present article nous explique que l'echec du projet decoule de l'abandon de ses strategies initiales qui impliquaient collaboration et participation intersectorielle. A la fin des annees 70, une prise de conscience grandissante a fait de la repartition inegale du fardeau des maladies entre pays pauvres et pays riches une preoccupation mondiale. La Declaration d'Alma-Ata a tente d'apporter une reponse a ce probleme a travers le principe des soins de sante primaires universels (SSP). Par ces SSP on s'est efforce de dispenser une education a la sante et de promouvoir le recours a une nourriture saine et a une alimentation equilibree, l'acces a l'eau potable et a des installations sanitaires de base; ainsi que les soins de sante maternels et infantiles, la vaccination, le traitement des maladies courantes et des accidents; et enfin l'acces aux medicaments essentiels. Vingt-sept annees apres le lancement de « la Sante pour tous », les objectifs du projet sont loin d'etre atteints. Des chiffres recents montrent une disparite encore plus grande entre pays riches et pays pauvres que celle qui existait dans les annees 70. Un examen de la litterature revele un grand nombre d'obstacles ayant empeche l'initiative de la « Sante pour tous » d'etre correctement mise en oeuvre dans les pays en voie de developpement Tout d'abord, la signification des SSP a ete mal comprise. L'engagement qu'ils impliquaient en terme de participation et de collaboration s'est litteralement perdu dans la traduction. Un exemple de cette mauvaise interpretation est la traduction erronee de l'expression « primary health care » (soins de sante primaires) en espagnol (atencion primaria de salud). Ensuite, les objectifs de « la Sante pour tous » ont ete amoindris. Les objectifs globaux des SSP ont ete critiques, car consideres comme irrealistes, et rapidement remplaces par les « soins de sante primaires selectifs » axes sur des programmes verticaux comme la surveillance de la croissance des enfants, les solutions de rehydratation orales, l'allaitement maternel et la vaccination. Des programmes drastiques d'ajustement structurel ont egalement ete desastreux pour la mise en oeuvre des SSP. La « Reforme du secteur sanitaire » de la Banque mondiale a affaibli le concept en mettant l'accent sur les strategies de recouvrement des couts, les assurances maladies privees et les partenariats public-prive pour la prestation de services. L'OMS a ete critiquee: on lui a reproche de n'avoir pas fourni le leadership necessaire pour soutenir la « Sante pour tous », et notamment d'accepter des gouvernements un interet de pure forme. Aujourd'hui, la « Sante pour tous » reste un objectif important a poursuivre. Cependant, sa reussite necessite des intervenants un reengagement a collaborer et a participer. Les ONGs ont un role decisif a jouer: en s'unissant les unes aux autres ainsi qu'avec des mouvements de terrain, elles peuvent donner une « voix » aux peuples. Ensemble, ils peuvent motiver les gouvernements a adopter des politiques qui tiennent compte des contextes sociaux et donner aux populations la force de demander des comptes aux gouvernements.

Many nongovernmental organizations in Africa rely on grassroots volunteers to provide critical health services. Considering context and the interplay of individual, organizational, and societal influences on the experience of volunteers, this paper addresses three questions: What do grassroots volunteers contribute? What organizational processes promote volunteer engagement? What are the positive and negative consequences of volunteering? Eighteen members and staff of the Tanzanian HIV and AIDS NGO, KIWAKKUKI, were selected from 6000+ women volunteers to be interviewed. The interviews were recorded, transcribed, and analyzed for themes. Within KIWAKKUKI, volunteers contributed time and local knowledge, leading to an indigenous educational approach building on local norms and customs. Volunteers’ engagement was motivated by the desire to support family members, reverse stigma, and work/socialize with other women. Benefits to volunteers included skills acquisition and community recognition; yet some volunteers also reported negative experiences including burnout, conferred stigma, and domestic violence. Positive organizational processes built on cultural practices such as collective decision-making and singing. The findings point to important considerations about context, including the synergistic effect training can have on local traditions of caring, complications of gender inequity, and how community health planning processes may need to be modified in extremely poor settings. This research also suggests good utility of the research framework (the Bergen Model of Collaborative Functioning) that was used to analyze volunteer engagement for service delivery in sub-Saharan contexts.

A Health in All Policies approach requires creating and sustaining intersectoral partnerships for promoting population health. This scoping review of the international literature on partnership functioning provides a narrative synthesis of findings related to processes that support and inhibit health promotion partnership functioning. Searching a range of databases, the review includes 26 studies employing quantitative (n = 8), qualitative (n = 10) and mixed method (n = 8) designs examining partnership processes published from January 2007 to June 2015. Using the Bergen Model of Collaborative Functioning as a theoretical framework for analyzing the findings, nine core elements were identified that constitute positive partnership processes that can inform best practices: (i) develop a shared mission aligned to the partners’ individual or institutional goals; (ii) include a broad range of participation from diverse partners and a balance of human and financial resources; (iii) incorporate leadership that inspires trust, confidence and inclusiveness; (iv) monitor how communication is perceived by partners and adjust accordingly; (v) balance formal and informal roles/structures depending upon mission; (vi) build trust between partners from the beginning and for the duration of the partnership; (vii) ensure balance between maintenance and production activities; (viii) consider the impact of political, economic, cultural, social and organizational contexts; and (ix) evaluate partnerships for continuous improvement. Future research is needed to examine the relationship between these processes and how they impact the longer-term outcomes of intersectoral partnerships.