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Table 2 Themes emerging form data analysis: Applying the Bergen Model of Collaborative Functioning

From: Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana

Basic themes

Organising themes

Global themes

1. Botswana government HIV National Strategic Framework (NSF) lead by NACA

2. All ministries, development partners CBOs, NGOs and private sector are part of the NSF

3. MH, DP1,DP2 are three main partners in the SMC program

4. DHMT works at district level

5. All partners involved throughout the planning process since 2007

6. All partners target HIV negative men aged 15–49 years to circumcise through SMC

7. All partners aim to have circumcised 80 % of HIV negative men by year 2016

Clear Partner Mission

Input

8. Botswana government integrated circumcision within health services nationwide since 2007

9. DPs introduced MOVE project in 2011 to help government push set target in selected areas

Approaches to the mission

10. DP1 viewed as a major financial contributor: more monetary funds; sub-constructs companies; built 2 permanent clinics; provides surgery kit; provides mobile clinics and transport

11. DP1 contributes funds and funds medical personnel and transport

12. MH contributes funds; provides health structures nationally; provides medical equipment and transport

Financial Resource Contribution

13. DPs deployed medical staff to Government health centers to do SMC

14. DPs deployed staff moved to form dedicated MOVE teams

15. DP1 brings in special scientific expertise

16. MH’s avails its medical staff nationally to participate in SMC

Partner Resource Contribution

17. MH as owner, coordinator, chair, provider of space and financing

18. DP1 as technical advisor, expert, advertising, mobilisation, provider of clinics structures and main donor

19. DP2 as donor, implementer and community mobiliser

Clear Partner Roles

Throughput

20. Partners developed short term and long term communication strategies; training manuals and reporting system together

Communication

21. Development partners use different reporting systems than MH’s

22. Development partners do not report to MH systematically

23. Reporting between partners was not transparent

24. Development partners reported directly to their international donors

25. The Government reported all donor funds usage to OECD

26. Way of accountability give blurry structure

Financial resources

27. More finances spent but less numbers of circumcised men causes conflict

28. MH’s financial contribution queried to be not transparent

29. Ownership seems linked to finance contribution

30. MH’s ownership of the program is questioned

31. MH sees structures as big contribution

Input Interaction

In-kind resources

32. Donors keep sending more equipment for circumcision

33. Lots of equipment is wasted

34. There is inconsistency on balance sheet for number of circumcision instruments, wasted and remaining

35. MH is blamed for not taking care of such equipment

Partner resources

36. MH viewed as a weak coordinator at times

37. MH ownership is queried

38. Government health centers is blamed to be participating little in circumcision

39. MH feels MOVE strategy naturally creates dependency on government health staff

40. Districts prioritised attending to ill patients than circumcision

41. DHMTs blamed for not prioritising SMC

42. Health centers viewed SMC as the DPs’ program

43. Partners consulted with the national traditional leadership at planning stage

44. MH is seen as a leader and owner

45. There is not enough support from the highest national leadership to influence men for circumcision

46. MH’s placements of coordination leadership is queried

47. DHMTs are said to not take leadership role accordingly

Leadership

 

48. DPs blame MH for setting the target high

49. DPs blame MH for not putting enough effort and resources to push the set target

50. MH is frustrated about the mathematical model used by WHO to set country target

49. Unattainable target is seen as the highest risk in program implementation

51. MH and DPs express frustration that the 80 % target is not attained regardless of their massive efforts

51. DPs report pressure from donors on reconciling dollar to numbers

Mission threatened

Feedback mission

52. DPs indicate that the donors will cut down on the funds

53. International donors reduce funding support to Botswana

54. DP2 pulls away its employed doctors gradually from 2013 and leaves a gap in implementation

55. DP1 pulls away its financial and technical assistance abruptly in 2014 and leaves a gap in implementation

Antagony

Output