Mutual learning in International Health Partnerships: Examining reverse innovation in the Norwegian health partnership scheme, fk Norway
File(s)
Author(s)
Issa, Hamdi
Type
Thesis or dissertation
Abstract
Increasingly high-income countries (HIC) have introduced concepts of mutual learning and reciprocity in their International Health Partnerships (IHPs), technical exchange links between their institutions and institutions in low and middle-income countries (LMIC), suggesting an environment ripe for Reverse Innovation. This research is a case study of fk Norway’s unique partnership model, one that explicitly mandates exchange of personnel between these contexts, to explore whether (and how) this leads to a learning dynamic supportive of the exchange of technical know-how.
The research draws on qualitative research methods, mainly semi-structured interviews, observations and document review, collected over a 15-month period, as a means to unpack this reciprocity narrative and understand how it is used in practice. Drawing on key concepts from the literatures of organizational learning, power and post-colonialism, the thesis sheds light on how individual and organisational learning is managed and framed in IHPs, and how the rhetoric of reciprocity is massaged and eroded for different purposes. The reciprocity narrative was exposed to be a euphemism of value mostly at institutional levels. Implicit knowledge hierarchies permitted HIC learning to be constituted of cultural, rather than technical, learning. Differences in what learning partners acquired and what learning partners shared was observed and enabled unequal power relationships to be perpetuated. Together, the concept of ‘epistemic fragility’ is advanced – where HIC participants exhibit an effortful reinstatement of a learning status quo. These apparent paradoxes and fragilities in knowledge brokerage were observed to influence whose knowledge was favoured. The research allowed a unique immersion into a governmental organisation and its IHPs and identifies a conduit where inconsistencies can be redressed through semantics and leadership. The analytical assertions offered by the research have considerable value in the examination of complex coordinating organisations managing IHP portfolios.
The research draws on qualitative research methods, mainly semi-structured interviews, observations and document review, collected over a 15-month period, as a means to unpack this reciprocity narrative and understand how it is used in practice. Drawing on key concepts from the literatures of organizational learning, power and post-colonialism, the thesis sheds light on how individual and organisational learning is managed and framed in IHPs, and how the rhetoric of reciprocity is massaged and eroded for different purposes. The reciprocity narrative was exposed to be a euphemism of value mostly at institutional levels. Implicit knowledge hierarchies permitted HIC learning to be constituted of cultural, rather than technical, learning. Differences in what learning partners acquired and what learning partners shared was observed and enabled unequal power relationships to be perpetuated. Together, the concept of ‘epistemic fragility’ is advanced – where HIC participants exhibit an effortful reinstatement of a learning status quo. These apparent paradoxes and fragilities in knowledge brokerage were observed to influence whose knowledge was favoured. The research allowed a unique immersion into a governmental organisation and its IHPs and identifies a conduit where inconsistencies can be redressed through semantics and leadership. The analytical assertions offered by the research have considerable value in the examination of complex coordinating organisations managing IHP portfolios.
Version
Open Access
Date Issued
2020-09
Date Awarded
2020-11
Copyright Statement
Creative Commons Attribution NonCommercial Licence
Advisor
Darzi, Ara
Harris, Matthew
Publisher Department
Surgery and Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)