Local Partnerships for Health on National Forests

The USDA Forest Service has recently piloted health partnerships that facilitate therapeutic outdoor experiences on national forests, building on the growing evidence of the multiple health benefits of activities and time spent in nature. This article presents brief case studies of three pilot partnerships between national forests and health organizations in California, Indiana, and Georgia (USA). These partnerships deliver nature-based programming for the general public as well as those who are in recovery from major surgeries, have been diagnosed with cancer, and face chronic health challenges. To help recreation managers and policy makers understand the potential for such local health partnerships in a federal context, we describe the programs’ enabling conditions, their incorporation of service and stewardship activities, and the challenges and successes they have faced. Insights inform an expanding variety of health partnership models that advance the interconnectedness of human and ecosystem health on public lands as a fundamental dimension of sustainable recreation management.

Hierarchy of qualities in global health partnerships: a path towards equity and sustainability

Despite the exponential growth of global health partnerships (GHPs) over the past 20 years, evidence for their effectiveness remains limited. Furthermore, many partnerships are dysfunctional as a result of inequitable partnership benefits, low trust and accountability and poor evaluation and quality improvement practices. In this article, we describe a theoretical model for partnerships developed by seven global health experts. Through semistructured interviews and an open-coding approach to data analysis, we identify 12 GHP pillars spanning across three interconnected partnership levels and inspired by Maslow’s hierarchy of needs. The transactional pillars are governance, resources and expertise, power management, transparency and accountability, data and evidence and respect and curiosity. The collaborative pillars (which build on the transactional pillars) are shared vision, relationship building, deep understanding and trust. The transformational pillars (which build on the collaborative pillars and allow partnerships to achieve their full potential) are equity and sustainability. The theoretical model described in this article is complemented by real-life examples, which outline both the cost incurred when GHPs fail to live up to these pillars and the benefits gained when GHPs uphold them. We also provide lessons learnt and best practices that GHPs should adopt to further increase their strength and improve their effectiveness in the future. To continue improving health outcomes and reducing health inequities globally, we need GHPs that are transformational, not just rhetorically but de facto. These actualised partnerships should serve as a catalyst for the greater societal good and not simply as a platform to accrue and exchange organisational benefits.

Barriers to decolonising educational partnerships in global health

Global health partnerships between high-income countries and low/middle-income countries can mirror colonial relationships. The growing call to advance global health equity therefore involves decolonising global health partnerships and outreach. Through decolonisation, local and international global health partners recognise non-western forms of knowledge and authority, acknowledge discrimination and disrupt colonial structures and legacies that influence access to healthcare.Despite these well-described aims, the ideal implementation process for decolonising global health remains ill-defined. This ambiguity exists, in part, because partners face barriers to adopting a decolonised perspective. Such barriers include overemphasis on intercountry relationships, implicit hierarchies perpetuated by educational interventions and ethical dilemmas in global health work.In this article, we explore the historical entanglement of education, health and colonialism. We then use this history as context to identify barriers that arise when decolonising contemporary educational global health partnerships. Finally, we offer global health partners strategies to address these challenges.

Mental Health, Partnerships, and Sexual Behavior of German Students After the Third Wave During the Corona Pandemic

Background. The corona pandemic has drastically changed students' lives and increased their perceived stress. At the end of winter and in spring 2021, Germany experienced the third wave of the pandemic. This study aims to examine the state of students’ mental health after the third wave as well as partnerships and sex life during the pandemic. Methods. In June and July 2021, 928 students (mean age: 23.6; 63.5% females) from four universities in Germany completed an online survey. The PHQ-9 and GAD-7 were used to assess mood problems and worrying. Results. Our results show that 56.4% were above the cut-off value for clinically relevant mood problems, 35.7% for worrying and 33.4% were above both cut-off values simultaneously (≥10). The female gender, higher study stress, low financial resources, higher strain due to corona and more loneliness were associated with severe symptoms, whereas higher life satisfaction, more sleep, and psychological/psychiatric treatment were related to better mental health. Students who started studying in the pandemic showed slightly more mood problems than longer enrolled students. The vast majority (89.3%) of all students were happy with their current relationship. While half of the students noted no change in their relationship, a quarter each reported improvement or deterioration. Every third single student has had less sex and in every fifth partnership it came to more sex during the pandemic. Conclusion: Students´ mental health seems to be worse compared to pre-pandemic data and also compared to the first wave data, especially concerning mood problems (depressive symptoms). Women are significantly more burdened than men. It should be further investigated whether rates of symptom load will be lower again when universities reopen and study life becomes normal.

Assessing how global health partnerships function: an equity-informed critical interpretive synthesis

Background Global health partnerships (GHPs) are situated in complex political and economic relationships and involve partners with different needs and interests (e.g., government agencies, non-governmental organizations, corporations, universities, professional associations, philanthropic organizations and communities). As part of a mixed methods study designed to develop an equity-sensitive tool to support more equity-centred North-South GHPs, this critical interpretive synthesis examined reported assessments of GHPs. Results We examined 30 peer-reviewed articles for power dynamics, equity and inequities, and contradictions or challenges encountered in North-South partnerships. Among articles reviewed, authors most often situated GHPs around a topical focus on research, capacity-building, clinical, or health services issues, with the ‘work’ of the partnership aiming to foster skills or respond to community needs. The specific features of GHPs that were assessed varied widely, with consistently-reported elements including the early phases of partnering; governance issues; the day-to-day work of partnerships; the performance, impacts and benefits of GHPs; and issues of inclusion. Articles shared a general interest in partnering processes and often touched briefly on issues of equity; but they rarely accounted for the complexity of sociopolitical and historical contexts shaping issues of equity in GHPs. Further, assessments of GHPs were often reported without inclusion of voices from all partners or named beneficiaries. GHPs were frequently portrayed as inherently beneficial for Southern partners, without attention to power dynamics and inequities (North-South, South-South). Though historical and political dynamics of the Global North and South were inconsistently examined as influential forces in GHPs, such dynamics were frequently portrayed as complex and characterized by asymmetries in power and resources. Generally, assessments of GHPs paid little attention to the macroeconomic forces in the power and resource dynamics of GHPs highlights the importance of considering the broader political. Our findings suggest that GHPs can serve to entrench both inequitable relationships and unfair distributions of power, resources, and wealth within and between countries (and partners) if inequitable power relationships are left unmitigated. Conclusions We argue that specific practices could enhance GHPs’ contributions to equity, both in their processes and outcomes. Enhancing partnering practices to focus on inclusion, responsiveness to North-South and South-South inequities, and recognition of GHPs as situated in a broader (and inequitable) political economy. A relational and equity-centred approach to assessing GHPs would place social justice, humility and mutual benefits as central practices—that is, regular, routine things that partners involved in partnering do intentionally to make GHPs function well. Practicing equity in GHPs requires continuous efforts to explicitly acknowledge and examine the equity implications of all aspects of partnering.