Brain sustain partnerships: Equity-orientation and decolonization theory to promote Global North-Global South collaborations in health professions education
5 affiliations
- 1School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- 2Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- 3Department of Paediatrics, Wilson Centre for Research in Education, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- 4Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
- 5Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Abstract
Academic partnerships between institutions in the Global North (GN) and Global South (GS) are promoted as a strategy to strengthen health systems and build workforce capacity, particularly through health professions education. At the same time, growing calls to decolonize global health partnerships have highlighted persistent inequities in power, knowledge production, and resource distribution that shape how these are enacted. While existing literature often emphasizes technical and outcome-oriented models of collaboration, the relational and processual dynamics that sustain or constrain partnerships in practice have been significantly under-examined. This qualitative study is a postcolonial exploration of academic global health partnerships and how they are experienced and negotiated by those involved. Nineteen participants with experience in long-term partnerships between GN and GS universities were interviewed using semi-structured interviews. Data were analyzed iteratively and thematically, revealing how people, processes, and power shape partnership work. Participants described partnerships as fundamentally relational, sustained by individuals who invested significant emotional and relational effort over time. Partnership processes were iterative and required ongoing negotiation of roles, expectations, and priorities in response to changing contexts. Power operated across relationships and processes, shaping whose expertise was recognized, how decisions were made, and how collaboration unfolded. Participants also described moments in which power was acknowledged, reflected upon, and, at times, resisted in efforts to create more egalitarian partnerships by mitigating systemic colonial practices. These findings suggest that academic global health partnerships are not sustained primarily through formal structures or predefined outcomes, but through the dynamic interplay of people, processes, and power. We introduce the concept of “brain sustain” to reframe health workforce development as a collective, relational, and contextually grounded endeavour. Advancing decolonial and equitable partnerships requires recognition of global, historical, and structural conditions, alongside promotion of the relational and processual work that sustain collaboration.
Related
- Ten simple rules for elevating Indigenous partnerships in research
- How to Foster Challenging Interdisciplinary Collaborations: Can Philosophy Support Neuroscientists?
- Leveraging collaborations between researchers, wildlife managers and citizen-volunteers to monitor endangered carnivore populations across space and time
- Evaluation of the collaborative process of public-private partnerships in the veterinary domain: The case of the sanitary mandate in Tunisia
- Impact of structured sexual health training incorporating standardised patients on health professions students’ sexual health communication competence: A single-blind randomised controlled trial in Tanzania
BibTeX
@article{enns2026brain,
title = {{Brain sustain partnerships: Equity-orientation and decolonization theory to promote Global North-Global South collaborations in health professions education}},
author = {Robin K. Enns and Maria Athina Martimianakis and Elizabeth Peter and Freida Chavez and Denise Gastaldo},
journal = {PLOS Global Public Health},
year = {2026},
month = nov,
doi = {10.1371/journal.pgph.0007630},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007630},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Brain sustain partnerships: Equity-orientation and decolonization theory to promote Global North-Global South collaborations in health professions education
AU - Robin K. Enns
AU - Maria Athina Martimianakis
AU - Elizabeth Peter
AU - Freida Chavez
AU - Denise Gastaldo
PY - 2026
DA - 2026/11/11
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007630
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007630
AB - Academic partnerships between institutions in the Global North (GN) and Global South (GS) are promoted as a strategy to strengthen health systems and build workforce capacity, particularly through health professions education. At the same time, growing calls to decolonize global health partnerships have highlighted persistent inequities in power, knowledge production, and resource distribution that shape how these are enacted. While existing literature often emphasizes technical and outcome-oriented models of collaboration, the relational and processual dynamics that sustain or constrain partnerships in practice have been significantly under-examined. This qualitative study is a postcolonial exploration of academic global health partnerships and how they are experienced and negotiated by those involved. Nineteen participants with experience in long-term partnerships between GN and GS universities were interviewed using semi-structured interviews. Data were analyzed iteratively and thematically, revealing how people, processes, and power shape partnership work. Participants described partnerships as fundamentally relational, sustained by individuals who invested significant emotional and relational effort over time. Partnership processes were iterative and required ongoing negotiation of roles, expectations, and priorities in response to changing contexts. Power operated across relationships and processes, shaping whose expertise was recognized, how decisions were made, and how collaboration unfolded. Participants also described moments in which power was acknowledged, reflected upon, and, at times, resisted in efforts to create more egalitarian partnerships by mitigating systemic colonial practices. These findings suggest that academic global health partnerships are not sustained primarily through formal structures or predefined outcomes, but through the dynamic interplay of people, processes, and power. We introduce the concept of “brain sustain” to reframe health workforce development as a collective, relational, and contextually grounded endeavour. Advancing decolonial and equitable partnerships requires recognition of global, historical, and structural conditions, alongside promotion of the relational and processual work that sustain collaboration.
SN - 2767-3375
ER -