Abstract:
Interuniversity global health partnerships are often between parties unequal in organizational
capacity and performance using conventional academic output measures. Mutual benefit and
reciprocity are called for but literature examining these concepts is limited. The objectives of
this study are to analyse how reciprocity is practiced in international interuniversity global
health partnerships and to identify relevant structures of reciprocity. Four East African
universities and 125 of their international partnerships were included. A total of 192 repre-
sentatives participated in key informant interviews and focus group discussions. Interviews
were transcribed and analysed thematically, drawing on reciprocity theories from international
relations and sociology. A range of reciprocal exchanges, including specific, unilateral and
diffuse (bilateral and multilateral), were observed. Many partnerships violated the principle of
equivalence, as exchanges were often not equal based on tangible benefits realized. Only when
intangible benefits, like values, were considered was equivalence realized. This changed the
way the principle of contingency—an action done for benefit received—was observed within
the partnerships. The values of individuals, the structures of organizations and the guiding
principles of the partnerships were observed to guide more than financial gain. Asymmetry of
partners, dissimilar perspectives and priorities, and terms of funding all pose challenges to
reciprocity. In an era when strengthening institutions is considered crucial to achieving
development goals, more rigorous examination and assessment of reciprocity in partnerships
is warranted.