Starting with a needs assessment, the partnership between Royal College of Nurses and the Zambia Union of Nurses Organisation could decide on priorities and plans and use their steering committees to define roles and responsibilities.

An equitable partnership – defining roles and sharing responsibilities

The Royal College of Nursing (RCN) in the UK and the Zambia Union of Nurses Organisation (ZUNO) are currently working in partnership. Their project aims to strengthen ZUNO in its role as the national nursing association in Zambia, and to enable and empower nurses to be leaders within their sphere of influence. The partnership has a particular focus on safer surgery and developing nursing leadership skills.

Jennifer Munsaka is Director of Programs and Professional Affairs at ZUNO and Ilona Johnston is Assistant International Adviser (Global Health) at the RCN.

Defining roles and responsibilities

For this project, an important part of the early process was a needs assessment. Steering committees in the UK and in Zambia guided work to identify what the partnership could achieve within the parameters of the strategic plans of both organisations and the Ministry of Health for Zambia. Through that process, the people working on the project at the RCN and ZUNO got to know one another, and also met and learned from important stakeholders in Zambia, such as the permanent secretary at the Ministry of Health, the nursing regulator, and the nursing colleges.

The partners mapped the strengths and weaknesses identified in both organisations as a result of the needs assessment. A good understanding of what each partner could bring to the project emerged.

The RCN wanted to expand its international work and developing ZUNO as a national nursing organisation was its core objective. ZUNO wanted to deliver strong outcomes as a result of its increased capacity and identified safer surgery as a key area to work on. The process of defining the required roles and responsibilities for the project and deciding which partner would be best placed to take them on happened quite naturally as a result of this early assessment work.

The RCN takes responsibility for monitoring and reporting, as well as garnering support for the project in the UK. It also provides expertise in the areas of nursing leadership and has considerable experience as a national nursing association. ZUNO knows how the systems in Zambia work, and knows who to build relationships with, so for the day-to-day work and liaison with stakeholders in Zambia, ZUNO takes a much more active role. All of these aspects are vital to the success of the partnership.

Jennifer explains, “This is a partnership built on similarities. Through the needs assessment, we decided on priorities and plans and through our steering committees on both sides, we defined roles and responsibilities.”

Both organisations employ one key project lead, which helps the flow of information between the two partners. They manage day-to-day interactions, monitor activity, and act as a link to the members of their respective organisations.

Building an equitable partnership

Creating an equitable partnership is not simply a case of listing tasks and dividing them up equally. Ilona says that although they don’t formally monitor the time and effort put in by each partner, open communication is key to ensuring both partners feel the partnership is equitable. The project leads stay in close contact, through weekly emails and regular phone calls.

There can be challenges to creating an equitable partnership – and challenges in communicating it to others. Among the general public, there can be a perception that in an international partnership there is a donor country and a recipient country, so one gives money but expects the other to do all the work. This can be a barrier when engaging stakeholders in Zambia and in the UK, as their understanding of the project can be hindered by this pre-conception. The relationship between the RCN and ZUNO is equitable and strong, with shared responsibility. It has been important to make this clear when engaging and involving people outside the project.

Jennifer describes the importance of bringing stakeholders along on the journey of building the partnership by consulting with them and talking to them about the partnership. Helping people to understand the project, to feel involved and to have a sense of ownership contributes to the project’s reach among nurses and other stakeholders and ultimately contributes to its success.

Maintaining shared responsibility

Sharing responsibility brings expertise and experience to both partners. Planning together, working together, and committing to the principles of partnership – all of these things make a partnership and a project more likely to succeed. Meeting face to face, in particular, and holding joint meetings with external stakeholders, helped the planning process. Ilona says, “If one organisation takes on a senior role, without mutual respect, it will be an unsuccessful partnership, with a lot of bitterness. If you haven’t planned together, you’ll go off in different directions.”

Reflecting and reporting back to one another is a key part of the project’s structure, so that both partners can learn and capture lessons from the partnership. In addition to the six-monthly narrative report sent to THET, ZUNO writes a monthly report. This aims to share relevant learning, challenges and successes, in addition to showing progress and highlighting areas of support required from RCN. The project leads have regular phone calls and weekly email updates. They have gradually built a relationship which means it is easy to pick up the phone to one another.

In addition to good communication, flexibility and mutual respect are important in maintaining shared responsibility and equitable division of work. Each partner respects the other’s expertise and learning flows in both directions. On an individual level, the two project leads respect each other’s work and skills, particularly when making requests for support or information. Both Jennifer and Ilona describe the importance of learning from each other.

Ilona concludes, “The things that ZUNO are doing, there’s no way that the RCN could do – we don’t have the skills and experience of working in Zambia. We rely on each other.”