Date of Conferral







James Goes


Healthcare providers increasingly recognize the importance of collaboration among stakeholders in cost-effective healthcare delivery. While collaborative relationships offer great advantages, little research has addressed their relevance in an international development aid context, particularly in sub-Saharan Africa. The region is a major recipient of international development support, yet health indicators on HIV/AIDS, malaria, tuberculosis, and child and maternal mortality indicate the health of the region is among the weakest worldwide. This sequential mixed method, descriptive study of a USAID-funded community health program in Ghana examined the nature of collaboration among six stakeholders and impact of this collaboration on effectiveness of program implementation. Stakeholder and resource dependence theories provided conceptual frameworks for analysis. Data were collected through surveys and interviews of officers of participating organizations (POs) and community health officers (CHOs). Surveys were analyzed using means, standard deviations, and t tests, while coding and themes determination were adopted for the interview data analysis. Results from both sources were integrated. Findings indicate both POs and CHOs perceived human relationship factors as more critical than physical resources. Collaboration, shared decision making, and frequency of communication in the relationship were perceived to substantially improve CHO skills and rural healthcare quality. Recommendations include active development of strong trust and dialogue in future relationships. These results could have important implications for positive social change by identifying the bases for collaborative success in providing impoverished rural communities with cost-effective and quality healthcare to address critical community health needs.