International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume and Efficiency to strengthen delivery of the service and push the target. The objective of this paper is to use a systems model to establish how the functioning of the partnership on Safe Male Circumcision in Botswana contributed to the outcome. Data were collected using observations, focus group discussions and interviews. Thirty participants representing all three partners were observed in a 3-day meeting; followed by three rounds of in-depth interviews with five selected leading officers over 2 years and three focus group discussions. Financial resources, “ownership” and the target influence the success or failure of partnerships. A combination of inputs by partners brought progress towards achieving set program goals. Although there were tensions between partners, they were working together in strategising to address some challenges of the partnership and implementation. Pressure to meet the expectations of the international donors caused tension and challenges between the in-country partners to the extent of Development Partners retreating and not pursuing the mission further. Target achievement, the link between financial contribution and ownership expectations caused antagonistic outcome. The paper contributes enlightenment that the functioning of the visible in-country partnership is significantly influenced by the less visible global context such as the target setters and donors.

Partnerships in global health and development governance have been firmly established as a tool to achieve effective outcomes. Botswana implements Safe Male Circumcision (SMC) for HIV prevention through a North-South partnership comprising the local Ministry of Health, US Centers for Disease Control and Prevention (funded by PEPFAR) and Africa Comprehensive HIV/AIDS Partnership (funded by the Bill and Melinda Gates Foundation). The SMC partnership experienced significant antagony and the aim of this paper is to illuminate the actions and processes in the SMC program that contributed to that antagony. Methods used to gather data include observation of the partners’ planning and strategic meeting in 2012, in-depth interviews with lead officers at national level, focus group discussions with district officers and implementers, younger male officers and old community members as recipients of the service. The findings reveal that the partnership experienced antagony during operational processes and as the ultimate outcome. Target setting, financial power of the North, superficial ownership given to the South, ignoring local traditional realities results in antagony. Three roots of antagony have been identified: 1. therapeutic domination–medical expertise given with arrogance; 2.iatrogenic violence–good intentions that cause unintended harm; 3. the Trojan horse–Reckless acceptance of the gift as well as deceptive power positioned under the pretext of benevolence. The three roots of antagony; therapeutic domination, iatrogenic violence and the Trojan horse, constitute attitudes, hidden intentions and unintended consequences that influence program implementation and cause harm at different levels. Examples of therapeutic domination and the Trojan horse have highlighted the need for vigilance at the stage of establishing a partnership, to prevent more powerful partners from developing and applying hidden agendas and to strengthen accountability from the local partner. Iatrogenic violence has highlighted the need for partnership interventions to prevent good partner intentions accidentally producing bad outcomes.

Background: In this study, objects are used as a representation of relational wellbeing to help young refugees living in Norway, Scotland, and Finland to talk about important persons who make them feel well. At the time of this research, there is no known study that uses objects to facilitate narratives of how young refugees and members of their social networks generate relational wellbeing. Methods: Using a qualitative approach, young refugees participated in individual interviews about the objects they brought to art workshops to understand their experiences, feelings, and acts of wellbeing. Results: Treating each object as unique to the owner was powerful in revealing how relational wellbeing is experienced and expressed. There were overlaps in experiences and expressions of wellbeing, hence our themes of discussion: overlaps between old and new social ties; between time and space; and between the three constructs of relational wellbeing. Old ties were not forgotten; instead, they evolved to a different form, supporting young refugees from a distance, while new ties contributed to what is needed in their present and at their current age. Experiences of relational wellbeing transcended time and space between their disrupted places of origin, their experiences on the journey, and settling in their new countries. The constructs of relational wellbeing—feeling good, being connected, and having enough—were inseparable in the participants’ experiences. Conclusions: We conclude that these overlaps have implications for a relational wellbeing approach in theory and practice. The results leave a challenge for both researchers and practitioners to develop complex research and intervention methods that can capture these tapestries of young refugees’ experiences of relational wellbeing.

This study explores the resilience and resemblance among children of parents with alcohol-related problems in Botswana. Alcohol misuse affects both users and their families, particularly children. Although children raised in an alcoholic environment often face long-term adversities, some become resilient adults while others present behaviours resembling those of their parents. This study used socio-ecological resilience theory to explore the perceptions and experiences of adult children of parents and carers with alcohol-related problems, as well as the pathways they use to navigate risks. We collected data from seven adult children in a village in Botswana using in-depth, unstructured interviews. The study revealed two global themes: familial practices and protective factors. The vulnerability, resemblance, and resilience experienced by adult children of parents with alcohol-related problems are discussed. This study helps us to understand the adult children of parents and carers with alcohol-related problems in a rural cultural context. Their lived experiences demonstrate that resilience and resemblance coexist and are not mutually exclusive.