We share experiences of a global health partnership between 2 hospitals, the Ministry of Health, and a nongovernmental organization that focused on improving obstetric care at a district hospital in northwestern Madagascar.

Despite having differing access to material, technical, and financial resources, the partners cultivated an environment for equity through a commitment to shared values and goals, active engagement in communication and implementing activities, and fostering of mutual respect and trust among individuals and institutions.

The success of the partnership also depended on flexibility and a willingness to use technology in new ways, especially when COVID-19-related restrictions necessitated the adaptation of a simulation-based training activity on respectful emergency obstetric and neonatal health care.

A global health partnership is a collaborative effort among 2 or more institutions that agree to work together toward a common public health goal. The types of institutions involved in global health partnerships vary widely. They may include government agencies, academic and research institutions, entire health systems, individual hospitals and clinics, businesses, nongovernmental organizations (NGOs), and others.1,2 Most global health partnerships link institutions in the Global North and the Global South, and some have achieved notable success in reaching tangible and mutually agreed goals.3,4

However, significant concerns persist about asymmetrical power dynamics in global health partnerships.5 These dynamics occur particularly when a partnership involves institutions with unequal access to resources (including status).6 When institutions from the Global North are involved in global health partnerships, they typically wield significantly more power than organizations from the Global South. This is partly due to better access to funding, training, equipment, specialist expertise, and other resources. Equally important, power dynamics in global health partnerships are often predicated on and replicate sociocultural assumptions and practices with deep roots in colonialism, neocolonialism, and racism, along …