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Table 9 Challenges encountered in the link

From: Analysis of an international collaboration for capacity building of human resources for eye care: case study of the college-college VISION 2020 LINK

Challenges identified by COECSA partners

Challenges identified by United Kingdom partners

Challenges in the context of the collaboration framework

-Lack of opportunity for clinical participation in the United Kingdom during visits (only observership)

-Delays in obtaining visas for travel to the United Kingdom for LINK visits

-Institutional bureaucracy delays changes such as adoption of curricula

Challenges due to multiple actors in the collaboration

-Harmonization is complex due to the multi-country nature of COECSA

-Heterogeneity of training programs impedes a uniform curriculum

-“Scramble for opportunities” means countries and institutions have not benefited equally

Resource constraints

-Inadequate time for LINK work

-Funding is unpredictable

-Delays in release of funds for scheduled activities

Inadequacy of involvement

-Ophthalmologists outside cities and teaching hospitals are not actively involved

-CPD inaccessible to those working outside the large cities

-Inadequate involvement of ECSA countries in agenda setting leading to insufficient ownership

Challenges in the context of the collaboration framework

- COECSA has not taken full ownership of LINK activities which creates gaps in running activities

-Cultural differences

-Leadership gaps in COECSA

-Reliance on a few individuals to carry out key roles both in the United Kingdom and COECSA

-CPD concept has been difficult to entrench

-Inadequate communication of decisions or changes related to LINK activities

Resource constraints

-Time constraints as United Kingdom partners have to use their personal time for LINK activities

-Uncertainty of funding

-Lack of appropriate technology in COECSA