INTRODUCTION:
Colonialism’s legacy manifests in global health partnerships as unequal division of labor and resources, including apportioning intellectual versus operational labor, or as unbalanced decision making around authorship or budgets, among other commonly cited challenges.1-4 Despite clear recognition of the need for more transparency and inclusion in global health partnerships, few practical examples exist in the global health literature of how to operationalize equitable partnership principles and frameworks.

METHODS:
We share our imperfect approach to striving for equity in a recent partnership that spanned Kenya, Malawi, Nigeria, Uganda, and the United States for the Innovations in Choice and Autonomy (ICAN) study. We describe our approach to building and sustaining our six-year, multi-disciplinary collaboration and reflect on lessons learned.

RESULTS:
We learned five major lessons during the ICAN partnership. First, our project kickoff meeting built collective ownership and helped establish mutual trust. Second, the deep contextual and methodological expertise of each partner institution contributed to robust study implementation, but we failed to foster strong multi-team communications to effectively share mutual benefits across teams. Third, we improved our approach to co-developing scopes of work & budgets as the project progressed, which helped balance decision-making power and clarify expectations. Fourth, creating and implementing an authorship secretariat and guidelines for equitable publishing fostered inclusivity, though the process was imperfect. Lasty, encouragement from our funder to invest in capacity building for less experienced staff/investigators enabled us to commit time and resources to intensive trainings and a mentorship program, though the mentorship program had insufficient accountability to promote sufficient engagement by senior team members.

CONCLUSIONS:
ICAN’s size (five countries, six years) and funder encouragement to strive for equity provided a unique opportunity to invest time and resources into operationalizing equitable partnership principles from global health literature.1,5-8 We showcase these successes and challenges to inform future partnerships.