Multi-sector Partnerships Research Articles

Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service

BackgroundPublic health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat.MethodsThis qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration.ResultsRelational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners’ behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed.ConclusionsWhen managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.

Evaluating Local Government Policy Innovations: A Case Study of Surabaya's Efforts in Combating Stunting and Enhancing Public Health Services Quality

This research aims to evaluate regional innovations in implementing Surabaya City government policies to reduce stunting rates and improve the quality of public health services. A qualitative descriptive method was used with a case study approach involving field observations and structured interviews. The research results show the success of Posyandu Prima in reducing stunting rates significantly in the last two years. The Surabaya City Government has proven effective in managing this program's human resources and budget. The active involvement of Great Surabaya Cadres (KSH) and non-governmental organizations also contributed greatly to the program's success. Cross-sector collaboration plays an important role in supporting implementation. Institutional characteristics, such as commitment to public health and ability to collaborate, also matter. Theoretically, this research shows that synergy between the parties involved and government commitment can achieve significant results in handling the stunting problem. In conclusion, the Prima Posyandu Program has proven successful in reducing stunting rates and improving the quality of public health services in Surabaya. Additionally, the collaborative efforts between community stakeholders, healthcare providers, and governmental bodies underscore the crucial role of multi-sectoral partnerships in addressing complex public health issues like stunting. This synergy fosters comprehensive approaches that combine local knowledge, resources, and policy support to effectively combat stunting and enhance the well-being of communities. Thus, the Prima Posyandu Program's success is a compelling example of how concerted action and sustained commitment can yield tangible improvements in population health outcomes.

Responding to domestic and family violence in resource-constrained contexts: a case study on rural policing innovations in Melanesia

PurposeDiscussions about progressive gender reform across Melanesia highlight the need for more gender-inclusive policies and improved conditions for women and girls throughout all sectors. However, for many of these countries, attempts to address the problems are marred by insufficient resources and low prioritization of the issue and traditional, cultural and religious perspectives about gender and gendered roles. This article discusses how police responses are coordinated to address domestic and family violence (DFV) and provides a critical reflection on both internal responses and the complexities of multi-partner operations beyond urban spaces.Design/methodology/approachThis article draws on the findings from a stakeholder engagement focus group with 20 participants from four Melanesian countries – Fiji, Papua New Guinea, the Solomon Islands and Vanuatu – to provide insight into policing innovations in rural contexts.FindingsThere is a need for improved multisector partnerships, increased police presence and greater reliance on indigenous strategies to improve responses to DFV in resource-constrained contexts.Originality/valueThe article provides insight into an under-researched area and makes recommendations for improving responses to DFV in rural areas in small-island developing states.

Exploring Circularity Toolkits for SMEs Learning Ecosystems.

This research explores the role of Circular Design and education in facilitating the transition to a Circular Economy for SMEs and start-ups. Despite accessible resources in Circular Design, the extent of their adoption by businesses—and e specially SMEs, who face resource limitations and lack scientific access—remains uncertain. Circular Design operates at a systemic level, requiring consideration of economic, social, and environmental aspects in innovation processes. This study analyzes existing tools and their alignment with SME needs, identifying critical areas for Circular Design adoption. The analysis reveals an emerging and diverse set of resources supporting circular transitions. Learning Ecosystems for the Circular Economy are characterized by multi-sectoral partnerships, flexible learning approaches, and digital advancements. Three key directions emerge for developing Learning Ecosystems: assessing companies’ circular maturity, integrating circular design into company culture, and fostering collaboration with innovation ecosystems. In conclusion, this research lays the groundwork for implementing targeted Learning Ecosystems to advance circularity within SMEs, emphasizing the importance of collaboration and innovative approaches in circular innovation.

Layered vulnerability and researchers’ responsibilities: learning from research involving Kenyan adolescents living with perinatal HIV infection

BackgroundCarefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/AIDS, without increasing burdens. Such studies, however, must navigate a ‘vulnerability paradox’, since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/AIDS (ALH) in Kenya, we develop an account of researchers’ responsibilities towards young people, incorporating concepts of vulnerability, resilience, and agency as ‘interacting layers’.MethodsUsing a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders’ perspectives on vulnerability and resilience of young people living with HIV/AIDS, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna’s layered account of vulnerability.ResultsALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.ConclusionsThe most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers’ responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities.

Equity in Cancer and Chronic Disease Prevention through a Multi-Pronged Network Intervention: Works-in-Progress.

The increasing rates of cancer incidence are disproportionately borne by populations that are ineligible for screening and historically marginalized populations. To address this need, our community-centered model seeks to catalyze the widespread diffusion of evidence-based information and resources (e.g., community-based organizations, federally qualified health centers) to reduce the risks of cancer, chronic disease, and other conditions. In this study, we tested whether improving personal health literacy (i.e., confidence in seeking information) and enabling successful information transfer (i.e., intention to share the specific information learned through the program) among community residents could contribute to greater diffusion intention (i.e., number of network members with whom residents plan to share information and resources). The current study used post-intervention surveys, which were administered to Chicago residents who were 18 years or older and had participated in the program. Among the 1499 diverse Chicago residents, improved personal health literacy was associated with greater diffusion intention (ORs = 2.00-2.68, 95% CI [1.27-4.39], p ≤ 0.003). Successful information transfer was associated with greater diffusion, especially for cancer and other chronic disease risk reductions (ORs = 3.43-3.73, 95% CI [1.95-6.68], p < 0.001). The findings highlight the potential gains for health equity through sustainable, scalable, multi-sectoral partnerships.

Lessons from a research partnership in southwest England to understand community palliative care needs in rural, coastal and low-income communities.

The South West Peninsula (Cornwall, Devon, Somerset) has the highest proportion of over 65s (24.2%) and is the only English rural population with greater economic deprivation than in urban areas. Coastal populations have the worst health outcomes in England. Despite innovation among communities to support those with health and care needs in later life, recruitment to palliative care research in the region is low and there has been no evaluation of public health palliative care interventions. A new South West Peninsula Palliative Care Research Partnership was funded for 15 months, bringing together four universities, the voluntary and community sector (including hospices) and local National Institute for Health and Care Research networks. The aim was to establish a sustainable multisectoral partnership that would identify community-based support needs for underserved rural and coastal populations by: • conducting a literature scoping review on interventions to enable community members to support the dying; • delivering a research capacity-building programme; • co-creating public and patient involvement capacity; • determining the resources and needs for communities to support dying well; • integrating findings to develop a framework of community-based support and identify future research questions; • establishing a sustainable research network infrastructure for the long-term design and delivery of palliative care research. We convened partners to identify research needs and co-designed activities to meet our objectives. These included a scoping review; a capacity-building programme of training, seminars and a journal club; forming a patient and public involvement group; a multistranded community engagement programme using different creative approaches; four focus groups with members of the public and one with community workers; and producing three 'storytelling' audio recordings. Findings were presented to the partnership at a regional workshop. The scoping review showed that community-engaged palliative care interventions can improve outcomes for individuals but provided little evidence about which approaches work for different communities. Five online seminars and a quarterly journal club to develop research capacity were regularly attended by 15 to 25 participants from across the partnership. While evaluating our engagement methods was beyond the partnership's scope, levels of participation suggested that creative methods of engagement show potential to help researchers and practitioners better understand the needs and priorities of underserved populations. Data showed that rural, coastal and low-income communities face challenges in accessing end-of-life care and support due to issues such as transport to and distance from services, erosion of neighbourhood networks, isolation from family and friends, 'patchiness' of palliative care services and a lack of care providers. Community organisations are well-placed to co-produce and facilitate methodologies for involving communities in palliative care research. Although activities took place in diverse areas, it was not possible within the available resources to cover the entire large geographical region, particularly the most isolated rural areas. Partnerships bringing together voluntary and community sector organisations, palliative care providers, health and social care providers, individuals with experience and academics have potential to design future research and public health interventions that better understand local context, involving and supporting communities to address their needs at end of life. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135312.

Lessons for TB from the COVID-19 response: qualitative data from Brazil, India and South Africa

BACKGROUND: Brazil, India and South Africa are among the top 30 high TB burden countries globally and experienced high rates of SARS-CoV-2 infection and mortality. The COVID-19 response in each country was unprecedented and complex, informed by distinct political, economic, social and health systems contexts. While COVID-19 responses have set back TB control efforts, they also hold lessons to inform future TB programming and services.METHODS: This was a qualitative exploratory study involving interviews with TB stakeholders (n = 76) in Brazil, India and South Africa 2 years into the COVID-19 pandemic. Interview transcripts were analysed using an inductive coding strategy.RESULTS: Political will – whether national or subnational – enabled implementation of widespread prevention measures during the COVID-19 response in each country and stimulated mobile and telehealth service delivery innovations. Participants in all three countries emphasised the importance of mobilising and engaging communities in public health responses and noted limited health education and information as barriers to implementing TB control efforts at the community level.CONCLUSIONS: Building political will and social mobilisation must become more central to TB programming. COVID-19 has shown this is possible. A similar level of investment and collaborative effort, if not greater, as that seen during the COVID-19 pandemic is needed for TB through multi-sectoral partnerships.

Abstract A028: Development of multisectoral partnerships in the quest to target effective HPV vaccination strategies in Puerto Rico

Abstract Introduction: Human Papilloma Virus (HPV) is the most common sexually transmitted infection worldwide. HPV accounts for 79% of related cancers in the United States (US). Puerto Rico has the highest incidence (12.1) of cervical cancer among the US and territories, for which HPV infections cause 91%. The Puerto Rico Community Cancer Control Outreach Program (PRCCCOP) and our long-term partner, UTHealth, have developed HPV vaccination educational materials tailored to be used by clinical and public health workers or as a standalone. Since 2019, PRCCCOP has been promoting HPV vaccine to prevent related cancers. Objective: To develop a network of multisectoral collaborators to facilitate the dissemination of Human Papillomavirus (HPV) prevention educational campaigns and HPV vaccination uptake in Puerto Rico (PR). Methods: From 2019 to March 2023, the Puerto Rico Community Cancer Control Outreach Program (PRCCCOP) has established a network of islandwide collaborators, which has developed alliances for the participation of several community activities in which our educational materials have been distributed. Collaborators were offered workshops on HPV, HPV- prevention, and the HPV vaccine, received educational materials, and continued assistance in their community activities. The collaborators were categorized by the type of organization or services they offered. Results: A descriptive assessment of collaborators was documented and categorized into 5 groups. A total of 44 new collaborations have been established, (1) academic (11.3%), (2) health services/FQHCs (36.5%), (3) community-based (7%), (4) private sector (25%), and (5) government (20.4%). Our team has participated in 129 community events in 39 (50%) municipalities. Moreover, our HPV educational campaigns have been distributed in 54 (69.2%) municipalities, including Vieques and Culebra Island municipalities. Conclusion: The PRCCCOP has effectively expanded its reach by developing partnerships with diverse organizations across PR. Most activities are from FQHCs, allowing us to reach the most vulnerable populations effectively. These partnerships helped increase the visibility of the program and the availability of our workshops and educational materials to different organizations in Puerto Rico. By establishing these collaborations, we aim to increase knowledge, raise awareness about HPV prevention, and increase vaccination uptake to eradicate HPV-caused cancers. We will keep growing our network in the next year to reach all municipalities in Puerto Rico. Citation Format: Yara Sánchez-Cabrera, Ileska M. Valencia-Torres, Maria E. Fernandez, Vivian Colón-López. Development of multisectoral partnerships in the quest to target effective HPV vaccination strategies in Puerto Rico [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A028.

Abstract A036: The role of multisectoral partnerships in the dissemination of HPV vaccination campaigns in Puerto Rico

Abstract INTRODUCTION: The Human Papillomavirus (HPV) is the most common sexually transmitted infection worldwide. Despite the availability of an effective vaccine, HPV vaccination uptake is suboptimal in Puerto Rico (PR). Knowledge and understanding of the benefits of HPV vaccination can influence the intention to vaccinate. The Puerto Rico Community Cancer Control Outreach Program (PRCCCOP) and our network of multisectoral partners disseminated an HPV vaccination educational campaign tailored to promote HPV vaccination among kids and adolescents aged 9-26. OBJECTIVE: To effectively disseminate Human Papillomavirus (HPV) prevention educational campaigns through a network of multisectoral collaborators to increase HPV vaccination uptake in PR. METHODS: The PRCCCOP trained collaborators on basic HPV, HPV-caused cancers, and HPV vaccine knowledge and the use of educational materials. Collaborators distributed educational materials to their clientele who visited in person, participated in sponsored events, and accessed their virtual platforms or via email. In addition to printable educational materials, PRCCOP public service announcement videos about HPV vaccination were transmitted at our participating Federally Qualified Health Centers (FQHC). The PRCCOP provided all collaborators with continued training, assistance, and educational materials. RESULTS: Our program impacted 65 municipalities (83.3% of the island). Electronic and printed versions of our educational materials were disseminated in 40 clinics and vaccination centers across the island, including all 22 FQHCs in Puerto Rico (PR). Over 2,000 people were reached via in-person events and health fairs. Additionally, 18 workshops were imparted in clinical and academic settings. CONCLUSION: Community outreach can be an expensive and labor-intensive task. By establishing partnerships and sharing resources, the PRCCCOP has lowered costs while widely disseminating its educational campaigns and expanding its network outside the traditional academic/health services arena. Collaborating with multisectoral organizations allowed us to increase our presence throughout the island, diversify the types of dissemination mediums, and reach vulnerable and hard-to-reach populations. Citation Format: Ileska M. Valencia-Torres, Yara Sánchez-Cabrera, María E. Fernández, Vivian Colón-López. The role of multisectoral partnerships in the dissemination of HPV vaccination campaigns in Puerto Rico [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A036.

Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation.

To learn feasible ways to increase multisector community partnership with tribal organizations, meaning tribal health authorities or American Indian and Alaska Native (AI/AN)-serving organizations, by examining characteristics of local public health systems with exceptional tribal organization participation. In total, 728 local public health departments were surveyed in 2018 to generate a nationally representative sample of local public health systems in the United States. A positive deviance approach using logistic regression helped identify local public health systems that had tribal organization participation despite characteristics that make such participation statistically unlikely. Local public health systems with exceptional tribal organization participation were compared with systems with conventional participation, examining measures known to impact the formation of public health partnerships. This study used an exploratory logistic regression approach to identify unique characteristics of local public health systems with exceptional tribal organization participation. Of 728 health systems surveyed, 21 were identified as having exceptional tribal organization participation. Across varying thresholds to identify exceptional participation, having a higher network density and prioritizing equity in public health activities were found to consistently distinguish exceptional tribal organization participation in both nonrural and rural areas. Public health partnerships with tribal organizations are possible even in circumstances that make them unlikely. Efforts to build denser networks of collaborating organizations and prioritize equity may help public health systems achieve success with tribal organization partnerships.

Enhancing Impact: A Call to Action for Equitable Implementation Science

Despite investments in evidence-based interventions and Implementation Science, most evidence-based interventions are not widely or routinely adopted, delivered, or sustained in many real-world community and healthcare settings. This gap is even greater in settings and populations experiencing numerous social and structural barriers to health, with important implications for persistent patterns in health inequities. In this Viewpoint, as part of a Special Issue on Advancing the Adaptability of Chronic Disease Prevention and Management through Implementation Science, we outline seven calls to action for the field of Implementation Science, with the goal of encouraging researchers, practitioners, and funders to be more intentional and accountable in applying Implementation Science to have greater impact on promoting health equity. Calls to action include (1) enhance public health, community, and multi-sectoral partnerships to promote health equity and equitable implementation; (2) revisit and build the evidence base needed to promote health equity and impact at multiple levels; (3) prioritize focus on policy development, dissemination, and implementation; (4) be agile and responsive in application of Implementation Science frameworks, processes, and methods; (5) identify and redefine meaningful metrics for equity and impact; (6) disseminate scientific evidence and research to a diverse range of partners and potential beneficiaries; and (7) extend focus on de-implementation, mis-implementation, and sustainability which are central to enhancing health equity. Additionally, we outline why a focus on prevention and public health is essential to making progress towards health equity in Implementation Science, summarize important advancements that the field has made towards making equity more foundational, and pose important research questions to enhance equitable impact of work in this area.

A longitudinal multi-site evaluation of community-based partnerships: implications for researchers, funders, and communities

BackgroundInnovative Models Promoting Access to Care Transformation (IMPACT) was a five-year (2013–2018), Canadian-Australian research program that aimed to use a community-based partnership approach to transform primary health care (PHC) organizational structures to improve access to appropriate care for vulnerable populations. Local Innovation Partnerships (LIPs) were developed to support the IMPACT research program, and to be ongoing structures that would continue to drive local improvements to PHC.MethodsA longitudinal development-focused evaluation explored the overall approach to governance, relationships and processes of the LIPs in the IMPACT program. Semi-structured interviews were conducted with purposively selected participants including researchers with implementation roles and non-researchers who were members of LIPs at four time points: early in the development of the LIPs in 2014; during intervention development in 2015/2016; at the intervention implementation phase in 2017; and nearing completion of the research program in 2018. A hybrid deductive-inductive thematic analysis approach was used. A Guide developed to support the program was used as the framework for designing questions and analysing data using a qualitative descriptive method initially. A visual representation was developed and refined after each round of data collection to illustrate emerging themes around governance, processes and relationship building that were demonstrated by IMPACT LIPs. After all rounds of data collection, an overarching cross-case analysis of narrative summaries of each site was conducted.ResultsCommon components of the LIPs identified across all rounds of data collection related to governance structures, stakeholder relationships, collaborative processes, and contextual barriers. LIPs were seen primarily as a structure to support implementation of a research project rather than an ongoing multisectoral community-based partnership. LIPs had relationships with many and varied stakeholders although not necessarily in ways that reflected the intended purpose. Collaboration was valued, but multiple barriers impeded the ability of LIPs to enact real collaboration in daily operations over time. We learned that experience, history, and time matter, especially with respect to community-oriented collaborative skills, structures, and relationships.ConclusionsThis longitudinal multiple case study offers lessons and implications for researchers, funders, and potential stakeholders in community-based participatory research.

Bridging communities and schools in Urban development: community and citizen science

This paper presents the results of two community and citizen science research projects – Cities at Play and Community Drive – in which young students (aged 11–15) from vulnerable residential areas in Copenhagen, Denmark, collaborated with architects and urban developers to engage in urban development initiatives in their neighborhoods. An educational design was developed over the two research projects in which students underwent phases of discovery, interpretation, ideation, and experimentation. Data were collected from surveys, observations, and interviews to elucidate the ways that three bridges central to community and citizen science projects can function. These include professional (bridges student learning in school and professional communities outside school), citizen (bridges student learning in school and local communities), and student (bridges student learning in school and new student communities) bridges. This research makes both theoretical and practical advancements. Theoretically, it advances our thinking about the diverse roles that participants in multi-sector partnerships can have, as well as how CCS widens the view of cultural asset-based learning by viewing students as experts of their local communities. Practically, we offer four guidelines that were gleaned from the results that can be instructive for the design of future educational community and citizen science projects.

Design and Implementation of the Diabetes Impact Project: A Multisector Partnership to Reduce Diabetes Burden in Indianapolis Communities.

Community-level health disparities have not arisen suddenly but are the result of long-term systemic inequities. This article describes the design and implementation of a community-engaged multisector partnership to address health disparities by reducing the diabetes burden in 3 Indianapolis communities through the implementation of evidence-based strategies across the prevention continuum. The project has 5 foundational design principles: engage partners from multiple sectors to address community health, focus on geographic communities most affected by the health disparity, practice authentic community engagement, commit for the long term, and utilize a holistic approach spanning the prevention continuum. The design principles are incorporated into the following project components in each community: (1) health system community health workers (hCHWs), (2) neighborhood CHWs (nCHWs), (3) community health promotion initiatives, and (4) resident steering committees, as well as a backbone organization responsible for overall coordination, project communication, evaluation, and partnership coordination. This complex multilevel intervention is being evaluated using data sources and methodologies suited to each project component and its purpose overall. Each component is being evaluated independently and included holistically to measure the impact of the project on the health and culture of health in the communities. Key Performance Indicators were established upon project initiation as our common metrics for the partnership. Because complex interventions aiming at population-level change take time, we evaluate Diabetes Impact Project-Indianapolis Neighborhoods (DIP-IN), assuming its impact will take many years to achieve. Health disparities such as the diabetes prevalence in project communities have not arisen suddenly but are the result of long-term systemic inequities. This complex issue requires a complex holistic solution with long-term commitment, trusted partnerships, and investment from diverse sectors as seen in this project. Implications for policy and practice include the need to identify stable funding mechanisms to support these types of holistic approaches.

Examining the roles of partnerships in enhancing the health systems response to COVID-19 in Nigeria

BackgroundThe COVID-19 pandemic overwhelmed the health systems and socio-economic foundations of many countries, Nigeria inclusive. The study was carried out to assess, understand, document and report the activities/measures that are considered nationally and sub-nationally significant, both in terms of COVID-19 responses and in terms of strengthening the health system for the future, in response to future threats since this will not be the last pandemic This paper examines how partnerships contributed to the health system and other sectors’ responses to COVID − 19 infection in Nigeria.MethodsThis was a qualitative study. Data was collected using a scoping literature review and key informant interviews with 36 key stakeholders in the COVID-19 response in Nigeria, in Abuja (national level) Lagos and Enugu states (sub-national level). Interviews were recorded and transcribed verbatim. The qualitative data was analysed using thematic analysis.ResultsIt was found that many partnerships were formed when responding to the COVID-19 pandemic in Nigeria. The health system leaned towards a horizontal dimension of partnership with non-health governmental sectors, non-governmental sectors, and other countries. All the components of the health system building blocks had a measure of partnership contributing to its accomplishments The partnerships came in varied forms, ranging from advocacy, funding, provision of palliatives to the citizens because of lockdowns, technical assistance, support to research, development of guidelines and health educational materials.ConclusionThe health sector’s collaboration with other sectors strengthened all the building blocks of the health system and was invaluable in enhancing the response to COVID-19, which needed a whole of government and a multi-sectoral approach. Formal frameworks for quickly initiating whole-of-government and multi-sectoral partnerships should be developed, with clear roles and responsibilities. This should be deployed for health system resilience and for response to shocks such as the COVID-19 pandemic.

Partnerships between anchor-med institutions and community organizations to address social determinants of health in urban populations: Do institutional pressures play a role?

ABSTRACT Social determinants of health (SDOH), the external environmental factors that determine health and well-being, often play a key role in health disparities and health inequities, and are outside the control of individuals. In urban and rural settings, hospitals have a critical role to play in addressing these SDOH; however, they cannot do so as a lone entity. Hospitals may function as anchor institution and form multi-sector partnerships with other community organizations (educational institutions, organizations addressing food insecurity, public health agencies, other healthcare provider organizations, etc.) to address these complex SDOH. However, as anchor institutions, urban hospitals may also face strong institutional pressures from their stakeholders and society at large. Based on institutional theory and resource dependency theory framework, we examine 1,191 urban hospitals in the United States reporting partnerships with community organizations to address SDOH. Our findings indicate that while addressing SDOH may be a driver, partnerships between hospitals and community organizations may also be in response to institutional pressures.

Perceived health system facilitators and barriers to integrated management of hypertension and type 2 diabetes in Kenya: a qualitative study

ObjectiveUnderstanding the facilitators and barriers to managing hypertension and type 2 diabetes (T2D) will inform the design of a contextually appropriate integrated chronic care model in Kenya. We explored the...

Joining Forces for Better Care: The Implications of Logic Multiplicity in Multisectoral Partnerships

Joining Forces for Better Care: The Implications of Logic Multiplicity in Multisectoral Partnerships

Designing for Health in Healthcare Deserts: A Medical City Master Planning Project in Nigeria.

Many countries and communities in sub-Saharan Africa suffer from inadequate access to healthcare and healthy lifestyles as reflected in their high mortality and morbidity rates. Large-scale interventions like the medical city project presented in this article are necessary to address the significant health burdens faced by populations in this region. This article shows how evidence-based approaches and multisectoral partnerships guided the development of the 327-acre Medical City master plan in Akwa Ibom, Nigeria. This is envisioned to be the first-of-its-kind medical city in this medically underserved "healthcare desert." The five-phased, seven-year (2013-2020) master planning process was guided by the overarching design framework of "sustainable one health" along with its 11 objectives and 64 performance measures. The data/evidence used to guide the planning decision-making process came from case studies, literature reviews, stakeholder interviews, and on-site investigations. The outcome of this project is a comprehensive medical city master plan that includes a self-contained, mixed-use community anchored by a hospital and a primary healthcare village. This medical city provides access to the full range of healthcare services (e.g., curative-to-preventive, traditional-to-alternative) and is supported by multimodal transportation systems and extensive green infrastructure. This project offers theoretical and practical insights on "designing for health" in a frontier market while responding to the complex local contexts that present many unique challenges and opportunities. Those insights provide useful lessons for researchers and professionals interested in promoting health and healthcare services in healthcare deserts.