Intersectoral Collaboration to Promote Child Development: The Contributions of the Actor-Network Theory

Abstract

An integrated intersectoral care model promises to meet complex needs to promote early child development and address health determinants and inequities. Nevertheless, there is a lack of understanding of actors’ interactions in producing intersectoral collaboration networks. The present study aimed to analyze the intersectoral collaboration in the social protection network involved in promoting early child growth and development in Brazilian municipalities. Underpinned by the tenets of actor-network theory, a case study was conducted with data produced from an educational intervention, entitled “Projeto Nascente.” Through document analysis (ecomaps), participant observation (in Projeto Nascente seminars), and interviews (with municipal management representatives), our study explored and captured links among actors; controversies and resolution mechanisms; the presence of mediators and intermediaries; and an alignment of actors, resources, and support. The qualitative analysis of these materials identified three main themes: (1) agency fragility for intersectoral collaboration, (2) attempt to form networks, and (3) incorporation of fields of possibilities. Our findings revealed that intersectoral collaboration for promoting child growth and development is virtually non-existent or fragile, and local potential is missed or underused. These results emphasized the scarcity of action by mediators and intermediaries to promote enrollment processes to intersectoral collaboration. Likewise, existing controversies were not used as a mechanism for triggering changes. Our research supports the need to mobilize actors, resources, management, and communication tools that promote processes of interessement and enrollment in favor of intersectoral collaboration policies and practices for child development.

Cross-Sector Collaboration to Improve Access to Community Services for People Living With Diabetes: Contributions From Actor-Network Theory

“…Ultimately, controversies are at the foundation of the network, and our understanding show that their presence enable the network to build, make and unmake itself. 22 , 25 Our article thus advances the literature on this subject, going further than Chiari et al 54 who argued about the importance of integrating actors and resources to advance action. Indeed, our results underline the importance of project coordination as a mediator and facilitator to identify controversies and accompany actors in the progress of action.…”

“…Stakeholders have been able to learn collaboratively around issues for people living with diabetes. As Hendriks et al, 55 van Eyk et al, 56 and Chiari et al 54 all point out, these actions facilitate the integration of stakeholders in the implementation of cross-sector collaboration. All stakeholders take a stand, share different opinions, improve their knowledge, and reframe the problem in such a way that they have an influence on different sectors.…”