Understanding the challenges of intersectoral action in public health through a case study of early childhood programmes and services

Bilodeau, Angèle; Laurin, Isabelle; Giguère, Nadia; Potvin, Louise

doi:10.1080/09581596.2017.1343934

Cited by 20 publications

(19 citation statements)

References 35 publications

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“…Colombia has established ISA as a core tool for development and promotes monitoring and evaluation of ISA to achieve the Sustainable Development Goals (SDG) (23). There is an emphasis worldwide on documenting the challenges in 'implementation' of ISA and their 'effectiveness' of outcomes (4,5,24).…”

Section: Discussionmentioning

confidence: 99%

“…However, ISA for childhood programs and services have shown there is a need to ensure convergence between sectors and within a variety of programs to attain the common objectives (24). Thus, prevention and management of stunting demands e cient coordination of ISA to reduce all forms of malnutrition, and to achieve a 40% decline in the number of stunted children under 5 years in Colombia by 2025 (25).…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

Botero-Tovar

Zuluaga

Varela

2020

Preprint

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Background Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-for-age) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA. Methods The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focal groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA. Results This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health results from collaboration facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers. Conclusions Intersectoral actions have been recently discussed in the literature due to challenges on implementation, idealization, inconsistent demands, and doubts about economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

Botero-Tovar

Zuluaga

Varela

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Colombia has established ISA as a core tool for development and promotes monitoring and evaluation of ISA to achieve the Sustainable Development Goals (SDG) [22]. There is an emphasis worldwide on documenting the challenges in 'implementation' of ISA and their 'effectiveness' of outcomes [4,5,23]. However, ISA for childhood programs and services have shown there is a need to ensure convergence between sectors and within a variety of programs to attain the common objectives [23].…”

Section: Discussionmentioning

confidence: 99%

“…There is an emphasis worldwide on documenting the challenges in 'implementation' of ISA and their 'effectiveness' of outcomes [4,5,23]. However, ISA for childhood programs and services have shown there is a need to ensure convergence between sectors and within a variety of programs to attain the common objectives [23]. Thus, prevention and management of stunting demands efficient coordination of ISA to reduce all forms of malnutrition, and to achieve a 40% decline in the number of stunted children under 5 years in Colombia by 2025 [24].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study

2020

View full text Add to dashboard Cite

Background: Intersectoral actions (ISA) are a recognized relationship between the health sector and other sectors to improve health outcomes. Although a frequent topic in public health studies, evidence for systematic evaluation of implementation of ISA is scarce. An intersectoral health intervention for infants under one-year-old with, and at risk of, stunting (low height-forage) was developed by a public-private partnership in Bogotá, Colombia, during 2018 and 2019. Here we report a case study conducted in parallel to the intervention designed to assess factors that influenced implementation of the ISA. Methods: The case study was developed using a concurrent mixed-methods design, with the qualitative component giving context to the quantitative results. The qualitative component was obtained from four workshops, three focus groups, and 17 semi-structured interviews with actors involved in the intersectoral intervention. The quantitative component was obtained with two questionnaires that evaluated perceptions on improvement and partnership functioning of the ISA. Results: This study collected information from 122 participants. The intervention demanded intersectoral collaboration. Political will, motivated human resources, and recognition that health improvement results from collaboration, were factors that facilitated intersectoral actions. Intersectoral actions were limited by difficulties in engaging the health sector, communication challenges related to local health service decentralization, and administrative barriers. Conclusions: Intersectoral actions have recently been discussed in the literature due to challenges in implementation and doubts regarding economic outcomes. The implementation of intersectoral public health interventions can be jeopardized by a lack of coordination and management skills.

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“…Given the complexities inherent in health equity challenges, there is little debate that intersectoral approaches are needed, despite their challenges (Bilodeau et al 2018 ). But how can we know whether our intersectoral processes are moving us towards a more justice-based public health?…”

Section: Discussionmentioning

confidence: 99%

Towards equity-focused intersectoral practice (EquIP) in children’s environmental health and housing: the transformational story of RentSafe

Phipps

Masuda

2018

Can J Public Health

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SettingThis paper chronicles the transformational process through which a national intersectoral collaboration, the Canadian Partnership for Children’s Health and Environment (CPCHE), came to embrace a more upstream, equity-based focus in its mandate to advance children’s environmental health.InterventionAfter 15 years of working within a conventional, evidence-informed approach to health promotion and policy advocacy, in 2010–2013, CPCHE had the opportunity to collaborate on the development of equity-focused knowledge translation (EqKT). EqKT is a relational approach to knowledge practices that challenges intersectoral actors to work to uncover biases and limitations within their own institutional paradigms and professional practices that constrain their capacity to address population health inequities.OutcomeThe ensuing transformation towards equity-focused intersectoral practice led CPCHE to create an intersectoral initiative called RentSafe. Conceptually and operationally, RentSafe provides an intersectoral space within which the grounded expertise of people with experience of unhealthy and undignified housing provides a roadmap for public health and other practitioners to critically explore professional and institutional blind spots and barriers. With RentSafe as its watershed moment, CPCHE is shifting from a top-down “for whom” orientation to an authentically engaged “with whom” approach that seeks to work integrally with community partners to expose and challenge systemic roots of health inequity.ImplicationsThe transformational story of CPCHE underscores the competencies needed for public health professionals to acknowledge the sources of our own biases and limitations as a necessary first step in equity-focused intersectoral practice (EquIP). It also affirms the value of working in partnership with those who experience the environmental health inequities that such efforts seek to address.

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Understanding the challenges of intersectoral action in public health through a case study of early childhood programmes and services

Cited by 20 publications

References 35 publications

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study.

Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia – a mixed methods case study

Towards equity-focused intersectoral practice (EquIP) in children’s environmental health and housing: the transformational story of RentSafe

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