The governance of local health systems in the era of Sustainable Development Goals: Reflections on collaborative action to address complex health needs in four country contexts

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dc.contributor.authorSchneider, Helen
dc.contributor.authorZulu , Joseph Mumba
dc.contributor.authorMathias, Kaaren
dc.contributor.authorCloete , Keith
dc.contributor.authorHurtig , Anna-Karin
dc.date.accessioned2024-04-15T02:36:10Z
dc.date.available2024-04-15T02:36:10Z
dc.date.issued2019
dc.description.abstractThis analysis reflects on experiences and lessons from four country settings - Zambia, India, Sweden and South Africa - on building collaborations in local health systems in order to respond to complex health needs. These collaborations ranged in scope and formality, from coordinating action in the community health system (Zambia), to a partnership between governmental, non-governmental and academic actors (India), to joint planning and delivery across political and sectoral boundaries (Sweden and South Africa). The four cases are presented and analysed using a common framework of collaborative governance, focusing on the dynamics of the collaboration itself, with respect to principled engagement, shared motivation and joint capacity. The four cases, despite their differences, illustrate the considerable challenges and the specific dynamics involved in developing collaborative action in local health systems. These include the coconstruction of solutions (and in some instances the problem itself) through engagement, the importance of trust, both interpersonal and institutional, as a condition for collaborative arrangements, and the role of openly accessible information in building shared understanding. Ultimately, collaborative action takes time and difficulty needs to be anticipated. If discovery, joint learning and developing shared perspectives are presented as goals in themselves, this may offset internal and external expectations that collaborations deliver results in the short term.
dc.identifier.citationSchneider H, Zulu JM, Mathias K, Cloete K, Hurtig AK (2019). The governance of local health systems in the era of Sustainable Development Goals: Reflections on collaborative action to address complex health needs in four country contexts. BMJ Global Health. 4(3). e001645-.
dc.identifier.doihttp://doi.org/10.1136/bmjgh-2019-001645
dc.identifier.issn2059-7908
dc.identifier.urihttps://hdl.handle.net/10092/106716
dc.languageeng
dc.publisherBMJ
dc.rights© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
dc.rights.urihttp://hdl.handle.net/10092/17651
dc.subjectcollaboration
dc.subjectcollaborative governance
dc.subjectcoordination
dc.subjectgovernance
dc.subjectlocal health systems
dc.subjectshared motivation
dc.subject.anzsrc42 - Health sciences::4203 - Health services and systems::420305 - Health and community services
dc.subject.anzsrc42 - Health sciences::4203 - Health services and systems::420306 - Health care administration
dc.titleThe governance of local health systems in the era of Sustainable Development Goals: Reflections on collaborative action to address complex health needs in four country contexts
dc.typeJournal Article
uc.collegeFaculty of Health
uc.departmentSchool of Health Sciences
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