Document Type : Original Article
Authors
1
Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
2
Dutch Research Institute for Transitions, Erasmus University Rotterdam, Rotterdam, The Netherlands
3
Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
4
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
Abstract
Background
Addressing perinatal health inequities is the joint responsibility of professionals working for local governments, the medical, social, and public health sector. Cross-sectoral collaboration between these professionals is challenging. For such collaborations to succeed, a transition is necessary, i.e. a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. We investigated facilitators and barriers for crosssectoral collaborations, when addressing perinatal health inequities in the Netherlands. Additionally, we studied how cross-sectoral collaborations can be facilitated by action research.
Methods
We used interview and questionnaire data of the Healthy Pregnancy 4 All-3 (HP4All- 3) program, which resulted from action research in six Dutch municipalities. All interviews were coded using open codes related to facilitators and barriers for cross-sectoral collaboration and categorized into three subgroups: structural, cultural, or practical. The answers to the questionnaire were analyzed and summarized quantitatively.
Results
We conducted 53 interviews with a total of 81 professionals. The most important ingredients for cross-sectoral collaborations mentioned by the interviewees were: (1) Structural: having a solid network with a clear overview of professionals working in the different sectors, (2) cultural: having a joint vision/goal, and (3) practical: short lines of communication and timely sharing of information. A total of 85 professionals filled in (parts of) the questionnaire. Two-thirds to over 80 percent replied that the HP4All-3 program had an added value in building cross-sectoral collaborations.
Conclusion
Our research shows that cross-sectoral collaboration in the context of perinatal health is hampered by structural, cultural, and practical barriers. Analyzing facilitators and barriers at these three levels helps to identify bottlenecks in cross-sectoral collaboration. Action researchers can be of great advantage in facilitating collaboration, as they can offer an open setting for reflection and instigate a sense of urgency for building collaborations.
Keywords
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