背景:人们对使用部门间协作(ISC)方法来解决复杂的与健康相关的问题越来越感兴趣。然而,关于实施的挑战的实证研究相对较少,促进和维持这些方法。我们的研究探讨了方案实施者对实施ISC方法的看法和经验,专注于阿萨姆邦营养计划的案例研究,印度。
方法:我们对来自阿萨姆邦两个选定地区的11名计划实施者进行了定性的半结构化面对面的深入访谈,印度。对这些参与者进行了有目的地抽样,以全面了解实施部门间合作的经验。采访之后,对收集的数据进行了归纳主题分析.
结果:该研究确定了三个主要主题:在日常实践中实施ISC,ISC的主持人,以及有效ISC的障碍。这些进一步细分为六个子主题:界定的部门任务、领导动态,人际关系和参与,集体愿景和监督,资源分配,和动力动态。这些发现凸显了ISC的复杂性,着眼于宏观上重要的结构和关系方面,meso,微观层面。利益相关者之间的人际关系和权力动态极大地影响了两个地区的ISC形成。
结论:尽管面临挑战,人们一直有兴趣在营养规划中建立ISC,政治发展议程的支持。成功取决于明确部门角色,解决功率动态问题,并系统地吸引利益相关者。具有可衡量目标的可操作计划对于促进和维持ISC至关重要,确保方案取得积极成果。我们研究的见解为应对类似挑战的全球卫生从业人员和政策制定者提供了宝贵的指导。强调鉴于在全球卫生实践中缺乏公认的ISC领域政策,迫切需要进行全面研究。
BACKGROUND: There is a growing interest in the use of intersectoral collaborative (ISC) approaches to address complex health-related issues. However, relatively little empirical research exists on the challenges of implementing, fostering and sustaining these approaches. Our study explores the perceptions and experiences of programme implementers regarding the implementation of an ISC approach, focusing on a case study of nutrition programming in Assam, India.
METHODS: We conducted qualitative semi-structured face-to-face in-depth interviews with eleven programme implementers from two selected districts of Assam, India. These participants were purposefully sampled to provide a comprehensive understanding of the experiences of implementing intersectoral collaboration. Following the interviews, an inductive thematic analysis was performed on the collected data.
RESULTS: The study identified three main themes: operationalisation of ISC in daily practice, facilitators of ISC, and barriers to effective ISC. These were further broken down into six subthemes: defined sectoral mandates, leadership dynamics, interpersonal relationships and engagement, collective vision and oversight, resource allocation, and power dynamics. These findings highlight the complexity of ISC, focusing on the important structural and relational aspects at the macro, meso, and micro levels. Interpersonal relationships and power dynamics among stakeholders substantially influenced ISC formation in both the districts.
CONCLUSIONS: Despite challenges, there is ongoing interest in establishing ISC in nutrition programming, supported by political development agendas. Success relies on clarifying sectoral roles, addressing power dynamics, and engaging stakeholders systematically. Actionable plans with measurable targets are crucial for promoting and sustaining ISC, ensuring positive programme outcomes. The insights from our study provide valuable guidance for global health practitioners and policymakers dealing with similar challenges, emphasising the urgent need for comprehensive research given the lack of universally recognised policies in the realm of ISC in global health practice.