Improving health through multisectoral collaboration: enablers and barriers

Abstract

Objective

Multisectoral partnerships (MPs) are increasingly viewed as an excellent strategy for promoting population health, although the Canadian evidence on MPs remains scant. The objective of this research was to identify enablers and barriers to multisectoral collaboration across three MPs (focused on food systems, urban development, and active transportation) in a Canadian urban centre.

Methods

This study is part of a pan-Canadian research program—MUSE (Multisectoral Urban Systems for health and Equity in Canadian cities). A qualitative case study methodology was used to explore enablers and barriers to collaboration among three MPs in a mid-sized Canadian city. Key strategy documents of the MPs and 13 in-depth, semi-structured interviews were conducted with stakeholders from each MP. Interview data were transcribed and subjected to thematic analysis using NVivo 12 software, with rigour ensured through member checking.

Results

Enablers to collaboration included agenda and goal alignment among partners, quality of relationships in MPs, and external enabling factors. Barriers to multisectoral collaboration included agenda and priority differences, factors related to partnership structure, constitution and processes, and external barriers. Based on these factors, we developed a multisectoral collaboration matrix that dichotomizes enablers and barriers into intrinsic/internal and extrinsic/external to increase understanding of health-promoting MPs in Canada.

Conclusion

Various enablers and barriers promote or inhibit multisectoral partnerships. By casting these factors into a matrix, members of ongoing or emerging MPs could take advantage of the factors that promote their work and are in their control (intrinsic enablers) or outside their control (extrinsic enablers) while working to overcome challenges presented by collaboration barriers.

Résumé

Objectif

L’établissement de partenariats multisectoriels (PM) est de plus en plus reconnu comme une excellente stratégie pour promouvoir la santé des populations bien que les données probantes canadiennes soient disponibles en quantités limitées. L’objectif de cette étude est d’identifier les leviers et les obstacles à la collaboration multisectorielle dans trois PM (visant respectivement le système alimentaire, le développement urbain et le transport actif) œuvrant dans un centre urbain canadien.

Méthodes

Cette étude fait partie d’un programme de recherche pancanadien – MUSE (Multisectorielles et urbaines : santé et équité dans les villes canadiennes). Une étude de cas méthodologie qualitative a été utilisée pour explorer les leviers et les obstacles à la collaboration dans trois PM dans une ville canadienne de taille moyenne. Les documents décrivant les orientations stratégiques de chacun des PM ont été examinés et 13 entrevues approfondies et semi-dirigées ont été menées avec les parties-prenantes de chacun des PM. Les verbatim d’entrevues ont été transcrits et soumis à une analyse thématique en utilisant le logiciel NVivo 12. La rigueur a été assurée via des vérifications entre codeurs.

Résultats

Les leviers à la collaboration incluent une bonne adéquation entre les agendas et les objectifs des différents membres d’un PM, la qualité des relations interpersonnelles entre membres des PM et des facteurs facilitants externes. Les obstacles à la collaboration multisectorielle incluent des agendas et priorités divergents, des facteurs reliés à la structure du partenariat, la composition et les processus de fonctionnement du PM, et les barrières externes. Les leviers et obstacles ainsi identifiés ont été catégorisés comme étant intrinsèques/internes ou extrinsèques/externes menant à la création d’une matrice de collaboration multisectorielle qui permet de mieux comprendre les enjeux vécus dans les PM qui font la promotion de la santé au Canada.

Conclusion

Différents leviers et obstacles soutiennent ou entravent les partenariats multisectoriels. En illustrant ces facteurs dans une matrice, les membres de PM existants ou émergeants peuvent prendre acte des facteurs qui soutiennent leurs travaux – qu’ils soient maniables (leviers intrinsèques) ou non (leviers extrinsèques) – tout en surmontant les défis occasionnés par les obstacles à la collaboration.

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Data availability

Data are managed by N.M. or L.G. as per procedures approved by relevant Human Research Ethics Committees.

Notes

  1. 1.

    The notation used for reporting key informant interviews is as follows: M1, M2, etc. = Member 1, Member 2, etc. interviewed from the given partnership; MP1, MP2, MP3 = the three partnerships under study (see Table 1).

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Acknowledgements

This work arises from the MUSE Team Grant and the authors acknowledge the MUSE researchers, staff and partners, especially Natalie Kallio and Margot Gough—our extraordinary Project Managers.

Funding

MUSE receives funding from CIHR Team Grant Program, Environments and Health: Programmatic Grants in Intersectoral Prevention Research (#IP2 – 150710).

Author information

Affiliations

Authors

Contributions

Conceptualization: L.G., N.M. Methodology: J.A.K.A., A.J., R.E-S. Formal analysis: J.A.K.A., A.J. Interpretation and writing, review, and editing: J.A.K.A., A.J., N.M., L.G., R.E-S., D.F. Supervision and resources: N.M., L.G. All the authors have read and agreed to the submission of the manuscript.

Corresponding author

Correspondence to Nazeem Muhajarine.

Ethics declarations

This study received ethical approval from the Behavioural Research Ethics Board at the University of Saskatchewan (Beh-122). All study participants have given informed consent. Ethics approval for the larger study has also been received from Comité d’éthique à la recherche du Centre Hospitalier de l’Université de Montréal (CHUM, 16.360).

Conflict of interest

The authors declare no conflicts of interest or stand to benefit from this work in any manner.

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Alhassan, J.A.K., Gauvin, L., Judge, A. et al. Improving health through multisectoral collaboration: enablers and barriers. Can J Public Health (2021). https://doi.org/10.17269/s41997-021-00534-3

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Keywords

  • Multisectoral partnerships
  • Intersectoral collaboration
  • Public health
  • Public policy
  • Healthy built environments
  • Healthy eating
  • Physical activity

Mots-clés

  • Partenariats multisectoriels
  • collaboration intersectorielle
  • santé publique
  • politiques publiques
  • environnement bâti favorable à la santé
  • saine alimentation
  • activité physique