International Journal of Health Policy and Management

International Journal of Health Policy and Management

Building Cross-sectoral Collaborations to Address Perinatal Health Inequities: Insights From the Dutch Healthy Pregnancy 4 All-3 Program

Document Type : Original Article

Authors
Leonie A. Daalderop 1, 2
Lisa S. Barsties 1, 2
Frank van Steenbergen 2
Adja J.M. Waelput 1
Jacqueline Lagendijk 1
Jasper V. Been 1, 3, 4
Eric A.P. Steegers 1
Derk Loorbach 2
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
10.34172/ijhpm.8115
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, ie, a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. We investigated facilitators and barriers for cross-sectoral 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 collaborations in the context of perinatal health are 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
Cross-sectoral Collaborations
Perinatal Health Inequities
Facilitators and Barriers
Transition
Action Research
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International Journal of Health Policy and Management
Volume 13, Issue 1
2024
Pages 1-12

  • Received Date 15 May 2023
  • Revised Date 05 January 2024
  • Accepted Date 27 May 2024
  • First Published Date 28 May 2024
  • Published Date 01 December 2024