School of Health and Medical Sciences, Orebro University, Orebro, Sweden.
J Health Organ Manag. 2013;27(2):225-45. doi: 10.1108/14777261311321798.
A vehicle to reduce health inequalities and improve public health has been provided by programmes at a neighbourhood level. The purpose of this paper is to analyse the development processes in four municipalities for achieving sustainable structures in area-based development programmes during and after a formal partnership period.
DESIGN/METHODOLOGY/APPROACH: A case-study database was compiled based on the strategic and local work of four municipalities and four municipal housing companies who cooperated in the Partnership for Sustainable Welfare Development 2003-2009. The case-study database includes nine in-depth studies with interviews (n = 68), participant observations (n = 125), a survey (n = 1,160), and documents. The data are analysed using three theoretical concepts: political support, alliances, and citizen participation.
Political support, alliances, and citizen participation are important building blocks in neighbourhood development work. However, when the partnership ended there was little left that could function as a sustainable structure. Political support seems to be a means to reach the target, including ensuring a consistent approach and allocation of resources. However, the support must continue also after the intervention period, when the formal partnership collaboration ends, otherwise the established structure will soon decompose. Citizen participation is another precondition for a sustainable structure able to continue despite reduced municipal support. Alliances have the best chance of forming sustainable structures when they involve both the strategic and the operational level.
ORIGINALITY/VALUE: Even though many evaluations have been conducted to capture the process of interventions, little attention has been given to the challenges facing the outcomes of the intervention when it comes to making permanent the activities for reducing health inequalities. This paper is an attempt to deal with these challenges.
通过邻里层面的项目,为减少健康不平等和改善公共卫生提供了一种手段。本文旨在分析四个城市在正式合作期内和之后,为实现基于区域的发展计划中的可持续结构而经历的发展过程。
设计/方法/途径:本研究基于四个城市和四个市营住房公司的战略和地方工作,编制了一个案例研究数据库。这四个城市和四个市营住房公司在 2003-2009 年的可持续福利发展伙伴关系中进行了合作。案例研究数据库包括九项深入研究,其中包括访谈(n=68)、参与观察(n=125)、调查(n=1160)和文件。数据采用三个理论概念进行分析:政治支持、联盟和公民参与。
政治支持、联盟和公民参与是邻里发展工作的重要组成部分。然而,当合作关系结束时,几乎没有留下任何可以作为可持续结构的东西。政治支持似乎是达到目标的一种手段,包括确保一致的方法和资源分配。然而,这种支持必须在干预期结束后继续,即正式的合作关系结束后,否则已经建立的结构很快就会分解。公民参与是另一个可持续结构的前提,即使在减少市政支持的情况下,也能够继续运作。当联盟涉及战略和运营层面时,它们最有机会形成可持续的结构。
原创性/价值:尽管已经进行了许多评估来捕捉干预过程,但对于干预的结果如何在减少健康不平等方面保持永久活动方面,很少关注面临的挑战。本文试图应对这些挑战。