Mahlangu Pinky, Goudge Jane, Vearey Jo
a Gender and Health Research Unit , South African Medical Research Council , Cape Town , South Africa.
b School of Public Health, Faculty of Health Sciences , University of Witwatersrand , Johannesburg , South Africa.
Glob Health Action. 2019;12(1):1617393. doi: 10.1080/16549716.2019.1617393.
: While multisectoral action (MSA) is advocated as one of the strategies to address complex health and development challenges, there is limited clarity about the process of multisector collaboration in practice. : Informed by the findings of the research on implementation of the multisectoral response to HIV in South Africa, and drawing from the existing literature; we propose a framework for multisector and multilevel collaboration. The framework describes key components of the process of multisector collaboration, and aims to inform policy and practice. : An integrative review and synthesis of existing frameworks, models and approaches on multisectoral action in public health, governance and health, and in public administration was conducted to inform the development of the proposed framework. : There are seven key components that are critical in the process of multisector collaboration namely: preconditions; key drivers; structure; mechanisms; administration; execution and evaluation. Multisector collaboration is presented as an iterative process that allow for improvement and learning. The framework is presented through a visual representation which shows how the seven elements are connected, and how learning happens through-out the multisector collaboration process. Structure and mechanisms are the two central and interrelated elements of the proposed framework. : The framework does not suggest that multisector collaboration is a panacea, but that MSA remains critical to address complex health and development issues. Focus should be on finding innovative ways to inform and strengthen its implementation in practice. The framework can be used by practitioners and policy makers to inform design, implementation, and evaluation of multisector collaborations. It reflects on complexities of MSA, and brings to the fore critical information to assess readiness and to inform the decision whether to engage in MSA or not.
虽然多部门行动（MSA）被倡导为应对复杂健康与发展挑战的策略之一，但在实践中多部门协作的过程尚缺乏清晰的认识。基于对南非艾滋病多部门应对措施实施情况的研究结果，并借鉴现有文献，我们提出了一个多部门和多层次协作的框架。该框架描述了多部门协作过程的关键组成部分，旨在为政策和实践提供参考。对公共卫生、治理与健康以及公共行政领域中关于多部门行动的现有框架、模型和方法进行了综合回顾与整合，以为所提出框架的制定提供参考。多部门协作过程中有七个关键组成部分至关重要，即：前提条件；关键驱动因素；结构；机制；管理；执行和评估。多部门协作被呈现为一个允许改进和学习的迭代过程。该框架通过可视化表示呈现，展示了七个要素如何相互关联，以及学习如何贯穿多部门协作过程。结构和机制是所提出框架的两个核心且相互关联的要素。该框架并非表明多部门协作是万灵药，而是指出多部门行动对于解决复杂的健康与发展问题仍然至关重要。重点应放在寻找创新方法以在实践中为其实施提供信息并加强实施。该框架可供从业者和政策制定者用于为多部门协作的设计、实施和评估提供参考。它反映了多部门行动的复杂性，并突出了关键信息以评估准备情况并为是否参与多部门行动的决策提供参考。
