Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, USA.
Health Studies, University College, University of Toronto, USA.
Soc Sci Med. 2022 Dec;315:115469. doi: 10.1016/j.socscimed.2022.115469. Epub 2022 Oct 22.
Despite the widespread acceptance of the need for intersectoral and multisectoral approaches, knowledge around how to support, achieve, and sustain multisectoral action is limited. While there have been studies that seek to collate evidence on multisectoral action with a specific focus (e.g., Health in All Policies [HiAP]), we postulated that successes of working cross-sectorally to achieve health goals with one approach can glean insights and perhaps translate to other approaches which work across sectors (i.e., shared insights across HiAP, Healthy Cities, One Health, and other approaches). Thus, the goal of this study is to assemble evidence from systematic approaches to reviewing the literature (e.g., scoping review, systematic review) that collate findings on facilitators/enablers of and barriers to implementing various intersectoral and multisectoral approaches to health, to strengthen understanding of how to best implement health policies that work across sectors, whichever they may be. This umbrella review (i.e., review of reviews) was informed by the PRISMA guidelines for scoping reviews, yielding 10 studies included in this review. Enablers detailed are: (1) systems for liaising and engaged communication; (2) political leadership; (3) shared vision or common goals (win-win strategies); (4) education and access to information; and (5) funding. Barriers detailed were: (1) lack of shared vision across sectors; (2) lack of funding; (3) lack of political leadership; (4) lack of ownership and accountability; and (5) insufficient and unavailable indicators and data. These findings provide a rigorous evidence base for policymakers to inform intersectoral and multisectoral approaches to not only aid in the achievement of goals, such as the Sustainable Development Goals, but to work towards health equity.
尽管人们普遍认识到需要采取跨部门和多部门的方法，但对于如何支持、实现和维持多部门行动的知识却有限。虽然已经有一些研究试图收集特定重点（例如“全健康政策”）的多部门行动证据，但我们假设，跨部门合作实现健康目标的成功经验可以为其他跨部门方法（即全健康政策、健康城市、One Health 等方法）提供启示。因此，本研究的目的是从系统方法（例如，范围综述、系统综述）综述文献中收集证据，总结各种跨部门和多部门方法实施的促进因素/促成因素和障碍，以加强对如何最好地实施跨部门有效的卫生政策的理解，无论它们是什么。本伞式综述（即综述的综述）遵循 PRISMA 范围综述指南，共纳入 10 项研究。详述的促进因素有：（1）联络和参与沟通的系统；（2）政治领导；（3）共同愿景或共同目标（双赢策略）；（4）教育和获取信息；以及（5）资金。详述的障碍有：（1）跨部门缺乏共同愿景；（2）缺乏资金；（3）缺乏政治领导；（4）缺乏所有权和问责制；以及（5）指标和数据不足且不可用。这些发现为政策制定者提供了严格的证据基础，以告知跨部门和多部门方法，不仅有助于实现可持续发展目标等目标，而且有助于实现健康公平。
