Hyatt Amelia, Chan Belinda, Moodie Rob, Varlow Megan, Bates Chris, Foliaki Sunia, Palafox Neal, Burich Shelley, Aranda Sanchia
Cancer Control Policy, Cancer Council Australia, Sydney, NSW, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Lancet Reg Health West Pac. 2023 Jan 13;33:100681. doi: 10.1016/j.lanwpc.2022.100681. eCollection 2023 Apr.
Cancer is a significant problem for the South Pacific region due to a range of complex health challenges. Currently gaps in diagnosis, treatment and palliative care are significant, and while governmental commitment is strong, economic constrains limit health system strengthening. Alliances have been successful in strengthening non-communicable disease and cancer control policy and services in resource constrained settings. A regional coalition approach has therefore been recommended as an effective solution to addressing many of the challenges for cancer control in the South Pacific. However, evidence regarding the effective mechanisms for development of alliances or coalitions is scarce. This study aimed to 1) create a Coalition Development Framework; 2) assess the use of the Framework in practice to co-design a South Pacific Coalition.
Creation of the Coalition Development Framework commenced with a scoping review and content analysis of existing literature. Synthesis of key elements formed an evidence-informed step-by-step guide for coalition-building. Application of the Framework comprised consultation and iterative discussions with key South Pacific cancer control stakeholders in Fiji, New Caledonia, Papua New Guinea, Samoa and Tonga. Concurrent evaluation of the Framework utilising Theory of Change (ToC) and qualitative analysis of stakeholder consultations was undertaken.
The finalised Coalition Development Framework comprised four phases with associated actions and deliverables: engagement, discovery, unification, action and monitoring. Application of the Framework in the South Pacific identified overwhelming support for a Cancer Control Coalition through 35 stakeholder consultations. Framework phases enabled stakeholders to confirm coalition design and purpose, strategic imperatives, structure, local foundations, barriers and facilitators, and priorities for action. ToC and thematic consultation analysis confirmed the Framework to be an effective mechanism to drive engagement, unification and action in alliance-building.
A Coalition to drive cancer control has significant support among key Pacific stakeholders, and establishment can now be commenced. Importantly results confirm the effective application of the Coalition Development Framework in an applied setting. If momentum is continued, and a regional South Pacific Coalition established, the benefits in reducing the burden of cancer within the region will be substantial.
This work was completed for a Masters of Public Health project. Cancer Council Australia provided project funding.
由于一系列复杂的健康挑战，癌症是南太平洋地区的一个重大问题。目前，在诊断、治疗和姑息治疗方面存在重大差距，尽管政府的承诺力度很大，但经济限制阻碍了卫生系统的强化。联盟在资源有限的环境中成功加强了非传染性疾病和癌症控制政策及服务。因此，建议采用区域联盟方法作为应对南太平洋癌症控制诸多挑战的有效解决方案。然而，关于联盟或联合体有效发展机制的证据很少。本研究旨在：1）创建一个联盟发展框架；2）评估该框架在实践中用于共同设计南太平洋联盟的情况。
联盟发展框架的创建始于对现有文献的范围审查和内容分析。关键要素的综合形成了一个基于证据的联盟建设逐步指南。该框架的应用包括与斐济、新喀里多尼亚、巴布亚新几内亚、萨摩亚和汤加的南太平洋主要癌症控制利益相关者进行协商和反复讨论。利用变革理论（ToC）对该框架进行同步评估，并对利益相关者协商进行定性分析。
最终确定的联盟发展框架包括四个阶段以及相关行动和可交付成果：参与、发现、统一、行动和监测。该框架在南太平洋地区的应用通过35次利益相关者协商确定了对癌症控制联盟的压倒性支持。框架各阶段使利益相关者能够确认联盟的设计和宗旨、战略要务、结构、当地基础、障碍和促进因素以及行动优先事项。ToC和主题协商分析证实该框架是推动联盟建设中的参与、统一和行动的有效机制。
推动癌症控制的联盟在太平洋主要利益相关者中获得了大力支持，现在可以开始建立。重要的是，结果证实了联盟发展框架在实际应用中的有效应用。如果势头持续下去，并建立一个南太平洋区域联盟，在减轻该地区癌症负担方面的益处将是巨大的。
这项工作是为一个公共卫生硕士项目完成的。澳大利亚癌症理事会提供了项目资金。
