Sornpaisarn Bundit, Chunharas Somsak, Sornpaisarn Sarnti, Saonuam Pairoj, Nipun Rifat Farzan, Butryee Chaniphun, Samutachak Bhubate, Chandarasorn Maneekwan, Supadulya Nattapon, Chunsuttiwat Suttikarn, Singha Sumonmarn, Rojanapithayakorn Wiwat, Ungchusak Kumnuan, Rehm Jürgen
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Room 916, 250 College Street, Toronto, ON, M5T 1R8, Canada.
Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
Health Res Policy Syst. 2024 Dec 18;22(1):169. doi: 10.1186/s12961-024-01262-z.
To achieve the Sustainable Development Goals (SDGs) by 2030, Thailand must engage in effective multi-sectoral collaboration (MSC). However, implementing MSC in Thailand presents significant challenges. Although Thailand had a 2011-2020 MSC strategic plan for the control of non-communicable diseases (NCDs) with the prime minister taking the lead, joined by many non-health ministers, not a single meeting was called over those 10 years. This paper describes the development of a new tool created to enhance MSC between health and non-health sectors in controlling NCDs in Thailand. Stakeholder-engaged research will be used to implement and evaluate this tool. This paper also describes the research planned to test the new approach.
The authors used two main methods: (1) a narrative review on MSC enhancement and (2) a series of four consultation meetings with key stakeholders - in the health, non-health and academic sectors - to develop a research study to implement and evaluate the new approach.
To address previous MSC implementation problems, the proposed novel MSC enhancement approach emphasizes three principles: (1) pursuit of committed-stakeholder involvement at the middle-management level, instead of relying on the top-management level, an approach which has never been successful; (2) production of knowledge to support specific, achievable target policies; and (3) use of a comprehensive set of knowledge-translation activities and knowledge brokers to solve the problem of ineffective routine official communications between members of the MSC. Using participatory consultations during the research proposal development, middle-level officials from three non-health ministries (the Ministries of Agriculture, Finance and Education) agreed to join the MSC to work together to solve specific problems regarding the control of NCDs. A target-advocated policy for each ministry was formulated and agreed upon by both non-health-sector and health-sector stakeholders.
This new approach (middle-management oriented), if implemented, may encourage more commitment from the Ministries' representatives, policy-relevant knowledge generation and effective communications between ministries involved in an MSC. Ideally, it would complement the conventional approach (top-management oriented) in enhancing the MSC for controlling NCDs, and thereby bring hope for achieving the NCD-related SDGs for Thailand and possibly other countries as well.
为在2030年前实现可持续发展目标(SDGs),泰国必须开展有效的多部门协作(MSC)。然而,在泰国实施多部门协作面临重大挑战。尽管泰国在2011 - 2020年有一项由总理牵头、众多非卫生部长参与的控制非传染性疾病(NCDs)的多部门协作战略计划,但在这10年里一次会议都没召开过。本文描述了一种新工具的开发,该工具旨在加强泰国卫生部门和非卫生部门在控制非传染性疾病方面的多部门协作。将采用利益相关者参与的研究来实施和评估该工具。本文还描述了计划用于测试新方法的研究。
作者使用了两种主要方法:(1)对加强多部门协作的叙述性综述;(2)与卫生、非卫生和学术部门的关键利益相关者举行一系列四次协商会议,以开展一项研究来实施和评估新方法。
为解决之前多部门协作实施中的问题,提议的新型多部门协作加强方法强调三项原则:(1)在中层管理层面寻求利益相关者的积极参与,而不是依赖高层管理层面,以往依赖高层管理层面的方法从未成功;(2)生成知识以支持具体、可实现的目标政策;(3)使用一套全面的知识转化活动和知识中介来解决多部门协作成员之间常规官方沟通无效的问题。在研究提案制定过程中通过参与式协商,来自三个非卫生部委(农业、财政和教育部)的中层官员同意加入多部门协作,共同解决与控制非传染性疾病相关的具体问题。为每个部委制定了目标倡导政策,并得到了非卫生部门和卫生部门利益相关者的认可。
这种新方法(以中层管理为导向)若得以实施,可能会促使各部委代表做出更多承诺,生成与政策相关的知识,并促进参与多部门协作的各部委之间的有效沟通。理想情况下,它将补充传统方法(以高层管理为导向),以加强控制非传染性疾病的多部门协作,从而为泰国乃至其他国家实现与非传染性疾病相关的可持续发展目标带来希望。