Equilibrium in the governance of cross-sectoral policies: how does it translate into practice?

Health Research Policy and Systems

Research

Pernelle Smits¹  Jean-Louis Denis²  Jacques Bourgeault³  Gerard Divay³  Nassera Touati³  Johanne Préval³ 

[1] Departement de Management, Université Laval, Montréal, Canada;Université de Montréal, CRCHUM, Montréal, Canada;École Nationale d’administration Publique, CRCHUM, Montréal, Canada;

关键词: Equilibrium;    HiAP;    Framework;    Governance;    Horizontal;   

DOI  :  10.1186/s12961-023-01035-0

 received in 2022-09-04, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is growing interest from health researchers in the governance of Health in All Policies (HiAP). Furthermore, the COVID-19 pandemic has re-ignited managers’ interest in HiAP governance and in health prevention activities that involve actors from outside health ministries. Since the dynamics of these multi-actor, multi-sectoral policies are complex, the use of systems theory is a promising avenue toward understanding and improving HiAP governance. We focus on the concept of equilibrium within systems theory, especially as it points to the need to strike a balance between actors that goes beyond synergies or mimicry—a balance that is essential to HiAP governance.MethodWe mobilized two sources of data to understand how the concept of equilibrium applies to HiAP governance. First, we reviewed the literature on existing frameworks for collaborative governance, both in general and for HiAP specifically, in order to extract equilibrium-related elements. Second, we conducted an in-depth case study over three years of an HiAP implemented in Quebec, Canada.ResultsIn total, we identified 12 equilibrium-related elements relevant to HiAP governance and related to knowledge, actors, learning, mindsets, sustainability, principles, coordination, funding and roles. The equilibria were both operational and conceptual in nature.ConclusionsWe conclude that policy makers and policy implementers could benefit from mobilizing these 12 equilibrium-related elements to enhance HiAP governance. Evaluators of HiAP may also want to consider and integrate them into their governance assessments.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023