On SAGE Insight: Analysis of community-led collaboration to reduce health inequity in a deprived neighbourhood

Article title: A stakeholder analysis of community-led collaboration to reduce health inequity in a deprived neighbourhood in South Korea

From Global Health Promotion

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Health inequity has no simple causes or solutions. People experience health inequity in their lives under systemic inequalities, and these disparities rarely stem from only one source of vulnerability.  Intersectoral collaboration amongst health and other sectors, as well as between government and non-governmental organisations, has been highlighted as a way to improve health equity. This study uses a mixed-methods approach to assess collaborative relationships between multiple government sectors and civil society and to s0uggest possible health promotion interventions and policy alternatives for the urban poor in deprived neighborhoods. This design combines a stakeholder analysis using qualitative data with a network analysis of quantitative data. A stakeholder analysis aims to understand key actors or to identify their relevance to a project or policy by asking about their position, influence, interrelations and other stakeholder characteristics.

Creating a healthier community for vulnerable people in deprived neighborhoods requires allocating resources in ways that will improve community conditions that shape health, as these are upstream contributors to health. Community-driven, multisectoral collaborations play a key role in redirecting and expanding effective upstream interventions. Moreover, to repair the fragmented social safety net that inhibits integration of health care and social services, intersectoral collaboration needs to be established between stakeholders who are currently polarised and skeptical of each other’s motivations. Indeed, intersectoral collaboration should be further investigated and supported to obtain the full range of knowledge, skills and resources that the community needs.

Abstract

Intersectoral collaboration amongst health and other sectors, as well as between government and non-governmental organisations, has been highlighted as a way to improve health equity. We used a mixed-methods approach to assess collaborative relationships between multiple government sectors and civil society and to suggest possible health promotion interventions and policy alternatives for the urban poor in deprived neighborhoods. A total of 18 participants involved in health promotion interventions and policy processes related to the inner-city area of Seoul were recruited using purposive sampling methods. Participants included stakeholders working for or engaging in governments (3), public health care institutions (5), social service providers (3), community-based organisations (CBOs) (4) and faith-based organisations (3). We conducted semi-structured, one-on-one interviews and then collected survey data. Quantitative data were analysed using social network analysis, and qualitative data were analysed through iterative and consensus processes. The social network analysis indicated that a CBO plays the most substantial role in sharing and controlling informational resources to promote health. A stakeholder analysis showed that the CBO neutrally and negatively viewed the possibility of collaboration with other stakeholders. Three themes related to challenges to intersectoral collaboration emerged: (1) lack of trust and communication, (2) need of a coalition with a committed leading actor for future collaboration and (3) organisational and political silos within and across public sectors. Increased understanding of the current status of and challenges to collaboration can inform the planning and implementation of complex intervening strategies and policies tailored to vulnerable people in deprived neighborhoods. Community-led collaborative actions empower people in marginalised communities to envision a healthier community.

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Article details
A stakeholder analysis of community-led collaboration to reduce health inequity in a deprived neighbourhood in South Korea
First Published December 14, 2018 Research Article
DOI: 10.1177/1757975918791517
From Global Health Promotion


     
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