Analyzing collaborative governance relationships among District Health Management Teams and stakeholders in local health systems: A scoping review
1
Independent Researcher, Virginia Beach, United States
2
Department of Health Policy Planning and Management, University of Ghana - School of Public Health, Legon-Accra, Ghana
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
This study sought to explore benefits and challenges of collaborative health governance in delivering Primary Health Care (PHC) at the lower level of care and identify barriers and facilitators in SSA.
METHODS:
Using the appropriate methodological guidance for carrying out scoping reviews, this study searched for relevant literature published until April 2023 on collaborative governance among DHMTs in three databases (PubMed, Web of Science, Google scholar), Google, and Google scholar search engines. The study was guided by a framework that identifies systemic, organizational and interactional determinants as enablers for collaborative health governance. Initial search identified a total of 1414 studies. Based on a predetermined inclusion criteria, 29 studies were included in the review for content analysis.
RESULTS:
Majority of the articles originated from the eastern part of Africa accounting for over 40 % of the total included studies. The study found 19 studies approach to collaborative health governance grounded on the application of specific theories or approach. Systemic factors such as diffusion of innovation, policy alignment to local needs, and technical and financial support were found to be enablers. Interacting factors that consolidate collaborative governance arrangements are shared roles and responsibilities; shared vision, goals, and values; and trust. Collaboration governance arrangements were mostly multidimensional. This review found leadership is an important driver to effective collaboration. DHMTs lack the capacity to initiate collaboration among stakeholders could hinder and effective locally driven collaborative health governance.
CONCLUSIONS:
Collaboration among DHMTs and relevant stakeholders at the local health system levels is a promising strategy for robust governance and institutional frameworks within complex health systems. However, DHMTs inability to strengthen their capacity in initiating and sustaining collaborative efforts within the local health system can affect the multidimensional nature of collaborative governance arrangements, characterized by accountability, transparency, participation, integrity, and capacity.
This study sought to explore benefits and challenges of collaborative health governance in delivering Primary Health Care (PHC) at the lower level of care and identify barriers and facilitators in SSA.
METHODS:
Using the appropriate methodological guidance for carrying out scoping reviews, this study searched for relevant literature published until April 2023 on collaborative governance among DHMTs in three databases (PubMed, Web of Science, Google scholar), Google, and Google scholar search engines. The study was guided by a framework that identifies systemic, organizational and interactional determinants as enablers for collaborative health governance. Initial search identified a total of 1414 studies. Based on a predetermined inclusion criteria, 29 studies were included in the review for content analysis.
RESULTS:
Majority of the articles originated from the eastern part of Africa accounting for over 40 % of the total included studies. The study found 19 studies approach to collaborative health governance grounded on the application of specific theories or approach. Systemic factors such as diffusion of innovation, policy alignment to local needs, and technical and financial support were found to be enablers. Interacting factors that consolidate collaborative governance arrangements are shared roles and responsibilities; shared vision, goals, and values; and trust. Collaboration governance arrangements were mostly multidimensional. This review found leadership is an important driver to effective collaboration. DHMTs lack the capacity to initiate collaboration among stakeholders could hinder and effective locally driven collaborative health governance.
CONCLUSIONS:
Collaboration among DHMTs and relevant stakeholders at the local health system levels is a promising strategy for robust governance and institutional frameworks within complex health systems. However, DHMTs inability to strengthen their capacity in initiating and sustaining collaborative efforts within the local health system can affect the multidimensional nature of collaborative governance arrangements, characterized by accountability, transparency, participation, integrity, and capacity.
| eISSN: | 2654-1459 |
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