• Building an intellectual hub for HPSR in Cape Town South Africa
  • CHESAI retreats
  • Participating in the 4th Global Symposium on Health Systems Research
  • Building an intellectual hub for HPSR in Cape Town South Africa
  • Supporting African HSPR capacity development
  • CHESAI retreats
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Collaboration for Health Systems Analysis and Innovation

A collaborative of health policy and systems researchers based in the Western Cape, South Africa, with a focus on strengthening the health policy and systems research field through conceptual and methodological development, as well as interdisciplinary and multisectoral engagement.
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Collaboration for Health Policy and Systems Analysis in Africa

Introduction to the Special Issue on “Analysing the Politics of Health Policy Change in Low- and Middle-Income Countries: The HPA Fellowship Programme 2017-2019”

This special issue presents a set of seven Health Policy Analysis (HPA) papers that offer new perspectives on health policy decision-making and implementation. They present primary empirical work from four countries in Asia and Africa, as well as reviews of literature about a wider range of low- and middle-income country (LMIC) experience. Read more

Watch the video summary by Prof. Lucy Gilson, Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town

Here’s what I discovered about multi stakeholder partnership (MSP)

For close to a year, I have been working on a project evaluating a complex heath system initiative to improve maternal and newborn outcomes in designated South African districts. The process has been lengthy, tedious, complex and has met countless challenges. We have conducted interviews with various key stakeholders involved in the planning and implementation of the initiative. In the process of the interviews, one word “multi-stakeholder partnership” caught my attention, to the point of wanting to know more about it.

In this blog I talk about how I went about finding more on multi-stakeholder partnership and what I discovered.
My search started with simple google and PubMed searches of the term multi stakeholder partnerships (MSPs). I discovered that there is a vast field of literature talking about MSPs mainly in the arena of global development and global health.
Some key things I learned from my quick searches include how MSPs are defined and their purpose, why people argue for MSPs, types of MSPs, and what makes for effective MSP.

1) How MSP are defined and their purpose
Multi-stakeholder partnerships are defined as innovative forms of governance to address implementation and participation challenges in global development.1 They provide a platform for multiple stakeholders to work and learn together, make decisions, and take actions for the collective good.2 They are also defined as ongoing relationships between diverse stakeholders, joining their expertise, resources and sharing risks to achieve agreed goals.3 The purpose of engaging in MSPs is to enhance the capacity of stakeholders and their organizations to effectively achieve their goals.4

2) Why argue for MSPs
Multi stakeholder partnerships establish structures for collective governance by bringing together stakeholders from different disciplines and backgrounds to address complex social issues that no one has the capacity or resources to solve alone (partnership). In doing so, MSPs complement the roles of existing governance structures within organizations and provide platforms for collective learning and innovation.

3) Types of MSPs
MSPs vary in nature and purpose, their scope ranges from addressing a specific problem locally to addressing systemic challenges. Joint projects and joint programmes address a specific problem, whereas strategic alliances and “collective impact partnerships”3 address systemic challenges.

4) What makes for effective MSPs
MSPs do not always produce the intended result, so to be effective MSPs need to consider systemic change, enable transformation, solve conflict, address issues of power, and foster social interactions and learning.

Systemic change
Multi stakeholder partnership should be able to embrace whole system thinking, recognizing complexity, unpredictability and emergent change.

Transformation
MSPs should enable transformation, through change in the way people do things, change in behaviour, change in rules, and change in values.

Working with power
MSPs need to address power differences amongst stakeholders, by helping them use power constructively.

Dealing with conflict
MSPs bring stakeholders with divergent expectations, and/or interests; as such conflicts are inevitable in MSPs. Hence, dealing with conflict is critical to ensure effective partnership.

Effective communication and engagement of all stakeholders
MSPs should create a platform where people work together and share responsibilities. Clear communication channels and platforms must be established to allow people express themselves freely. From the start, clear leadership structures, and responsibilities must be developed and agreed on by all involved. Leadership roles should be vested in a range of actors, not only on those with formal authority.

Fostering participatory learning
Learning is essential in MSPs, hence, through the life cycle of an MSP, there should be events and activities that bring stakeholders together to reflect on what they are doing and learning together.

Thinking back to the partnership I have been evaluating, there is a need to clearly discuss MSPs in health systems, and how they function. Attention needs to be paid on their design in order for them to succeed. If well designed, MSPs can be a powerful governance mechanism for shared decision making, co-creation of innovation, and collaborative practices.

Conclusion
Given the many requirements outlined above, it is not surprising that building effective MSPs is difficult and time consuming, it involves changing systems, changing the way people work and do things through new structures and collaboration mechanisms.

Reference
1. Haas P. Addressing the global governance deficit. Glob Environ Polit. 2004;4(4):1-15.
2. Brouwer H, Woodhill J, Vugt M, Verhoosel K, Van S. How to design and facilitate multi-steholder partnerships MSP. Vol 95.; 2001.
3. Hazlewood P. Global Multi-stakeholder Partnerships : Scaling up public-private collective impact for the SDGs. World Resour Inst. 2015;(Background Paper 4):1-8.
4. Lasker RD, Weiss ES, Miller R. Partnership Synergy: A Practical Framework for Studying and Strengthening the Collaborative Advantage. Milbank Q. 2001;79(2):179-205. doi:10.1111/1468-0009.00203

Acknowledgement
Edits from Helen Schneider

Cape Town’s response to COVID-19 shows that another kind of society is possible

Cape Town Together and the CANs were catalysed by an unprecedented, global pandemic. This was not an attempt to bring people together under an explicitly municipalist agenda – or under any one coherent political ideology – other than a belief that local knowledge and self-organisation is best placed to respond to certain contextualities of a crisis such as Covid-Guiding principles, such as horizontality, radical generosity and solidarity across class and race lines were arrived at through praxis, rather than a theoretical or ideological positioning.

Yet, under the banner of responding to Covid-19, the CANs demonstrated a different way of doing politics at the municipal level that potentially sets the stage for extended projects in radical democracy and local action to challenge the deep-seated socio-economic inequality and spatial injustice that abounds in the city.

It’s hard to imagine how this reconciles with the inherent hierarchies in our entrenched system of electoral politics but if there’s one thing we have learned it is that networks of ordinary people doing ordinary things in an extraordinary way can be a powerful tool to demonstrate the kind of society that is possible. Read the full article

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