The potential role of local government in NSW to address public health nutrition issues has received encouraging reports. This treatise deals with the question of whether intersectoral collaboration theory is useful to assist development of a relationship with local government to develop food and nutrition policy. Intersectoral collaboration theory describes six conditions necessary for successful action: necessity, opportunity, capacity, relationships, planned action, and sustained outcomes. The project was a feasibility study carried out in a densely populated and multicultural local government area in Sydney�s southwest during April 1998. Eight Council employees and one elected representative were interviewed using the semi-structured questionnaire to collect a range of opinions and knowledge about Council�s involvement in a food and nutrition policy. Conceptual frameworks for the study included the Ottawa Charter and the food and nutrition system. Theoretical underpinning�s were provided by intersectoral collaboration theory and organisational change theory. Using intersectoral collaboration theory, analysis of the interviews revealed that participants were very concerned with conditions of necessity, opportunity and capacity to develop food and nutrition policy. Intersectoral collaboration theory correctly predicted that the action proposed would have to assist Council to achieve their core business, gain social and political support and be possible within the current economic environment and level of other resources available. Participants were not able to identify how a food and nutrition policy would meet these conditions and be feasible within the current capacity of the organisation, and therefore did not become fully engaged in the feasibility study. The health sector needs to develop arguments for local government involvement from their perspective. Organisational change within the heath sector is required to develop capacity for intersectoral partnerships, as an effective strategy to address public health nutrition issues.

The potential role of local government in NSW to address public health nutrition issues has received encouraging reports. This treatise deals with the question of whether intersectoral collaboration theory is useful to assist development of a relationship with local government to develop food and nutrition policy. Intersectoral collaboration theory describes six conditions necessary for successful action: necessity, opportunity, capacity, relationships, planned action, and sustained outcomes. The project was a feasibility study carried out in a densely populated and multicultural local government area in Sydney�s southwest during April 1998. Eight Council employees and one elected representative were interviewed using the semi-structured questionnaire to collect a range of opinions and knowledge about Council�s involvement in a food and nutrition policy. Conceptual frameworks for the study included the Ottawa Charter and the food and nutrition system. Theoretical underpinning�s were provided by intersectoral collaboration theory and organisational change theory. Using intersectoral collaboration theory, analysis of the interviews revealed that participants were very concerned with conditions of necessity, opportunity and capacity to develop food and nutrition policy. Intersectoral collaboration theory correctly predicted that the action proposed would have to assist Council to achieve their core business, gain social and political support and be possible within the current economic environment and level of other resources available. Participants were not able to identify how a food and nutrition policy would meet these conditions and be feasible within the current capacity of the organisation, and therefore did not become fully engaged in the feasibility study. The health sector needs to develop arguments for local government involvement from their perspective. Organisational change within the heath sector is required to develop capacity for intersectoral partnerships, as an effective strategy to address public health nutrition issues.

Intersectoral collaboration for health is widely recognised as a critical component of interventions to address complex public health issues. However, there is limited research that has examined how intersectoral approaches are formulated and implemented, especially in low- and middle-income countries. As a result, although the literature is populated with calls for action, little exists that can inform the evidence on how to sustain intersectoral action for health. This thesis is a case study of intersectoral action in the Western Cape Province of South Africa, examining the unfolding policy formulation and implementation processes of an initiative referred to as First 1,000 Days, in the period 2016 to 2019. Within early childhood, the First 1,000 Days (FTD) period presents a favourable window for intersectoral interventions that can ensure positive outcomes from early years of life to adulthood. The FTD initiative emerged in the Western Cape Province of South Africa in response to the growing number of children exposed to the social challenges of violence and of alcohol and drug abuse.

O presente trabalho visa analisar as percepções, vivências e experiências dos profissionais da saúde e da educação envolvidos no Programa Saúde da Escola (PSE) do Município de Guarulhos (SP), incluindo a pesquisadora. Pela saúde, foram entrevistados 10 profissionais da Unidade Saúde da Família (USF) (gerente, enfermeira, auxiliar de enfermagem, três agentes comunitárias com maior tempo de serviço na Unidade, além de nutricionista, assistente-social, educador físico e psicóloga que atuam no Núcleo de Apoio à Saúde da Família (NASF) da Unidade; da pesquisadora, foi utilizado o diário de campo. Pela educação, foram entrevistados os profissionais da Escola da Prefeitura de Guarulhos (EPG) escolhida, sendo 6 da gestão (supervisora, diretor, vice-diretora, coordenadora pedagógica, assistente de gestão e agente escolar) e mais 9 educadoras, selecionadas segundo amostra intencional (maior tempo de contato com PSE e tempo de trabalho na escola). Foram propostas entrevistas individualizadas, com 6 questões abertas que nortearam as conversas, no local de trabalho do entrevistado. Para analisar o conteúdo das falas, foi escolhida um método qualitativo da Hermenêutica-Dialética. Como resultado notou-se que a presença constante da coordenadora em todos os grupos, no planejamento e nas conversas pode ter sugestionado um viés mais positivo na educação e mais negativo na saúde, pois nesta não há reuniões e encontros. A grande maioria não participa das ações nas escolas e não entende a sua função e importância no programa. Pelas quatro categorias criadas concluem-se que há falhas a serem trabalhadas, mas se houver mais momentos de compartilhamento entre os profissionais, seja na Saúde quanto na Educação e ações de formação (educação continuada), haverá uma melhora nas relações intersetoriais e trabalho multiprofissional. Foi proposto um encarte para ajudar na criação de estratégias para consolidar as ações dos profissionais, para melhorar a padronização das ações e de continuidade do programa. / The present study aims to analyze the perceptions, experiences and experiences of health and education professionals involved in the School Health Program (PSE) of the Municipality of Guarulhos (SP), including the researcher. For health, 10 professionals from the Family Health Unit (USF) (manager, nurse, nursing assistant, three community agents with a longer period of service in the Unit, as well as a nutritionist, social worker, physical educator and psychologist In the education, the professionals of the chosen School of the City of Guarulhos (EPG) were interviewed, being 6 of the management (supervisor, director, assistant coordinator, pedagogical coordinator, management assistant and school agent) and 9 other educators, selected according to an intentional sample (longer time of contact with PSE and working time in school). Individualized interviews were proposed, with 6 open questions that guided the In order to analyze the content of the speeches, a qualitative method of Dialectic Hermeneutics was chosen. it was noted that the constant presence of the coordinator in all groups, in planning and in conversations may have suggested a more positive bias in education and more negative health, since there are no meetings and meetings. The vast majority do not participate in school actions and do not understand their role and importance in the program. For the four categories created it is concluded that there are flaws to be worked out, but if there are more moments of sharing among the professionals, whether in Health or Education and training actions (continuous education), there will be an improvement in intersectoral relations and multiprofessional work. An insert was proposed to assist in the creation of strategies to consolidate the actions of professionals, to improve standardization of actions and continuity of the program.

As sociedades contemporâneas passam por processos de transformação social rápidos e profundos. Essas põe em xeque as teorias, conceitos e modelos considerados eficazes para alavancar o desenvolvimento econômico e social e enfrentar as crises sociais decorrentes das iniquidades sociais. É necessário compreender como se dá a inserção de estratégias como a intersetorialidade e a formação de redes que instigam novas formas de gestão para superar as fragmentações sociais e transformar estruturas institucionais e dinâmicas políticas. A pesquisa realiza um estudo de caso sobre como as práticas intersetoriais e o trabalho em rede estão sendo incorporadas na Rede Intersetorial Guarulhos Cidade que Protege, implementada em Guarulhos, São Paulo, desde 2010 para enfrentar a violência que afeta crianças e jovens. Realizou-se um estudo qualitativo para compreender as concepções e significados da atuação intersetorial e em rede para os atores que a desenvolvem e implementam. Também teve como objetivo compreender a estrutura das redes criadas, identificar fatores que intervêm na produção da intersetorialidade e na formação de rede, quais as condicionam e como estas contribuíram para os resultados da iniciativa. A produção de dados baseou-se em 56 entrevistas semi-estruturadas, selecionando-se os sujeitos pela técnica Bola de Neve, observação, revisão documental e Análise de Redes Sociais. Identificaram-se 90 parceiros e 170 parcerias ativas. As atividades realizadas pelas parcerias incluíram discussão de caso, ações de encaminhamento e seguimento, reorientação de práticas de trabalho, matriciamento, projetos conjuntos, ações em conjunto tendo como grupo alvo as famílias e usuários dos territórios, entre outras. Os resultados indicam que as parcerias seguem a lógica da administração pública e das redes de serviços setoriais existentes, com poucas articulações com a sociedade civil e outros setores. Apontam também as potencialidades do trabalho em rede com a consolidação de estruturas de apoio à intersetorialidade, fortalecimento da capacidade dos atores sociais para o trabalho intersetorial, promoção de novas parcerias, fortalecimento de laços de confiança e relações entre atores sociais e ações direcionadas ao enfrentamento da violência. Constatou-se também a gestão intersetorial limitada pois esta se estabelece em estruturas setoriais e fragmentadas, fragilizando sua capacidade de ação e deliberação e a contribuição que esta poderia oferecer às ações de enfrentamento da violência no município. Coloca-se em dúvida a ideia da intersetorialidade como prática social compartilhada ou modelo de gestão de políticas públicas que promova a autonomia e interdependência dos setores envolvidos. Conclui-se propondo dois marcos analíticos: um para apoiar o planejamento da Rede Intersetorial para o enfrentamento da violência a partir do olhar ampliado ao território e em conexão com órgãos da Rede Municipal de Proteção da Criança e do Adolescente, e outro que sistematiza como a intersetorialidade e as redes podem contribuir para as transformações sociais, políticas e institucionais no contexto da sociedade em rede e informacional. / Contemporary societies are undergoing rapid and intense transformations. These challenge current theories, models and concepts that are considered effective to promote economic and social development and to address social crises that arise from social inequities. It is important to understand how strategies such as intersectoriality and network development are incorporated into such context as they promote new management models to address social fragmentation and transform institutional structures and political dynamics. The research conducted a case study on how intersectoral practices and network models are being developed within the Intersectoral Network Guarulhos Cidade que Protege (\"Guarulhos, City that Protects\"), implemented in the city of Guarulhos, São Paulo, since 2010 to tackle violence that affects children and adolescents. A qualitative study was conducted to understand the conceptualizations and significance of intersectoral action and networking for those who are developing and implementing them. The study also aimed to comprehend the structure of the networks created, which factors intervened in the production of intersectoriality and network development and which ones conditioned them, and how these processes contributed to the initiative´s results. Fifty-six (56) semi-structured interviews were conducted; subjects were selected through the snowball technique. The study also included observation and document analysis. Ninety partners and 170 partnerships were identified. Activities conducted by these partnerships included case discussions, community mapping, referrals and follow-ups, reorientation of work and team practices, joint projects, development of activities with families and users in territories, among others. Results pointed out that partnerships usually followed the logic of the public administration structure and service networks with few partnerships being developed with civil society and others. The data highlight the potential of networks to help consolidate supporting structures for intersectoral action, strengthening the capacity of social actors for intersectoral work, promoting new partnerships, increasing trust, improving relationships among social actors and fostering actions aimed at addressing violence. It also highlighted that intersectoral management was limited given that such arrangements took place within sectoral and fragmented structures, a situation which weakened the capacity of the intersectoral actions undertaken and the contribution that they could make to decreasing violence in the city. The results challenge the assumption that intersectorial collaboration is a socially shared practice or a management model of public policies that promotes autonomy and interdependence among the sectors involved. The study concludes with the proposal of two analytical frameworks: one aimed at supporting better planning for the Intersectoral Network to address violence by considering a greater scope of social actors in the territory and seeking better connections with other entities that conform the Municipal Network for the Protection of Child and Adolescents, and another model that synthesizes how intersectoral action and networks can contribute to social, political and institutional transformations in the context of our network and informational society.

O presente trabalho visa analisar as percepções, vivências e experiências dos profissionais da saúde e da educação envolvidos no Programa Saúde da Escola (PSE) do Município de Guarulhos (SP), incluindo a pesquisadora. Pela saúde, foram entrevistados 10 profissionais da Unidade Saúde da Família (USF) (gerente, enfermeira, auxiliar de enfermagem, três agentes comunitárias com maior tempo de serviço na Unidade, além de nutricionista, assistente-social, educador físico e psicóloga que atuam no Núcleo de Apoio à Saúde da Família (NASF) da Unidade; da pesquisadora, foi utilizado o diário de campo. Pela educação, foram entrevistados os profissionais da Escola da Prefeitura de Guarulhos (EPG) escolhida, sendo 6 da gestão (supervisora, diretor, vice-diretora, coordenadora pedagógica, assistente de gestão e agente escolar) e mais 9 educadoras, selecionadas segundo amostra intencional (maior tempo de contato com PSE e tempo de trabalho na escola). Foram propostas entrevistas individualizadas, com 6 questões abertas que nortearam as conversas, no local de trabalho do entrevistado. Para analisar o conteúdo das falas, foi escolhida um método qualitativo da Hermenêutica-Dialética. Como resultado notou-se que a presença constante da coordenadora em todos os grupos, no planejamento e nas conversas pode ter sugestionado um viés mais positivo na educação e mais negativo na saúde, pois nesta não há reuniões e encontros. A grande maioria não participa das ações nas escolas e não entende a sua função e importância no programa. Pelas quatro categorias criadas concluem-se que há falhas a serem trabalhadas, mas se houver mais momentos de compartilhamento entre os profissionais, seja na Saúde quanto na Educação e ações de formação (educação continuada), haverá uma melhora nas relações intersetoriais e trabalho multiprofissional. Foi proposto um encarte para ajudar na criação de estratégias para consolidar as ações dos profissionais, para melhorar a padronização das ações e de continuidade do programa. / The present study aims to analyze the perceptions, experiences and experiences of health and education professionals involved in the School Health Program (PSE) of the Municipality of Guarulhos (SP), including the researcher. For health, 10 professionals from the Family Health Unit (USF) (manager, nurse, nursing assistant, three community agents with a longer period of service in the Unit, as well as a nutritionist, social worker, physical educator and psychologist In the education, the professionals of the chosen School of the City of Guarulhos (EPG) were interviewed, being 6 of the management (supervisor, director, assistant coordinator, pedagogical coordinator, management assistant and school agent) and 9 other educators, selected according to an intentional sample (longer time of contact with PSE and working time in school). Individualized interviews were proposed, with 6 open questions that guided the In order to analyze the content of the speeches, a qualitative method of Dialectic Hermeneutics was chosen. it was noted that the constant presence of the coordinator in all groups, in planning and in conversations may have suggested a more positive bias in education and more negative health, since there are no meetings and meetings. The vast majority do not participate in school actions and do not understand their role and importance in the program. For the four categories created it is concluded that there are flaws to be worked out, but if there are more moments of sharing among the professionals, whether in Health or Education and training actions (continuous education), there will be an improvement in intersectoral relations and multiprofessional work. An insert was proposed to assist in the creation of strategies to consolidate the actions of professionals, to improve standardization of actions and continuity of the program.

WHO rekommenderar hälso- och sjukvården att bli mer hälsofrämjande. Däremot visar forskning att hälso- och sjukvården inte lever upp till denna rekommendation. Landstinget Västmanland har dock gjort en satsning på det hälsofrämjande arbetet. Fyra hälsocenter har etablerats i länet till följd av detta. Syftet med denna uppsats var att undersöka hur personalen vid dessa hälsocenter upplevde sina förutsättningar att jobba hälsofrämjande med kost- och motionsvanor. Metoden som användes för att besvara syftet var kvalitativ. Datainsamlingen skedde genom att sex semistrukturerade intervjuer genomfördes. Fem hälsovägledare och en person med övergripande ansvar för hälsocenterverksamheten intervjuades. Datamaterialet analyserades med hjälp av en induktiv och manifest kvalitativ innehållsanalys. Resultatet visar att hälsocenters arbete följer de grundprinciper som tagits fram för hälsofrämjande arbete. Stöd i organisationen och den egna kompetensen var faktorer som underlättade arbetet, medan bristfälliga lokaler och samverkansproblem till exempel var faktorer som upplevdes hindra arbetet. Slutsatserna som presenterats utifrån uppsatsens resultat var att delar av hälsocenters arbete fungerade bra men att det fanns vissa förbättringsmöjligheter. Till följd av att hälsocenters arbete bedömdes ligga i linje med grundprinciperna för hälsofrämjande arbete drogs även slutsatsen att verksamheten kan vara ett gott exempel för andra vårdorganisationer som önskar arbeta hälsofrämjande. / WHO recommend health services to become more health promoting. Yet, research indicates that health services don’t fulfill these recommendations. The county Landstinget Västmanland however, has made a commitment to work health promoting. Due to this commitment four Health facilities has been established in the county. The aim of this study was to investigate how the staff at these health facilities experienced their premises to work health promoting with diet- and physical activity habits. A qualitative method was used to answer this. Six semistructured interviews was performed to collect data. Five health counselors and one person with administrative responsibility for the health facilities was interviewed. An inductive and manifest qualitative content analysis was used to analyze the collected data. The result indicated that the health facilities was working health promoting according to the fundamental principles for health promotion. The result also showed that a supportive organization and the individual competence was two factors among others that made the work easier. Inadequate facilities and collaboration issues for example was on the other hand factors that the respondents felt complicated their work. The conclusions drawn from the result is that parts of the health facilities, health promotion work is working well, but that there is room for improvements. Also the conclusion that the health facilities can set an example for other health services that wishes to become more health promoting was drawn.

WHO rekommenderar hälso- och sjukvården att bli mer hälsofrämjande. Däremot visar forskning att hälso- och sjukvården inte lever upp till denna rekommendation. Landstinget Västmanland har dock gjort en satsning på det hälsofrämjande arbetet. Fyra hälsocenter har etablerats i länet till följd av detta. Syftet med denna uppsats var att undersöka hur personalen vid dessa hälsocenter upplevde sina förutsättningar att jobba hälsofrämjande med kost- och motionsvanor. Metoden som användes för att besvara syftet var kvalitativ. Datainsamlingen skedde genom att sex semistrukturerade intervjuer genomfördes. Fem hälsovägledare och en person med övergripande ansvar för hälsocenterverksamheten intervjuades. Datamaterialet analyserades med hjälp av en induktiv och manifest kvalitativ innehållsanalys. Resultatet visar att hälsocenters arbete följer de grundprinciper som tagits fram för hälsofrämjande arbete. Stöd i organisationen och den egna kompetensen var faktorer som underlättade arbetet, medan bristfälliga lokaler och samverkansproblem till exempel var faktorer som upplevdes hindra arbetet. Slutsatserna som presenterats utifrån uppsatsens resultat var att delar av hälsocenters arbete fungerade bra men att det fanns vissa förbättringsmöjligheter. Till följd av att hälsocenters arbete bedömdes ligga i linje med grundprinciperna för hälsofrämjande arbete drogs även slutsatsen att verksamheten kan vara ett gott exempel för andra vårdorganisationer som önskar arbeta hälsofrämjande. / WHO recommend health services to become more health promoting. Yet, research indicates that health services don’t fulfill these recommendations. The county Landstinget Västmanland however, has made a commitment to work health promoting. Due to this commitment four Health facilities has been established in the county. The aim of this study was to investigate how the staff at these health facilities experienced their premises to work health promoting with diet- and physical activity habits. A qualitative method was used to answer this. Six semistructured interviews was performed to collect data. Five health counselors and one person with administrative responsibility for the health facilities was interviewed. An inductive and manifest qualitative content analysis was used to analyze the collected data. The result indicated that the health facilities was working health promoting according to the fundamental principles for health promotion. The result also showed that a supportive organization and the individual competence was two factors among others that made the work easier. Inadequate facilities and collaboration issues for example was on the other hand factors that the respondents felt complicated their work. The conclusions drawn from the result is that parts of the health facilities, health promotion work is working well, but that there is room for improvements. Also the conclusion that the health facilities can set an example for other health services that wishes to become more health promoting was drawn.

Baggrund: Patientbehandling på sygehuse sker i et højt specialiseret tempo, hvor flere patienter modtager kompliceret pleje og behandling, som ofte fortsætter i kommunerne efter udskrivelsen. Efter strukturreformen skal aftaler om infektionshygiejnisk bistand fra sygehus til kommune indskrives i sundhedsaftaler. Formål: Formålet med studiet var at udforske og analysere samarbejde på tværs af sektorer, og få en øget forståelse for fænomenet tværsektorielt samarbejde i relation til patient/borger med behov for ydelser, hvori der indgår infektionshygiejnisk bistand. Metode: Studiet er et kvalitativt multiple casestudie, hvor empirien hentes via semistrukturerede interviews. Teorigrundlaget er perspektivet på tværsektorielt samarbejde, eksempler på modeller for samarbejde, og styrker og svagheder i samarbejde. Resultat: Studiet viste, at motiverende faktorer for tværsektorielt samarbejde i praksis var: fokus på organisering og struktur i organisationerne, at arbejde sammen i netværk, bevidsthed om klare kommunikationsveje og fokus på faglighed og kompetencer i forhold til infektionshygiejne. Struktureret samarbejde mellem kommune og sygehus med oprettelse af hygiejneorganisation mellem sektorer, gav adgang til ekspertviden, tryghed hos plejepersonalet og motivere til at arbejde med infektionshygiejne som indsatsområde. Konklusion: Nosokomielle infektioner hos patienter og borgere i sektorovergange, kan sandsynligvis forebygges ved dels at tilføre viden om infektionshygiejne til personale på alle niveauer i organisationerne, og dels ved at indgå et formelt samarbejde mellem kommune og sygehus omkring etablering af en tværsektoriel hygiejneorganisation. / Background: Today, patient care in hospitals is highly specialised and undertaken at high speed. Many patients receive complex treatment and care, which often continues in the primary-care sector after the patient is discharged. Structural reform of the health care sector requires infection control measures in intersectoral health agreements. Aim: This study aimed to investigate and analyse intersectoral collaboration and gain better understanding of collaboration across health sectors in relation to the treatment and care of patients requiring treatment and care for infection control. Method: This is a qualitative, multiple-case study, wherein semi-structured interviews form the basis of the empirical knowledge. The theory underpinning the study is the perspective on intersectoral collaboration, examples of models of collaboration, and the strengths and weaknesses of collaboration. Results: The findings showed that the motivational factors for intersectoral collaboration include focus on organisational structure and organisation, collaboration through networks, awareness of the importance of clear communication, and focus on the relationship between professional competencies and infection hygiene. Structured collaboration with the establishment of an actual infection control organisation resulted in access to expert knowledge, security among personnel, and motivation to work with infection control as an area of focus. Conclusion: Patient transference of nosocomial infections from one health sector to another likely can be prevented by increasing workers’ knowledge of infection control in all sectors, and by formalised collaboration across health sectors to establish an intersectoral, infection control organization. / <p>ISBN 978-91-86739-26-3</p>

Top-down, centralised approaches to reform of mental health services implemented over the past 15 years in Australia have failed to achieve the widely shared aim of comprehensive, integrated systems of care. Investment to date has focused on the development and integration of specialist mental health services and primary medical care, and evaluation research suggests some progress. Substantial inadequacies remain however in the comprehensiveness and continuity of care received by people affected by mental health problems, particularly in relation to social and psychosocial interventions. Intersectoral collaboration that includes the diverse range of non-medical primary health and social care services is one of the most fundamental remaining challenges facing mental health system reform.