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Intermediary organisations in collaborative environmental governance: evidence of the EU-funded LIFE sub-programme for the environment (LIFE-ENV).

ABSTRACT: In the framework of the collaborative environmental governance and specifically of network concepts, this study makes an exploratory analysis of the EU-funded LIFE sub-programme for the Environment (LIFE-ENV) and its priority area Environment and Resource Efficiency focused on the role of networks and in particular of intermediary organizations by using Social Network Analysis (SNA). More specifically, by investigating the evolving pattern of key statistics (density, clustering coefficient, betweenness and degree centrality) related to bipartite (organisations and projects) and dynamic (eleven years) networks, we identified 3003 organisations and 1006 projects and studied how they operate by forming new relations and reorganising existing connections. Results evidence that the LIFE-ENV attests a structural coherence and a stable structure over time and it is characterised by four different structures of network components, namely isolated coordinating beneficiary, isolated components, small components and giant components. Moreover, the LIFE-ENV is not a cohesive network, due to low values of both density and clustering coefficient. Based on betweenness centrality and degree centrality measures, the LIFE-ENV sub-programme has facilitated the emergence of 4855 intermediary organisations, which equals 29.5% of the total number of coordinating and associate beneficiaries involved in the programme in the eleven years considered. Transnational cooperation in the LIFE-ENV sub-programme is characterised by a different intensity of relations: some countries (i.e. Italy, Spain and Belgium) implement transnational cooperation with multiple European countries in both the North and South of Europe, while others tend to cluster with countries in the same geographical area, and lastly East European countries have limited participation in transnational cooperation. Our analysis supports the hypothesis of a declining collective action in the LIFE-ENV sub-programme.

SUBMITTER: Pisani E

PROVIDER: S-EPMC7371759 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe role of governance in strengthening tuberculosis (TB) control has received little research attention. This review provides evidence of how institutional designs and organisational practices influence implementation of the national TB control programme (NTP) in Nigeria.Main textWe conducted a scoping review using a five-stage framework to review published and grey literature in English, on implementation of Nigeria's NTP and identified themes related to governance using a health system governance framework. We included articles, of all study designs and methods, which described or analysed the processes of implementing TB control based on relevance to the research question. The review shows a dearth of studies which examined the role of governance in TB control in Nigeria. Although costed plans and policy coordination framework exist, public spending on TB control is low. While stakeholders' involvement in TB control is increasing, institutional capacity is limited, especially in the private sector. TB-specific legislation is absent. Deployment and transfer of staff to the NTP are not transparent. Health workers are not transparent in communicating service entitlements to users. Despite existence of supportive policies, integration of TB control into the community and general health services have been weak. Willingness to pay for TB services is high, however, transaction cost and stigma among patients limit equity. Effectiveness and efficiency of the NTP was hindered by inadequate human resources, dilapidated service delivery infrastructure and weak drug supply system. Despite adhering to standardized recording and reporting format, regular monitoring and evaluation, revision of reporting formats, and electronic data management system, TB surveillance system was found to be weak. Delay in TB diagnosis and initiation of care, poor staff attitude to patients, lack of privacy, poor management of drug reactions and absence of infection control measures breach ethical standards for TB care.ConclusionsThis scoping review of governance of TB control in Nigeria highlights two main issues. Governance for strengthening TB control programmes in low-resource, high TB burden settings like Nigeria, is imperative. Secondly, there is a need for empirical studies involving detailed analysis of different dimensions of governance of TB control.

Project description:In many countries, healthcare systems suffer from fragmentation between hospitals and primary care. In response, many governments institutionalized healthcare networks (HN) to facilitate integration and efficient healthcare delivery. Despite potential benefits, the implementation of HN is often challenged by inefficient collaborative dynamics that result in delayed decision-making, lack of strategic alignment and lack of reciprocal trust between network members. Yet, limited attention has been paid to the collective dynamics, challenges and enablers for effective inter-organizational collaborations. To consider these issues, we carried out a scoping review to identify the underlying processes for effective inter-organizational collaboration and the contextual conditions within which these processes are triggered. Following appropriate methodological guidance for scoping reviews, we searched four databases [PubMed (n = 114), Web of Science (n = 171), Google Scholar (n = 153) and Scopus (n = 52)] and used snowballing (n = 22). A total of 37 papers addressing HN including hospitals were included. We used a framework synthesis informed by the collaborative governance framework to guide data extraction and analysis, while being sensitive to emergent themes. Our review showed the prominence of balancing between top-down and bottom-up decision-making (e.g. strategic vs steering committees), formal procedural arrangements and strategic governing bodies in stimulating participative decision-making, collaboration and sense of ownership. In a highly institutionalized context, the inter-organizational partnership is facilitated by pre-existing legal frameworks. HN are suitable for tackling wicked healthcare issues by mutualizing resources, staff pooling and improved coordination. Overall performance depends on the capacity of partners for joint action, principled engagement and a closeness culture, trust relationships, shared commitment, distributed leadership, power sharing and interoperability of information systems To promote the effectiveness of HN, more bottom-up participative decision-making, formalization of governance arrangement and building trust relationships are needed. Yet, there is still inconsistent evidence on the effectiveness of HN in improving health outcomes and quality of care.

Project description:BackgroundMental health policy and service design is increasingly recognizing the importance of the lived experience voice and its inclusion in all aspects of work. Effective inclusion requires a deeper understanding of how best to support lived experience workforce and community members to meaningfully participate in the system.ObjectivesThis scoping review aims to identify key features of organizational practice and governance that facilitate the safe inclusion of lived experience in decision-making and practice within mental health sector contexts. Specifically, the review focuses on mental health organizations devoted to lived experience advocacy or peer support or those in which lived experience membership (paid or voluntary) is central to advocacy and peer support operations.MethodsThis review protocol was prepared with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and registered with the Open Science Framework. The review will be guided by the Joanna Briggs Institute methodology framework and is being conducted by a multidisciplinary team including lived experience research fellows. It will include published and grey literature, including government reports, organizational online documents, and theses. Included studies will be identified through comprehensive searches of five databases: PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), MEDLINE (Ovid), and ProQuest Central. Studies published in English from 2000 onwards will be included. Data extraction will be guided by pre-determined extraction instruments. Results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flow chart. Results will be presented in tabular form and narratively synthesized. The planned commencement and completion dates for this review were July 1, 2022 and April 1, 2023.DiscussionIt is anticipated that this scoping review will map the current evidence base underpinning organizational practices in which lived experience workers are involved, specifically in the mental health system. It will also inform future mental health policy and research.Trial registrationRegistration: Open Science Framework (registered: July 26, 2022; registration DOI: 10.17605/OSF.IO/NB3S5).

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Intermediary organisations in collaborative environmental governance: evidence of the EU-funded LIFE sub-programme for the environment (LIFE-ENV).

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