Transformative governance for public health: A scoping review

Abstract

As coordination issues arise in an increasingly complex health domain with a growing number of stakeholders involved in health initiatives, WHO proposed a transformation towards a Whole of Society approach. However, this abstract approach lacks practical guidelines to tackle these issues. In domains such as the environmental policy sector, similar transformations were established by applying governance strategies. This study aims to answer, which conditions and arrangements are found in the governance literature for the coordination and evaluation of the transformation of health towards a Whole of Society approach?A systematic search was conducted by combining ’governance’, with adjectives as ’collaborative’, ’adaptive’, ’experimentalist’ and ’reflexive’ in order to target relevant governance theories in JStor, Web of Science, EBSCO and Google Scholar. Based on inclusion criteria two reviewers independently selected articles following PRISMA.Analysis of 56 articles showed that transformation should be coordinated by stimulating favourable conditions such as learning and experimenting in networks that cut across traditional boundaries. These conditions and methods can be divided into three categories. First, establish collaborations with government as equal partner by making the inclusion and decision-making process open and transparent. Second, stimulating innovation by engaging local initiatives, and supporting learning, experimentation, reflection and adaptation. Third, ensuring the sustainability of innovation by enabling institutional change.To coordinate and evaluate the transformation of health towards a Whole of Society approach, conditions may consist of a combination of collaboration, innovation and institutional change.To bring together the fragmented resources for public health, we present emerging conditions for the coordination of a Whole of Society approach as transformative governance strategy. The transformative capacity of governance can be found in the combination of the theories as adjectives: collaborative, adaptive, experimentalist and reflexive.