Micro-level factors of successful cross-sectoral collaborations in palliative care in the Czech Republic.

• In Event: Key Stakeholders, Power, and Decision-Making

Abstract

In 2018, a major change was completed in the field of palliative care in the Czech Republic. Specialised mobile palliative care became part of public health insurance. This change is the result of a long-term effort of service care providers and advocacy organizations from the third sector as well as cross-sectoral collaboration (CSC) between a number of players – civil society organisations (CSOs), Ministry of Health and health insurance companies and actors from private sector and corporate foundations. Each player has had a significant role in the CSC. This particular case provides insight into advocacy activities of CSOs in post-socialist Central Europe and can serve as base for further cross-cultural comparison. The aim of this paper is to describe the specific factors that have determined the success of this collaboration.

A case study methodological framework was employed (Yin, 2014; Mills et al., 2009). As methods of data collection, document analysis (annual reports, project documentation, field studies) and in-depth interviews (Rubin & Rubin, 2012; Hermanowicz, 2002; Gee, 2014) were utilized. Interviews were conducted with stakeholders in decision-making positions from the three sectors involved.

Theoretical basis for this paper stems from studies on CSC in social services and health care (Selsky & Parker, 2005; McQuaid, 2010) predominantly from the perspective of non-profit organizations (Schiller & Almog-Bar, 2013). I employed a critical epistemological lens in my analysis, especially intersectionality (Crenshaw, 1989; Schmidt, 2009).

My findings are consistent with conditions for successful cross-sectoral collaboration in the health sector (Corbin, Jones, & Barry, 2018), particularly reflection on power, decision-making, role division, trust-building, and communication.
The main contribution to the field of study is filling the gap of studying micro-level factors of CSC, such as competencies and skills necessary for advocacy mission (Almog-bar & Schmid, 2013) and strategies for overcoming sectoral differences and addressing power inequalities (Selsky & Parker, 2005).

I would especially like to discuss one of my findings about cross-sectoral competencies. Key stakeholders in the case had experiences from different sectors. Several business sector players were Scouts (Youth CSO promoting engagement, solidarity and cooperation), the CSO staffers who succeeded in negotiations with the ministry had experience working at it, the foundation staff had experience both from the business and the nonprofit sector.

The paper also illustrates how key stakeholders emphasized professionalization and adopted a more technocratic way of arguing, contrasted to the care ethos of the non-profit service provider organizations.
Furthermore, the research adds new perspective to the question: to what extent is success tied to the interpersonal rather than interorganizational trust (Almog-Bar & Schmid, 2018), by reflecting on cross-cutting bias of gender and qualification.

References

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Author

• Alena Košák Felcmanová, Charles University, Faculty of Humanities