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J Health Organ Manag ; 27(2): 225-45, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23802400

RESUMO

PURPOSE: A vehicle to reduce health inequalities and improve public health has been provided by programmes at a neighbourhood level. The purpose of this paper is to analyse the development processes in four municipalities for achieving sustainable structures in area-based development programmes during and after a formal partnership period. DESIGN/METHODOLOGY/APPROACH: A case-study database was compiled based on the strategic and local work of four municipalities and four municipal housing companies who cooperated in the Partnership for Sustainable Welfare Development 2003-2009. The case-study database includes nine in-depth studies with interviews (n = 68), participant observations (n = 125), a survey (n = 1,160), and documents. The data are analysed using three theoretical concepts: political support, alliances, and citizen participation. FINDINGS: Political support, alliances, and citizen participation are important building blocks in neighbourhood development work. However, when the partnership ended there was little left that could function as a sustainable structure. Political support seems to be a means to reach the target, including ensuring a consistent approach and allocation of resources. However, the support must continue also after the intervention period, when the formal partnership collaboration ends, otherwise the established structure will soon decompose. Citizen participation is another precondition for a sustainable structure able to continue despite reduced municipal support. Alliances have the best chance of forming sustainable structures when they involve both the strategic and the operational level. ORIGINALITY/VALUE: Even though many evaluations have been conducted to capture the process of interventions, little attention has been given to the challenges facing the outcomes of the intervention when it comes to making permanent the activities for reducing health inequalities. This paper is an attempt to deal with these challenges.


Assuntos
Planejamento de Cidades/organização & administração , Participação da Comunidade , Implementação de Plano de Saúde/organização & administração , Disparidades nos Níveis de Saúde , Saúde Pública , Planejamento de Cidades/métodos , Comportamento Cooperativo , Órgãos Governamentais/organização & administração , Implementação de Plano de Saúde/métodos , Humanos , Relações Interinstitucionais , Entrevistas como Assunto , Estudos de Casos Organizacionais , Características de Residência , Suécia
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