Aligning Systems to Improve Health, Equity, and Well-being

October 29th, 2021 | News


The majority of multi-sector health initiatives identify a set of four principles—or core componentsthat are similar to what is described in the Aligning for Health theory of change: purpose, data, financing, and governance. However, there is little clarity or consistent guidance on the systematic development and operationalization of these elements. Additionally, while equity is frequently cited as a guiding principle or objective, there is a lack of clear strategy for how to advance it through multi-sector efforts.

Aligning Systems for Health is a national initiative focused on identifying ways for the public health, health care, and social services sectors to align to meet the goals and needs of the people and communities they serve. The Georgia Health Policy Center (GHPC) administers a $3 million grant portfolio with funding from the Robert Wood Johnson Foundation (RWJF) to support original research and evaluation that advance alignment. 

GHPC hired us to research how multi-sector collaboratives (MSCs) could operationalize core components and equity from the RWJF Cross-sector Alignment Theory of Change. Our findings were recently published in Chapter 6 of GHPC’s new book, “Aligning Systems: Two Years of Learning.”

Our researchers focused on questions of operationalization in partnership with three MSCs working across the country: Wellville, the California Accountable Communities for Health Initiative, and the BUILD Health Challenge. The team conducted a literature scan, qualitative interviews, and a document review to develop its research paper, the findings of which included:

  1. The foundational role of governance and purpose. 
  2. The importance of relationship-building.
  3. A need to acknowledge and achieve racial equity. 

The team also developed visuals that elucidate the process of MSC development in practice. 

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