Strength in numbers. The whole is greater than the sum of its parts. These aphorisms are compelling because they define the power of a group committed to a common purpose and that is willing to pool resources to bring their vision to life.

Students of history know that collaboration has been a hallmark of significant historical movements, including civil rights, minimum wage, and public education. It is clear that a collaborative approach will be vitally important to enhancing the health and well-being of our communities—and the nation as a whole.

The growing numbers of multi-sector partnerships for health—also known as collaborations, coalitions, or alliances—are a recognition that the challenges facing our health ecosystem involve many players and cannot be addressed by any one organization alone.

Progress Along the Pathway for Transforming Regional Health: A Pulse Check on Multi-Sector Partnerships, a report released by ReThink Health today, provides a snapshot of these multi-sector partnerships, and reveals distinct developmental phases that they experience as they work to redesign and reimagine their regional health systems. The survey of 237 partnerships throughout the country provides rich detail about what contributes to—or gets in the way of—progress toward health improvement.

For the Pulse Check, we define three broad phases—Earlier, Middle, and Later—to describe these distinct developmental stages common to most multi-sector partnerships. When viewed this way, a clear majority of partnerships place themselves in the Earlier phase, where efforts are concentrated on improving elements within an existing health system. Far fewer have progressed to the Middle phase and even fewer to the Later phase, where the focus is on transforming the structure of the health system itself.

In the report you can learn more about the characteristics that partnerships tend to exhibit in in Earlier, Middle, and Later phases, along with information about the most common barriers partnerships face in each phase. The report also describes how partnerships build momentum, and how that varies as partnerships progress in their development.


What more do these findings tell us? How can they inform the ongoing work of partnerships, whether they are just getting started or have been around for awhile? The Pulse Check provides rich and detailed descriptions for partnerships in all phases of development. These suggestions are supported by the Pulse Check data, reflect insights from ReThink Health’s field work, and lessons from research across many disciplines:

  • All Phases: All partnerships may benefit by having a wider view of the health ecosystem in their region, and by contributing to a strategy for the region as a whole that will assure all of the vital conditions and services that people need are met.
  • Earlier Phase: Partnerships in the Earlier phase can set themselves up for success when they: (1) articulate a region-wide vision based on shared values; (2) establish authority and expand engagement far as possible; and (3) strengthen partnership infrastructure.
  • Middle Phase: Progress in the Middle phase may turn on building enough trust and transparency for more ambitious action as well as more difficult negotiations ahead. Groups may want to: (1) engage policymakers to create conditions that better enable regional action; and move beyond a reliance on short-term grants.
  • Later Phase: To propel progress in the later phase, we recommend that partnerships: (1) surface vested interests and negotiate tough topics that otherwise threaten to reinforce the status quo; (2) employ a learning practice that delivers evidence of results and is also tied to evidence of adaptation; and (3) establish new forms of distributed leadership, with a focus on broad-based coordination to avoid placing too much power in the hands of a few key players.

Pulse Check data reinforce what ReThink Health has learned from working with regional partnerships throughout the country these past 10 years: the ways in which multi-sector partnerships are led, funded, and weigh programmatic priorities are critical to their ability to truly transform their regional health ecosystem. Where does your multi-sector partnership fall in these developmental phases? Have you identified momentum builders or pitfalls? Let us know.

Keep reading the ReThinkers’ Blog to learn more about our insights from the Pulse Check…and to find out how those on the ground respond.

Support for the Pulse Check report was provided by the Robert Wood Johnson Foundation and the Rippel Foundation.

The personal views and opinions expressed in this blog (and in any comments) are those of the original authors only, and do not reflect the opinions of The Rippel Foundation or ReThink Health. Neither The Rippel Foundation nor ReThink Health is responsible for the accuracy or validity of any of the information contained in the blog or any comments. All information is provided on an “as-is” basis.

Join the Conversation

  • Toni Lewis

    The report reflects what I see in many New Jersey coalitions as a community coach. In my experience working for the County Health Rankings and Roadmaps in collaboration with New Jersey Health Initiatives, long term fiscal sustainability is seen as integral to supporting a long term vision. Coalitions of multiple organizations approach structure and sustainability with a very similar mindset as one single organization. Leadership and decision making is found at the top of a hierarchical structure. In what ways can we engage people intimately experiencing health disparity as change makers? This engagement is a momentum builder capable of inspiring long term solutions.

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