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Table 8 Themes and Open Codes of Barriers and Enablers to Uptake, Implementation and Continuation of Co-financing Models

From: Financing intersectoral action for health: a systematic review of co-financing models

Example of Open Codes for BarriersSub Categories of BarriersThemeSub-Categories of EnablersExample of Open Codes for Enablers
• perceived risk,
• ambiguities,
• unclear timeframes to realise positive impact,
• concerns over likely power shifts,
• concerns over expansion of duties without matched increase in capacity,
• perceived sense of position threat,
• streamlining of functions leading to job loss,
• lack of buy-in from actors across levels,
• fear of impact on branding and position,
• unsupportive public/client groups
• Perceived underperformance of programme
Actor resistance due to perceived risk, ambiguities and threatsConceptual Buy-InFavourable political climate, client, actor and public support• Recognition of need for change
• effective incentives and perceived value,
• limited resource as opportunity
• upstream-downstream discord-non-aligned prioritisation between administrative levels of government,
• lack of consensus in negotiated details,
• ambiguous terms,
• inequitable funding arrangements,
• lack of pre-defined responsibilities,
• dissimilar shared purpose (operational, programmatic and of partnership),
• (lack of) unity between leads,
• ineffective change management,
• unclear lines of authority
Unclear terms and unmatched partnershipModel Design, Planning Framing and ImplementationEffective planning• Specific and outcome focussed framing in design and implementation,
• extensive stakeholder consultation,
• space for flexibility,
• sustainability planning,
• external facilitation and mediation
Context level for implementation• Actors were positioned to facilitate intersectoral coordination
• limited resources as obstacle,
• differential IT infrastructure- hardware/Software,
• lack of shared information sources,
• turnover of key positions (operational)
• hardware and software
Inadequate or incongruent resourcesOrganizational Resources and CapacityMatched Partnership• Matched partner resources - equal size, capacity, financial equity,
• decision-making and implementation
• differences in pay scale,
• different operational processes
Differences in human resources and ways of workingAdequate Expertise and Capacity• Expertise of implementing team,
• multidisciplinary capacity,
• capacity to offset risk and uncertainties,
• ability to be responsive to needs,
• stability of key positions
• lack of leadership readiness,
• no leadership buy in
LeadershipLeadership• Strong leadership,
• Prioritisation from leaders,
• low turnover of leadership position
• timelines not sufficient to produce impact,
• long-term sustainability to continue beyond pilot or single term
TimeTime• Time to foster relationship and achieve impact
• no confidence in partners,
• poor relationships,
• different work culture/practices/processes,
• strained communication,
• unmatched prioritisation of co-financing between collaborators
Non-constructive relational and work dynamicsRelational and Organizational CultureEstablished positive relational and work dynamics• Extensive engagements,
• effective relationships,
• mutual trust,
• culture of collaborative work,
• history/record of collaborative work and partnership, progressive understanding of each other organization, culture, and practices,
• joint-training and knowledge dissemination
• weak and subjective evidence,
• access to data and confidentiality issues,
• lack of common culture, record and practice for accountability,
• different data reporting requirements
Insufficient result-focussed practicesEvidence, Output Data Monitoring and EvaluationSet targets• Creation of interagency performance targets
Evidence of success• Demonstrated success of pilot initiatives
• different accounting techniques,
• reduced sense of financial flexibility,
• rigidity in resource allocation,
• rigid line-item accounting,
• unanticipated rise in costs, or non-budgeted cost domains,
• no matched change in accounting practice,
• allocations based on historic trends-not current needs
Unmatched methods and capacity to adapt to needsFinance and Accounting PracticesFinancial control• shared pre-negotiated control of funds