building cross-sectoral collaborations to address perinatal health inequities: insights from the dutch healthy pregnancy 4 all-3 program

Background addressing perinatal health inequities is the joint responsibility of professionals working for local governments, the medical, social, and public health sector. cross-sectoral collaboration between these professionals is challenging. for such collaborations to succeed, a transition, ie, a fundamental shift in the dominant structure, culture, and practices at the systems level, is necessary. we investigated facilitators and barriers for cross-sectoral collaborations, when addressing perinatal health inequities in the netherlands. additionally, we studied how cross-sectoral collaborations can be facilitated by action research.methods we used interview and questionnaire data of the healthy pregnancy 4 all-3 (hp4all-3) program, which resulted from action research in six dutch municipalities. all interviews were coded using open codes related to facilitators and barriers for cross-sectoral collaboration and categorized into three subgroups: structural, cultural, or practical. the answers to the questionnaire were analyzed and summarized quantitatively.results we conducted 53 interviews with a total of 81 professionals. the most important ingredients for cross-sectoral collaborations mentioned by the interviewees were: (1) structural: having a solid network with a clear overview of professionals working in the different sectors, (2) cultural: having a joint vision/goal, and (3) practical: short lines of communication and timely sharing of information. a total of 85 professionals filled in (parts of) the questionnaire. two-thirds to over 80 percent replied that the hp4all-3 program had an added value in building cross-sectoral collaborations.conclusion our research shows that cross-sectoral collaborations in the context of perinatal health are hampered by structural, cultural, and practical barriers. analyzing facilitators and barriers at these three levels helps to identify bottlenecks in cross-sectoral collaboration. action researchers can be of great advantage in facilitating collaboration, as they can offer an open setting for reflection and instigate a sense of urgency for building collaborations.