Governance characteristics in building collaborative networks: lessons from a local initiative to reduce health inequalities

Introduction: Despite extensive policy interventions, health inequalities persist. Local networks increasingly play an important role to combat inequalities. The aim of this study is to gain more insight into the governance characteristics that determine the successful establishment and early survival of a local collaborative network. Specifically, we will focus on which structural and relational characteristics of collaborative governance facilitate or hamper the initiative during the starting phase, and why. Methods: We analyze the illustrative case of Healthy and Happy The Hague, a collaborative network in one of the larger cities in the Netherlands, the main goal of which is to reduce socioeconomic health inequalities. Data collection consisted of three elements: retrospective, semi-structured interviews with participants of the network were conducted, re-occurring meetings were observed, and policy documents were systematically analyzed. A deductive analysis method was used. Results: The most important structural characteristics contributing to reducing health inequalities are multilevel collaboration, context-governance fit and adequate resources. Besides, the most important relational governance characteristics consist of incentives and commitment to collaborate, personal leadership, communication, and knowledge acquisition. Conclusion: This study shows the importance of governance characteristics when building local collaborative networks. We describe both structural and relational governance characteristics from the collaborative governance literature relevant for starting and continuing local and regional initiatives, such as our illustrative case study.