Holistic view and organizational fragmentation in governance of local public health interventions

Research problem and specific questionsThis study aims to deepen the understanding of the institutional conditions within which governance and organization of local public health work is formed.

The research problem is based on fact that the governance of several welfare issues is characterized by the pursuit of a holistic view across organizational boundaries, while contemporary administrative reforms have created organizational fragmentation of the welfare bureaucracy.

Against this background, it is examined how the organizations that in practice implement Swedish public health policy navigate in a complex institutional reality.

The project examines 1) how organizations are made responsible for the implementation of Sweden´s public health policy, 2) how these organizations navigate a conflicting institutional context, and 3) which institutional arrangements do exist to bridge governance conflicts.

The project is delimited empirically to focus on local public health work with a focus on children and young people.Data and methodThe project is based on ethnographic studies of about 10 organizations that work with local public health towards children and young people, both public (local and regional governments) and non-public (civil society) organizations.

Empirical material is collected through interviews, focus group interviews and participant observation of meetings and other workplace contexts.Societal relevance and utilisationGovernance and organization for the implementation of high welfare ambitions is a big but sometimes underestimated challange.

In particular, cross-sectoral and cooperation-driven welfare areas, such as public health, are characterized by problems rooted in the fact that political and governance institutions are rarely adapted to the cross-sectoral logic.

Investigating in depth how institutional contradictions are expressed at the local organizational level generates knowledge that is necessary for the improvement of governance and organization of complex welfare issues such as public health.Plan for project realisationAccess to organizations to study is secured through dialogue with two networks for local public health work that bring together 7 and 15 public and non-public organizations respectively.

An exploratory and at the same time interactive approach allows the project to be designed in dialogue with the organizations studied. In this way, both relevance and validity in interpretations and conclusions are ensured.