Intended for healthcare professionals

Analysis Making Multisectoral Collaboration Work

Business not as usual: how multisectoral collaboration can promote transformative change for health and sustainable development

BMJ 2018; 363 doi: (Published 07 December 2018) Cite this as: BMJ 2018;363:k4771
  1. Shyama Kuruvilla, senior strategic adviser1,
  2. Rachael Hinton, technical officer2,
  3. Ties Boerma, director and professor3,
  4. Ryan Bunney, intern4,
  5. Nuria Casamitjana, training and education director5,
  6. Rafael Cortez, senior economist and team lead6,
  7. Patrizia Fracassi, senior nutrition analyst and strategy adviser7,
  8. Jennifer Franz-Vasdeki, independent consultant8,
  9. Daniel Helldén, research assistant9,
  10. Joanne McManus, independent consultant10,
  11. Susan Papp, managing director of policy and advocacy11,
  12. Kumanan Rasanathan, coordinator health systems12,
  13. Jennifer Requejo, senior adviser13,
  14. Karlee L Silver, co-chief executive officer14,
  15. Petra Tenhoope-Bender, technical adviser15,
  16. Yael Velleman, senior policy analyst16,
  17. Mary Nell Wegner, executive director17,
  18. Corinne E Armstrong, independent consultant18,
  19. Sarah Barnett, counsultant19,
  20. Carla Blauvelt, country director20,
  21. Saidatul Norbaya Buang, public health physician21,
  22. Louise Bury, independent consultant22,
  23. Emily A Callahan, consultant23,
  24. Jai K Das, senior instructor24,
  25. Vandana Gurnani, joint secretary25,
  26. Mary White Kaba, independent consultant26,
  27. Helia Molina Milman, dean of the medical sciences faculty27,
  28. John Murray, independent consultant28,
  29. Ilona Renner, research manager29,
  30. Marion Leslie Roche, senior technical adviser30,
  31. Victoria Saint, independent consultant31,
  32. Sarah Simpson, independent consultant32,
  33. Hasina Subedar, adviser33,
  34. Daria Ukhova, independent consultant34,
  35. Claudia Nieves Velásquez, independent consultant35,
  36. Patricia Young, director36,
  37. Wendy Graham, professor37,
  38. PMNCH Multisectoral Collaboration Study Group
  1. 1World Health Organization, Geneva, Switzerland
  2. 2Partnership for Maternal, Newborn, and Child Health, Geneva, Switzerland
  3. 3Countdown to 2030, and University of Manitoba, Manitoba, Canada
  4. 4World Health Organization, Chicago, USA
  5. 5ISGlobal, Barcelona Institute for Global Health, University of Barcelona, Spain
  6. 6World Bank, Washington DC, USA
  7. 7Scaling up Nutrition Secretariat, Geneva, Switzerland
  8. 8Seattle, USA
  9. 9Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  10. 10Oxford, UK
  11. 11Women Deliver, New York, USA
  12. 12WHO Cambodia, Phnom Penh, Cambodia
  13. 13UNICEF, New York, USA
  14. 14Grand Challenges Canada, Toronto, Canada
  15. 15UNFPA, Geneva, Switzerland
  16. 16WaterAid, London, UK
  17. 17Maternal Health Task Force, Harvard University TH Chan School of Public Health, Boston, Massachusetts, USA
  18. 18London, UK
  19. 19SB Consultancy World, Bristol, UK
  20. 20VillageReach, Lilongwe, Malawi
  21. 21Family Health Development Division, Ministry of Health, Kuala Lumpur, Malaysia
  22. 22Global Research Consultancy, Ipswich, UK
  23. 23EAC Health and Nutrition, Washington DC, USA
  24. 24Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
  25. 25Ministry of Health and Family Welfare, Government of India, New Delhi, India
  26. 26Montreal, Canada
  27. 27University of Santiago, Chile
  28. 28Iowa City, Iowa, USA
  29. 29National Centre for Early Prevention, Federal Centre for Health Education, Cologne, Germany
  30. 30Nutrition International, Adolescents’ and Women’s Health and Nutrition, Ottawa, Ontario, Canada
  31. 31Berlin, Germany, Council on International Educational Exchange (CIEE), Berlin, Germany
  32. 32EquiACT 71, Montluel, France
  33. 33National Department of Health, Pretoria, South Africa
  34. 34Berlin, Germany
  35. 35Guatemala City, Guatemala
  36. 36Child to Child, London, UK
  37. 37London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to: S Kuruvilla kuruvillas{at}

Shyama Kuruvilla and colleagues present findings across 12 country case studies of multisectoral collaboration, showing how diverse sectors intentionally shape new ways of collaborating and learning, using “business not as usual” strategies to transform situations and achieve shared goals

The 2030 Agenda for Sustainable Development states that if the “interlinkages and integrated nature of the Sustainable Development Goals (SDGs)” are realised, then “the lives of all will be profoundly improved and our world will be transformed for the better.”1

In line with the SDGs, multisectoral action (box 1) is a key action area of the Global Strategy for Women’s, Children’s and Adolescents’ Health.2 It is central to other global health priorities, for example, universal health coverage, the prevention and control of non-communicable diseases, and the “health in all policies” approach.345 A fundamental question arises: could the transformative changes envisioned in the SDGs be achieved by each sector acting independently, or do they require multisectoral collaboration (see box 1 for definitions)?

Box 1


  • Stakeholders are actors, whether individuals or groups, who can influence or be affected by a particular concern, process, or outcome.6 Stakeholders may include governments, non-governmental organisations (NGOs), civil society, private actors, international organisations, donors, service users, service providers, the media, and other groups.

  • Sectors comprise an array of actors and institutions linked by their formal, functional roles or area of work. Highlighted here are sectors related to specific policy areas or topics, including those relevant to the 17 SDGs. These sectors can be supported by institutions, which assume cross cutting functions, such as those responsible for budgeting or planning. These sectors and cross cutting institutions can include both public and private entities. The term “sector” also can be used to denote these entities, as in discussions about the “public sector” and the “private sector.” …

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