The importance of networks in public health practise

Many public health issues involve a complex mixture of actors from diverse sectors. Similarly, therefore, the public health response to such an issue necessitates the involvement of the private, public and not-for-profit sectors; various academic disciplines, government departments and health fields; and actors form the local, regional and global level. The mixture of diverse actors represents a public health network. The six case studies in this thesis demonstrate how public health networks are utilised as an important tool to address complex public health problems and so achieve public health objectives. This thesis presents publications from original research I undertook during placements in the Victorian Public Health Training Scheme (VPHTS). A publication from each placement forms the substantive aspect of each chapter. The publications related to an evaluation of Campylobacter surveillance in Victoria, balancing population and an individual perspective in tobacco control, developing a guideline to better utilise mortuary data for public health, utilising blood samples to determine prevalence of Pandemic (H1N1) 2009 and a prevalence study on dermatological conditions in India. Each publication contains important findings in its own right. In addition to the publication findings a surrounding commentary was developed around the theme of networking for public health practise. This networking theme is explored in more depth in the background chapter, which provides a framework within which to understand the network that existed behind each publication. This framework outlines the factors that are important in public health network activation, framing, mobilising and synthesising. They can be divided into “nodes” (or network players), and the “ties”(or relationship glue). Important nodes included network brokers, bridging nodes, facilitators, legitimate and charismatic nodes. Ties often existed around homophily and expediency. For each placement particular nodes and ties were more, or less, important in the development of an effective public health network. These particular factors are further examined in the commentary section of each chapter which discusses the context and network learnings from each project. A number of key ingredients, vis-a-vis a singular one determinant factor, were found to be important. The benefit to networking (expediency) was typically in the form of meeting organisational objectives (for example, protecting the public health in the case of the government and the World Health Organisation), publications and follow-on grants (a benefit especially important for academic players), generating resources for ongoing programmatic work (often important for the non-governmental players), and direct financial reward (especially for private for profit organisations). However, the factors that motivated nodes to activate into a network were quite different for each of the networks involved in the different placements. An important learning from the projects was that the barriers to network development need to be managed closely to ensure network success. The thesis demonstrates that networks need to be carefully facilitated to be an effective tool in public health practise. Therefore, public health practitioners will require networking skills for successful public health leadership and practise. These skills should be valued and imbibed in our public health workforce.