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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Health Services Research 1/2014

Networking between community health programs: a team-work approach to improving health service provision

BMC Health Services Research > Ausgabe 1/2014
Nathan J Grills, Robert Kumar, Maneesh Philip, Gillian Porter
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

NG conceived of the study, and participated in its design and coordination. NG oversaw the implementation of the study on the ground, assisted with the thematic analysis and preparation of the paper. RK helped plan the study, gain access to the network, arranged the fieldwork, undertake the research and review the data. MP helped plan the survey, facilitated the FGDs, arranged the fieldwork, compiled the data and reviewed the findings. GP reviewed the data, corresponded with the co-authors, lead the thematic analysis of the study and lead manuscript development. All authors read and approved the final manuscript.



Networking between non-government organisations in the health sector is recognised as an effective method of improving service delivery. The Uttarakhand Cluster was established in 2008 as a collaboration of community health programs in rural north India with the aim of building capacity, increasing visibility and improving linkages with the government. This qualitative research, conducted between 2011-2012, examined the factors contributing to formation and sustainability of this clustering approach.


Annual focus group discussions, indicator surveys and participant observation were used to document and observe the factors involved in the formation and sustainability of an NGO network in North India.


The analysis demonstrated that relationships were central to the formation and sustainability of the cluster. The elements of small group relationships: forming, storming, norming and performing emerged as a helpful way to describe the phases which have contributed to the functioning of this network with common values, strong leadership, resource sharing and visible progress encouraging the ongoing commitment of programs to the network goals.


In conclusion, this case study demonstrates an example of a successful and effective network of community health programs. The development of relationships was seen to be to be an important part of promoting effective resource sharing, training opportunities, government networking and resource mobilisation and will be important for other health networks to consider.
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