. 2024 Apr 30;102(7):521–532F. doi: 10.2471/BLT.23.291246

Table 1. Characteristics of the studies included in a systematic review of the effect of multisectoral interventions for health on health system performance.

Reference	Country, WHO region, income level^a	Study objective(s)	Methods	Data analysis
Skeen et al., 2010⁷¹	South Africa, African Region, upper middle	To assess progress in intersectoral collaboration, and intersectoral roles and responsibilities, for mental health to generate lessons that are potentially applicable to other low- and middle-income countries	Qualitative study using semi-structured interviews, and focus group discussion with policy-makers, health providers, community members and NGOs	Thematic and framework analysis for qualitative data
Barton et al., 2011⁶⁶	European cities, European Region, high	To evaluate progress by European cities in relation to healthy urban planning during Phase IV of WHO’s Healthy Cities programme (2003–2008)	Quantitative study using secondary data analysis	Quantitative analysis using descriptive approach
Paes-Sousa et al., 2011⁴⁶	Brazil, Region of the Americas, upper middle	To identify potential associations between enrolment in the Programa Bolsa Família and the anthropometric indicators: height for age, weight for age and weight for height in children < 5 years	Quantitative cohort study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Storm et al., 2011²⁵	Netherlands (Kingdom of the), European Region, high	To analyse opportunities to reduce health inequalities in the Dutch population by health in all policies strategy; identify ongoing policy resolution inside and outside the health domain with potential impact on health inequalities (and their determinants); and identify critical factors (e.g. drivers and barriers) with regards to collaboration between various ministries	Qualitative study using policy document review, semi-structured interviews and focus group discussion with policy-makers	Thematic analysis for qualitative data
Ramanadhan et al., 2012³⁸	USA, Region of the Americas, high	To explore the concept of community mobilization and intersectoral collaboration in the context of community-based participatory research to reduce cancer disparities	Social network analysis using semi-structured interviews and quantitative survey involving policy-makers, health providers, community members, private sectors, NGOs, media and academics	Quantitative analysis using descriptive, inferential and social networks analysis
Serrate et al., 2012²⁰	Cuba, Region of the Americas, upper middle	To identify social actors’ perceptions of the process of intersectoral action, and its implications for population health and well-being	Mixed-methods study using survey (self-administered) and participatory discussion	Qualitative and quantitative descriptive analyses
Fawcett et al., 2013⁵⁴	USA, Region of the Americas, high	To determine whether the implementation of the health for all model (within the Latino Health for All Coalition in Kansas City, Kansas) was consistent with principles of community-based participatory research	Mixed-methods study using semi-structured interviews and quantitative survey with community members and NGOs	Content analysis for qualitative data and descriptive analysis for quantitative data
Guanais, 2013⁶⁰	Brazil, Region of the Americas, upper middle	To examine how enhanced access to medical services and expansion of poverty alleviation measures interact in the reduction of infant mortality	Quantitative study using secondary data analysis for the ecological longitudinal approach	Quantitative analysis using descriptive and inferential analysis
Johnson Thornton et al., 2013⁷²	USA, Region of the Americas, high	To describe the methods and results of a health impact assessment of TransForm Baltimore, a rezoning effort in Baltimore, Maryland, and highlight findings specific to physical activity, violent crime and obesity	Mixed-methods study using secondary data analysis, policy documents review, and in-depth interviews with policy-makers from Department of Planning and city officials	Content analysis for qualitative data and quantitative impact assessment using ArcGIS (Esri, Redlands, USA)
Prasad et al., 2013⁷⁶	India, South-East Asia Region, upper middle	To document strategies employed under the National Rural Health Mission, evaluate their impacts on reducing inequities and propose the mission as a model to address inequities	Case study by data collection using secondary data analysis and policy document review	Qualitative analysis using descriptive approach
Shei, 2013⁷⁰	Brazil, Region of the Americas, upper middle	To examine whether the implementation and expansion of the major antipoverty (conditional cash transfer) Programa Bolsa Família was associated with improved infant health	Quantitative study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Addy et al., 2014²⁷	Canada, Region of the Americas, high	To highlight a case for how polycentric governance underlying the whole-of-society approach is already functioning, while outlining an agenda to enable adaptive learning for improving such governance processes	Case study using secondary data analysis and policy document review	Qualitative data analysis using descriptive approach
Bardosh et al., 2014³⁹	Lao People's Democratic Republic, Western Pacific Region, lower middle	To identify and investigate the sociocultural drivers and major transmission pathways of Taenia solium, assess community responses to an intervention, and explore locally acceptable strategies for long-term sustainable parasite control in the villages of highest incidence	Qualitative study using observation, semi-structured interviews and focus group discussion with community members	Thematic analysis for qualitative data
Baum et al., 2014³⁵	Australia, Western Pacific Region, high	To determine the extent to which health in all policies is effective as a method of developing and delivering public policy that modifies the determinants of health in ways that improve population health and/or reduce health inequalities	Mixed-methods study using policy document review, semi-structured interviews, quantitative survey and focus group discussion with policy-makers	Thematic analysis for qualitative data and descriptive analysis for quantitative data
Bohn et al., 2014⁶⁹	Brazil, Region of the Americas, upper middle	To verify whether conditional cash transfer policies have any impact on three important spheres of an individual’s life: consumption (the attainment of food security), inversion (access to the education system and acquisition of professional qualification) and production (entry into the job market)	Mixed-methods study using in-depth interviews and quantitative survey with community members	Content analysis for qualitative data and descriptive and inferential analysis for quantitative data
Nascimento et al., 2014⁵¹	Brazil, Region of the Americas, upper middle	To determine how social agendas are impacting living conditions and health in municipalities of the five regions of Brazil, and to demonstrate the impact of social agendas on selected millennium development goal indicators in Brazilian municipalities	Quantitative study using semi-structured interviews with municipal managers and secondary data analysis for the ecological longitudinal approach	Quantitative analysis using descriptive and inferential analysis
Nery et al., 2014⁴³	Brazil, Region of the Americas, upper middle	To evaluate the impact of the Programa Bolsa Família and a family health programme on the incidence and detection of leprosy in Brazil during 2004–2011	Quantitative ecological study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Newman et al., 2014²⁶	Australia, Western Pacific Region, high	To develop the evidence framework for healthy weight policy levers, develop a document analysis process, identify policy opportunities in South Australia government departments and consult with departments to develop policy recommendations	Qualitative study using policy document review	Qualitative analysis using descriptive approach
Pridmore et al., 2015⁴⁸	Chile, Region of the Americas, high; Kenya, African Region, low	To use a controlled action research intervention and evaluate its impact on the nutritional status of children living in informal settlements in the cities of Mombasa (Kenya) and Valparaiso (Chile)	Non-RCT using quantitative survey and workshops involving policy-makers, health providers, community members and NGO representatives	Content analysis for qualitative data, and descriptive and inferential analysis for quantitative data
Kusuma et al., 2016⁵⁵	Indonesia, South-East Asia Region, upper middle	To provide evidence on the effects of household and community cash transfers on determinants of maternal mortality, and provide a comparison of their effectiveness	RCT study using secondary data with clustered-randomized trials design	Quantitative analysis using inferential analysis
Olu et al., 2016⁴⁷	African countries, African Region, low	To evaluate progress in the nine Sendai Framework for Disaster Risk Reduction targets, document lessons learnt and propose recommendations for accelerating the framework implementation within the health sectors	Mixed-methods study by using secondary data analysis, quantitative survey, and focus group discussion meetings involving health ministry policy-makers and NGO representatives (WHO)	Qualitative data analysis and descriptive analysis for quantitative data
Owusu-Addo, 2016⁶¹	Ghana, African Region, low	To understand the impact of conditional cash transfers on child health in rural Ghana	Qualitative study using semi-structured interviews with health providers, community members and programme implementers	Thematic analysis for qualitative data
Basso et al., 2017⁵⁰	Uruguay, Region of the Americas, high	To assess the effectiveness of the Innovative Intervention approach and its acceptance	RCT study using entomological survey and quantitative survey with policy-makers and community members	Quantitative analysis using descriptive, inferential and cost analysis
Baum et al., 2017⁴⁰	Australia, Western Pacific Region, high	To describe the extent to which non-health actors engaged with the South Australian health in all policies initiative, determine why they were prepared to do so and explain the mechanisms of successful engagement	Qualitative study using policy document review and in-depth interviews with policy-makers, academics and public servants	Thematic analysis for qualitative data
Durovni et al., 2017⁵²	Brazil, Region of the Americas, upper middle	To examine the effect of the family health strategy and conditional cash transfer programme on tuberculosis outcomes in Rio de Janeiro	Secondary data analysis using data from patients in data registry	Quantitative analysis using inferential analysis
Ekirapa-Kiracho et al., 2017⁵³	Uganda, African Region, low	To determine the effect of this participatory multisectoral intervention on the use of maternal and newborn services and care practices in the intervention and comparison areas, and determine the predictors of maternal service use and newborn care practices	Non-RCT using quasi-experimental pre- and post-comparison approach via observation of health provider or facility	Quantitative analysis using inferential analysis
Kananura et al., 2017⁷³	Uganda, African Region, low	To explore the effect of a participatory multisectoral maternal and newborn intervention on birth preparedness and knowledge of obstetric danger signs among women in eastern Uganda	RCT study using quasi-experimental pre- and post-comparison design with health provider	Quantitative analysis using inferential analysis
Nery et al., 2017⁴⁴	Brazil, Region of the Americas, upper middle	To evaluate the impact of the Programa Bolsa Família on the incidence of tuberculosis	Quantitative ecological study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Ruducha et al., 2017⁵⁷	Ethiopia, African Region, low	To assess changes in the health and non-health policy and programme environment that contributed to or detracted from progress in child survival; examine the trends of health financing; assess coverage trends and equity of high-impact interventions; and develop estimates of selected high-impact interventions that possibly contributed to child survival using the Lives Saved Tool	Case study using secondary data analysis, policy document review, and in-depth interviews with policy-makers and NGOs	Descriptive analysis and predictive modelling using the Lives Saved Tool for quantitative data and evaluation framework from Countdown case study⁸²
Triyana et al., 2017⁵⁸	Indonesia, South-East Asia Region, upper middle	To extend earlier reports by exploring antenatal care component coverage for specific service items and antenatal care provider quality of midwives, and add to the current understanding on how conditional cash transfer programmes affect antenatal care services as a channel to improve pregnancy outcomes	Quantitative study using secondary data analysis	Quantitative analysis using descriptive and inferential analysis
Das et al., 2018²³	Afghanistan, Eastern Mediterranean Region, low	To examine the effect of multisectoral collaboration using the case study of the Basic Package of Health Services	Case study by using secondary data analysis, policy document review, and focus group discussion involving policy-makers, health providers, NGO representatives and donors	Qualitative analysis using descriptive approach and content analysis
Hall et al., 2018³⁴	USA, Region of the Americas, high	To explore whether government officials and advocates use the health in all policies framework to elevate health equity as a policy concern across sectors and jurisdictions	Qualitative study using semi-structured interviews with policy-makers and government officials	Thematic analysis for qualitative data
Milman et al., 2018²²	Chile, Region of the Americas, high	To summarize progress towards implementation of Chile Crece Contigo, investigating how cross-sectoral collaboration and coordination were managed to provide integrated child development care on a national scale	Qualitative study using in-depth interviews and focus group discussion (multistakeholder dialogue) with policy-makers and health provider or facility	Thematic analysis for qualitative data
Renner et al., 2018²¹	Germany, European Region, high	To describe to what extent the change framework condition is reflected in the attitude and action of health actors and whether related to intersectoral changes, and identify barriers and facilitators for intersectoral collaboration	Mixed-methods study using guided telephone interview, expert focus groups and workshop with specialists, as well as monitoring survey	Descriptive and inferential statistics for quantitative data; qualitative data not presented
Sohn et al., 2018³¹	USA, Region of the Americas, high	To identify perceived effect of health impact assessments, and outline the mechanisms through which these effects can occur	Mixed-methods study using semi-structured interviews and quantitative survey with policy-makers, health providers, community members, private actors and NGOs	Thematic analysis for qualitative data, and descriptive and inferential analysis for quantitative data
Velásquez et al., 2018³²	Guatemala, Region of the Americas, upper middle	To examine the factors that enable multisectoral collaboration	Case study using in-depth interviews with policy-makers, health providers, NGOs and donors	Thematic analysis for qualitative data
Agbo et al., 2019³³	Guinea, Liberia and Sierra Leone, African Region, low	To outline the process of and highlight progress towards One Health institutionalization	Case study using secondary data analysis	Qualitative data analysis using descriptive approach
Baum et al., 2019⁸⁰	Australia, Western Pacific Region, high	To examine the extent to which the activities of the South Australian health in all policies initiative can be linked to population health outcomes	Mixed-methods study using policy document review, semi-structured interviews and quantitative survey with policy-makers	Thematic analysis for qualitative data and inferential analysis for quantitative data
Hall et al., 2019⁷⁸	Timor-Leste, South-East Asia Region, low	To investigate intersectoral collaboration for people-centred mental health care in the mental health system	Qualitative study using in-depth interviews with policy-makers, health providers, community members, private actors and NGOs	Qualitative data analysis using social network analysis
Kietzman et al., 2019²⁹	USA, Region of the Americas, high	To describe collaborative efforts of Healthy Aging Partnerships in Prevention Initiative to enhance local capacity by training personnel from community health centres and community-based organizations, implementing a small grants programme and forming a community advisory council	Case study using situation report based on pilot study	Qualitative data analysis using descriptive approach
Moncayo et al., 2019⁴²	Ecuador, Region of the Americas, lower middle	To evaluate the effect of social programme Bono de Desarrollo Humano in mortality of children < 5 years in counties (from poverty-related causes including diarrhoea, malnutrition and lower respiratory infections) and on some of the potential intermediate mechanisms	Quantitative ecological study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Olney et al., 2019⁴⁵	Burundi, African Region, low	To estimate the secondary impacts of a food-assisted multisectoral nutrition programme (Tubaramure) on children’s motor and language development	RCT study using quantitative household survey and measurement of clinical indicators with community members (mother and children)	Quantitative analysis using descriptive, inferential, and predictive or modelling analysis
Pescud et al., 2019²⁸	Australia, Western Pacific Region, high	To explore the public policy attention given to inequities in obesity using a case study	Qualitative study using in-depth interviews with policy-makers, government actors and NGO representatives	Thematic analysis for qualitative data
van Eyk et al., 2019³⁷	Australia, Western Pacific Region, high	To provide insight into the facilitators of and impediments to intersectoral efforts to progress shared educational and health goals and achieve sustainable change, and identify lessons for others intending to use this approach	Mixed-methods study using secondary data analysis, policy document review and semi-structured interviews with policy-makers	Thematic analysis for qualitative data and descriptive analysis for quantitative data
Aizawa, 2020⁷⁷	India, South-East Asia Region, lower middle	To describe the extent to which expanded eligibility criteria and increased cash incentive affect health care use, and to examine whether policy reform mitigates or deteriorates socioeconomic inequality in use of health care	Quantitative study using secondary data analysis	Quantitative analysis using descriptive and inferential analysis
de Araujo Palmeira et al., 2020⁶⁷	Brazil, Region of the Americas, upper middle	To examine prospectively access to 27 government programmes related to food and nutrition services among families living in a socioeconomically deprived municipality during 2011–2014, and determine whether access to different programmes was associated with changes in the household food insecurity status over time	Quantitative study using cross-sectional survey with community members and policy document review	Quantitative analysis using descriptive and inferential analysis
Stoner et al., 2020⁶²	South Africa, African Region, upper middle	To determine how the cash transfer intervention (Swa Koteka) and components of study participation influenced sexual behaviour in young women (age 13–20 years), and explore mechanisms through which the programme affected this behaviour	Qualitative study using semi-structured interviews with community member (young women)	Thematic analysis for qualitative data
Alves et al., 2021⁶⁵	Brazil, Region of the Americas, upper middle	To investigate the association between the expansion of the Programa Bolsa Família in Brazil and malaria incidence in endemic Brazilian municipalities between 2004 and 2015	Quantitative ecological study using secondary data analysis	Quantitative analysis using descriptive and inferential analysis
Asaaga et al., 2021⁴¹	India, South-East Asia Region, lower middle	To inform the effective operationalization of contextually appropriate One Health by improving practical understanding of the policy and local influences its implementation, and identify barriers and facilitators linked to the prevention and control of zoonoses	Qualitative study using policy document review and semi-structured interviews with key actors and One Health practitioners	Thematic analysis for qualitative data
Ramponi et al., 2021⁸¹	Malawi, African Region, low	To illustrate an analytical framework that lays out the various effects, and makes explicit the opportunity costs, of a social cash transfer programme to each stakeholder to communicate the value of a cross-sectoral policy	Quantitative economic evaluation study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Rasella et al., 2021³⁰	Brazil, Region of the Americas, upper middle	To assess the impact of the Programa Bolsa Família on maternal mortality and evaluate its effects on potential intermediate mechanism	Quantitative study using secondary data analysis	Quantitative analysis using predictive or modelling analysis
Turner et al., 2021⁷⁴	Colombia, Region of the Americas, upper middle	To analyse how intersectoral coordination took place in three cities (Bogota, Cali and Cartagena) and describe the main roles that two sectors (academic institutions and private enterprise) assumed in their efforts to assist the response of the health sector to the COVID-19 pandemic	Qualitative study using semi-structured interviews with policy-makers, private actors and academia	Thematic analysis for qualitative data
Al Dahdah et al., 2022⁴⁹	India, South-East Asia Region, lower middle	To explore the genesis of India’s digital turn in health care and map the characteristics of such a policy, based on empirical analysis of Rashtriya Swasthya Bima Yojana, India’s first digital-based UHC programme	Qualitative study using secondary data analysis and in-depth interviews with policy-makers, health providers, community members and private actors	Thematic analysis for qualitative data
Blanken et al., 2022³⁶	Netherlands (Kingdom of the), European Region, high	To explore and compare the development of structures of information exchange in networks over time, concerning both material and knowledge-based information	Mixed-methods study using semi-structured interviews and quantitative survey with policy-makers, health providers, community members and NGOs	Descriptive analysis for quantitative data and social network analysis
Bokhour et al., 2022⁵⁶	USA, Region of the Americas, high	To evaluate the use of a whole health system of care on opioid use (because of the focus of the Comprehensive Addiction and Recovery Act focus on opioid use) and assess the impact on patient-reported outcomes	Quantitative case–control study using secondary data analysis and quantitative survey with community members (veterans)	Quantitative analysis using descriptive and inferential analysis
Machado et al., 2022⁶⁸	Brazil, Region of the Americas, upper middle	To investigate the association of a large conditional cash transfer programme with the reduced occurrence of suicide	Non-RCT using quasi-experimental pre- and post-comparison using secondary data analysis	Quantitative analysis using inferential analysis
Wang et al., 2022⁵⁹	China, Western Pacific Region, upper middle	To investigate China’s COVID-19 vaccination system and summarize its implementation experience from a health system perspective	Qualitative study using policy document review and semi-structured interviews with policy-makers, health provider and government staff at community level	Thematic analysis for qualitative data
de Jong et al., 2023²⁴	Netherlands (Kingdom of the), European Region, high	To provide insights into the processes of a coalition that facilitate building and maintaining intersectoral collaboration within a health promotion programme, and describe how these processes contribute to the success of the coalition	Qualitative study using in-depth interviews and observation with community members and private actors	Qualitative analysis using document and composed network analysis
Jimenez et al., 2023⁷⁹	Ethiopia and countries in western Africa, African Region, low	To describe how the bottom-up community inclusiveness developed during the Ebola virus disease outbreak enhanced pandemic preparedness, and how community resilience was improved through sustainable entrepreneurs implementing One Health policies	Case study using participant observation and policy document review	Qualitative analysis using descriptive approach
Naughton et al., 2023⁷⁵	Ireland, European Region, high	To explore the experiences of the members of the schools teams model in Ireland to identify factors that influenced effective interdisciplinary working, and describe how lessons learnt can inform future multisectoral collaborations to address complex public health priorities	Mixed-methods study using semi-structured interviews and online survey with schools teams members	Thematic analysis for qualitative data and descriptive analysis for quantitative data
Sello et al., 2023⁶³	South Africa, African Region, upper middle	To identify how different care support systems can be linked to ensure optimal childhood nutrition outcomes	A sequential mixed-methods approach	Descriptive quantitative analysis and thematic analysis for qualitative data
Silva et al., 2023⁶⁴	Brazil, Region of the Americas, upper middle	To characterize the nutritional and breastfeeding status of children < 2 years among both beneficiaries and non-beneficiaries of Programa Bolsa Família	A cross-sectional study based on food and nutritional surveillance data	Quantitative data analysis using χ² and estimating odds ratio

COVID-19: coronavirus disease 2019; NGO: nongovernmental organization; RCT: randomized controlled trial; UHC: universal health coverage; WHO: World Health Organization.

^a World Bank Classification.