Table 8. Final axial coding process included both inductive and deductive codes and reflects emerging themes for successful collaboration.

Levels	Starting Condition Factors Initial deductive code (Table 5)	Process Factors Initial deductive code (Table 5)
Individual (Emergent Axial code Table 7)	Individual Factors Education and Training (including skills & competencies) Preemptive technical training/ continuing education [37–45] Disease specific technical training [34,45,46] Preemptive collaborative training [47,48] Strong public-sector led training [39] training and capacity building provided a platform for better collaboration for outbreak [49] NGOs support gov. through staff training [50] Participatory epidemiology training [51] Prior Experience & Existing Relationships (informal/formal) Pre-existing multisectoral relationships [45,52–55] Previous experience collaborating for health events [34,56,57]	Individual Factors Ad hoc “just-in-time” training Shared training & organizational alignment; aggressive, rigorous, just-in-time, and critical trainings for key positions and critical events with monthly follow-up meetings to support compliance [31,58] Training and capacity building provided a platform for better collaboration for outbreak response [49] Instituting multisectoral disease specific training; Ongoing training—for new and existing systems [39,45]
Organizational (Emergent Axial code Table 7)	Organizational Factors (applicable to both starting conditions and process of collaboration): Structures Policies and Protocols Shared response guidelines [42,50] Structures frequently included policies/protocols [59,60] Reporting -Management protocol -Task Management -Response Plan -Communications/ communication strategy [34,61] Infection planning, control and traceback procedures [62] Systems Reporting, laboratory systems [59] Surveillance systems [41,58,59] Planning; Iterative Improvement of systems [46,48,60] Information management system/ database [41,48,63,64] Information Sharing (data available and useful) [45,48]) Tool sharing during response [65] Lab systems in place [59] Online system for HR recruitment [45] Intentional multidisciplinary engagement, collaborative capacity [43,48,66,67] Standard operating procedures [55] Interoperability [42] Needs assessment and prioritization [38,48] Culture Leadership, accountability, ownership, trust, transparency of processes, systems based thinking, cultural awareness and engagement Leadership to support the iterative and developmental review of collaborative processes [58] Strong, engaged Leadership [32,35,52,68] Accountability; Ownership [67,68] Cultural Engagement; Engagement; Diversity/ Involvement of community [67,69] Trust [38,41,49,70] Transparency [31,34,61] Need to understand each other’s' processes [53,70] Systems based thinking/ approach [34,48] Cultural awareness; engagement of diverse stakeholders to reflect community needs [53] Credibility [38] Human Resources Prior Experience & Relationships Existing Relationships [49] Institutional Knowledge (experience and relationships) [31,45] Revise and revisit mandates based on lessons learned [37,71] Staffing/ Roles & Responsibilities Clearly defined roles and responsibilities [35,42,65] Resources available and accessible (including Human Resource allocation) [35,45] Informed staff/ staff are aware of systems in place, increased engagement of staff [31,45] Reflexive workforce Reflexive Human Resource Protocol to ensure positions are adequately filled & workers are incentivized [31,57] Reflexive approach [31,45] Adaptability to rapidly changing context [42] Rapid start-up response; shared response guidelines [42]
Network (in/formal) (Emergent Axial code Table 7)	Network Factors Network Structures Structures & Coordinating Mechanisms Multi Sectoral Coordinating Mechanisms/ platforms for engagement [34,41,45,52,60] Memoranda of Understanding, Terms of Reference or bilateral agreements to support the development of existing relationships that promote ongoing engagement [41,45,48,72] Use of the Incident command system (ICS) [60] Creating shared protocols—platform for scientific engagement, information/ tool sharing during response [65]Reporting structure [49,60] Creating shared protocols [45] Policies -Institutional—nation-nation/ regional agreements [45,49,58,72]Basic public health and infection control measures including contact tracing, infection control procedures, and quarantine [62] Joint tasks forces and bilateral agreements ie. the crossborder task force and bilateral agreement between public hospitals [42,48,72] Jointly developed procedures to ensure coordinated investigation and cross-sector data exchange [72] Presence of Lead agency/ Task Force [41] Establish committees/ subcommittees [48,73] Established Roles & Responsibilities Clearly defined and previously established roles and responsibilities [34,42,65,72] Establish a framework with clearly established partnership roles and responsibilities [42] Identification of an inter-agency/ interdisciplinary liaison [31,73] Network Relationships Preemptive Planning Preemptive planning for potential disease threats (ex: MERS CoV, SARS, Ebola, etc.) [45] Creating common goals across the network [47] Setting goals [34] Local preparedness and logistics [43] Relationships & Partnerships Established/ preexisting relationships & partnerships [45,55,74] Established forum for information sharing, developing relationships, building capacity [49] Partnerships with clearly defined roles and responsibilities [40,42,49,54] Partnerships include public-private partnerships [49], NGO and donor partnerships [42], training and capacity building partnerships [40] Partnership with community centers that work with vulnerable populations [59,75] Partnership with external/ global organizations to support response [62,65] Partnership with experts [56,61] Partnership with patients and their families [35] Linking researchers with community representatives [51] Public-private partnerships/ public engagement [39,43] Diverse/Inclusive Stakeholder Engagement Cultural awareness/engagement/diversity and community engagement [53] Need "an expanded network of partners that includes full representation from all regions, and possibly other disciplines" [37] Diverse representation and inclusion within collaborative platforms/networks [37,45,52,56] Existing Resources Human Resources/Skilled Professionals Resources available and accessible, including Human Resource allocation and existing relationships [35,44,45,54,77] Reposition of supplies to high risk areas [41] Financial Resources/Funding Access to regional and international investors [49] Third party coordinating supported public-private mixed projects with financial support [31,39] Political environment Political will to aid in the development/ institutionalization of effective collaborative structures [41,48,65] Political support for empowered decision making [72]	Network Factors Network Leadership Support networks to identify a lead agency [41,52] Promote information sharing and joint decision-making across the network [49,60,65] Joint decision making, joint planning [60] Strong and engaged leadership [52] Multisectoral partners worked together for a common goal [47] Strategic risk communication with leadership [45] Network Management Task Management Task/ Case Management through MCMs [41] Convene regular multi-sectoral meetings [53,58,60] Shared response guidelines [52] Management protocol [58] Rapid startup response [42] Technical discussions held with community to support management systems [51] Awareness Awareness of systems in place, education/awareness, coordination, multidisciplinary info/data sharing [31,38,44,55,60,70] Increased engagement [31,45] Joint/coordinated public communications [60,70] Health threat communication includes early notification [49] Team/Internal communication includes data and information sharing [41,76] Public communication includes public awareness [54] Public release of risk analysis reports [77] Joint interviews with stakeholders [70] Finding common ground especially in regions of conflict to ensure health equity [49] Sharing perspectives [53] Behavior change communication [41] Effective information dissemination Communication Characteristics: frequent and honest [44,45] Timely; Consistent [45]; Reflexive/ flexible [59]; Iterative feedback [53]; Clear purpose [31,44,70]; Prioritized [riskbased] [45] Trust [49]; Interdisciplinary [31,53]; Contextualized [51]; Streamlined [54,70] Methods: Communication through MCMs—pre-meetings, data collection and sharing, forum for info sharing [48,58] ICS methods supported multisectoral communication/ effort [60] Regularly scheduled meetings/ Multidisciplinary meetings established/Follow-up meeting [43,48,53,58,60] Established clear lines of communication [31,43,51,77,78] Diversity of methods and platforms such as press briefs, websites, tv, newspaper, teleconferencing, listserv, available contact list, local/ regional/ cross-border meetings, periodic reporting [44,45,49,53,58,62,77,78] [38] Ongoing Stakeholder Engagement Engagement of diverse stakeholders to reflect community needs [53,75] Community engagement around prevention and control activities and biosecurity measures [51] Bottom-up approach with involvement of all levels/Champion/advocates [52,55] Action plans were agreed to with the community] needs ie. planning and implementation [51] Public, community, local authorities, govt agencies, NGOs, patients [45,49] Public health agencies/programs, travelers, global partners, federal and non-federal agencies [45] Civil-military; military/ foreign military involvement provided necessary support for other sectors [39,71,79] Monitoring and Evaluation Monitoring goals [35] Iterative review of collaborative processes [55,60] Monitoring and evaluation to show the outcome of interventions as beneficial or not [31,45,48] Research to understand outreach effectiveness [38] Resource mobilization & allocation Material distribution Established supply location [standardized, accessible, risk-based strategy); Subcommittee assigned to monitor supplies [41] Accessibility, standardized location, allocation, flow, product deployment [34,68,80] Human Resource mobilization Reflexive HR Protocol to ensure positions are adequately filled and that workers are incentivized [31,57] Additional military support allowed struggling organizations to leverage support and stay involved[71] Online recruitment [45]