BACKGROUND While intersectoral collaboration is considered valuable and important for achieving health outcomes, there are few examples of successes. The literature on intersectoral collaboration suggests that success relies on a shared understanding of what can be achieved collectively and whether stakeholders can agree on mutual goals or acceptable trade-offs. When health systems are faced with negotiating intersectoral responses to complex issues, achieving consensus across sectors can be a challenging and uncertain process. Stakeholders may present divergent framings of the problem based on their disciplinary background, interests and institutional mandates. This raises an important question about how different frames of problems and solutions affect the potential to work across sectors during the initiating phases of the policy process. METHODS In this paper, this question was addressed through an analysis of the case of the First 1000 Days (FTD) Initiative, an intersectoral approach targeting early childhood in the Western Cape Province of South Africa. We conducted a documentary analysis of 34 policy and other documents on FTD (spanning global, national and subnational spheres) using Schmidt's conceptualisation of policy ideas in order to elicit framings of the policy problem and solutions. RESULTS We identified three main frames, associated with different sectoral positionings - a biomedical frame, a nurturing care frame and a socioeconomic frame. Anchored in these different frames, ideas of the problem (definition) and appropriate policy solutions engaged with FTD and the task of intersectoral collaboration at different levels, with a variety of (sometimes cross) purposes. CONCLUSIONS The paper concludes on the importance of principled engagement processes at the beginning of collaborative processes to ensure that different framings are revealed, reflected upon and negotiated in order to arrive at a joint determination of common goals.

中文翻译：

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不同框架对跨部门合作的早期阶段的影响：西开普省的“第一千天”倡议的案例。

背景技术虽然跨部门合作被认为对实现健康成果具有重要意义和重要性，但很少有成功的例子。有关部门间合作的文献表明，成功取决于对集体可达成的目标以及利益相关者是否可以就共同目标或可接受的权衡达成共识的共识。当卫生系统面临跨部门对复杂问题的应对谈判时，跨部门达成共识可能是一个充满挑战和不确定性的过程。利益相关者可能会根据其学科背景，兴趣和机构要求来提出不同的问题框架。这就提出了一个重要的问题，即在政策过程的初始阶段，不同的问题和解决方案框架如何影响跨部门工作的潜力。方法在本文中，通过分析“头1000天（FTD）倡议”的案例解决了这个问题，这是一种针对南非西开普省幼儿的跨部门方法。我们使用施密特（Schmidt）对政策思想的概念化，对有关FTD（跨越全球，国家和次国家领域）的34项政策和其他文件进行了文献分析，以得出政策问题和解决方案的框架。结果我们确定了与主要部门定位相关的三个主要框架：生物医学框架，营养护理框架和社会经济框架。在这些不同的框架中，紧紧围绕着与FTD进行合作的问题（定义）的思想和适当的政策解决方案，以及不同级别的部门间协作的任务，有各种各样的目的（有时是交叉的）。结论本文总结了有原则的参与过程在协作过程开始时的重要性，以确保揭示，反思和协商不同的框架，以便共同确定共同的目标。