Initiative on Health & Peace

Cross-sector Collaboration in Accra, Ghana

Cross-sector collaboration is a tool to address systemic issues in urban slums in developing countries worldwide. In Accra, Ghana hundreds of thousands of people have flooded the modern city seeking employment and liberation from increasingly difficult lives. This rapid growth has contributed to the multitude of development challenges the community faces, including high rates of environmental deterioration, poverty and unemployment, high levels of social conflict and gender-based violence, overcrowding, inadequate housing and infrastructure, and poor sanitation and waste management.  Cross-sector collaboration is being pioneered through a model in Old Fadama, the largest urban slum in Accra, Ghana with an estimated population of 150,000. In February of 2015, the city led the development of a cross-sector collaboration to address these complex challenges, researched by Professor Jessica Kritz of Georgetown University and funded by the Conrad N. Hilton Foundation. The collaboration is facilitated by the National Catholic Health Service (NCHS), with stakeholders including four Catholic Sisters’ organizations, the Accra Metropolitan Assembly (AMA), the Old Fadama Youth Development Association (OFADA) and the Kayayei Youth Association of Ghana.

The project uses Participatory Action Research (PAR), which involves researchers and participants working together to define the problem and formulate research questions and solutions. The participants were entirely local organizations, including stakeholders from city government, local non-governmental organizations, and the slum community. The stakeholders resourced their own participation, made the strategy decisions and selected the challenge to install latrines. The PAR process introduced the concept of cross-sector collaboration, educated the stakeholders about the existing evidence, and supported the stakeholders in forming a cross-sector collaboration. Using an innovative stakeholder platform that supports cross-sector collaboration around Old Fadama community needs, the government was able to work with transparency and provide a voice for citizens to take part in resolving challenges that affect them. This stakeholder platform provides for one government official to interface with the leaders of 16 tribes of Old Fadama. These leaders’ perspectives are corroborated with 300 research participants—each of whom have their own networks and communities—to develop consensus-based solutions required to improve the lives of the 100,000-150,000 people who dwell in the slum. Each phase of the research resulted in decision-making by consensus, meaning that all stakeholders were in agreement, which led to the next phase of the project. The stakeholders’ first strategy, improving community health by installing latrines, resulted in city sanitation policy change. The strategy was adopted by local businesses, creating local sustainability and freeing the stakeholders to develop a new strategy.

Jessica Kritz, J.D.

Jessica Kritz, J.D.

Jessica Kritz studies cross-sector collaboration at the intersection of global health and conflict. She is the principal investigator on a long-term research project, funded by the Conrad N. Hilton Foundation to build a health-focused, strategic, cross-sector collaboration between city government, non-governmental and community organizations in the Old Fadama slum of Accra, Ghana. Jessica brings a multidisciplinary approach to health through her career and research trajectory, which began with dispute resolution in law and has transformed to include broader work in conflict resolution and health, with a focus on policy change in developing countries. This unique perspective has helped her to create a theory-of-change model that focuses on stakeholders and involves local communities in policy change. The model is now being tested in other slums in Accra with increasing numbers of stakeholders. Jessica is an Assistant Research Professor in the Conflict Resolution Program at Georgetown University and the Director of the Georgetown Initiative on Health and Peace.

Student Involvement

Students who demonstrate interest in cross-sector collaboration will have plenty of opportunities to work with Jessica on this project, including conducting cross-sector collaboration research, writing about the collaboration in Ghana, and contributing to the design of course modules to teach about cross-sector collaboration worldwide.

Jessica offers a course at Georgetown University titled “Strategic Collaboration: Addressing Complex Challenges through Cross-Sector Collaboration,” which serves as an introduction to this work. This course focuses on how to resolve complex challenges, which impact all sectors and often result in protracted and entrenched conflicts. The course expands upon the traditional view of conflict and development, introducing a framework for thinking about setting joint goals, enhancing communication and forming strategies across disciplinary and technical sectors and ideological boundaries. Based on evidence from well-established developed-country research and practice, and focusing the professor’s developing-country formative research, the course is built for students working with or in government, non-profit or community organizations and seeking creative means to achieve more in depth and sustainable results.