The factor – Effective Decision-Making Framework supporting collaboration – involves four elements:

  • Inclusive, transparent decision-making processes,
  • Effective governance that defines the rules of engagement for collaboration,
  • Optimal process for resource allocation,
  • Effective mechanisms for resolving conflict between public health and primary care.

At the systemic level, having an effective framework for decision making is a key component that helps to strengthen collaboration processes between the two sectors – public health and primary care.

The need for public health–primary care framework
For the most part, there are different decision-making frameworks that exist within public health and primary care sectors.

Related IconRelated: Optimal Use of Resources


While single-siloed frameworks guide activities carried out by public health orprimary care, a public health-primary care decision-making framework would support intersectoral collaboration decision processes. These frameworks would provide components and would ideally include a comprehensive, transparent decision-making mechanism; a governance structure that defines the rules of engagement for collaboration; an optimal means for resource allocation; and instruments for resolving conflict between public health and primary care.

A decision-making framework has two primary functions. Firstly, it is a quality assurance tool which formalizes decision making as a consistent procedure with identifiable steps. Secondly, it helps to identify the important principles and organizational values of decision making itself.

Health Quality Ontario (Health Quality Ontario, 2013) offers the following perspective. An effective systemic level decision-making framework:

  • Produces the basis for a systematic, comprehensive, coordinated systemic level approach;
  • Sustains a focus on the health and safety issues;
  • Guides with an evidence-based approach;
  • Expands the base of information used for decision-making;
  • Furnishes clarity in terms of the process followed, information used, and decisions made;
  • Strengthens the ability to evaluate risk management strategies;
  • Serves as a tool at the center of a broader framework for policy development and execution;
  • Presents greater opportunities for the involvement of interested and affected partners;
  • Provides sufficient flexibility to address a range of risk issues and situations, such as narrow applications, insufficient resources, or decision conflicts;


In developing an effective bi-sectoral decision-making framework, the following provides essential points to consider:

  • Role clarity including responsibilities, accountabilities, and relationships;
  • Goals and objectives that are mutually developed and mutually agreed upon;
  • A systemic perspective that has a focus on both sectors;
  • An approach that is collaborative, integrated, and evidence-informed;
  • Effective communication with transparent and inclusive processes.

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