Background:
In India, since the 1990s, there has been a burgeoning of NGOs involved in providingprimary health care. This has resulted in a complex NGO-Government interface which isdifficult for lone NGOs to navigate. The Uttarakhand Cluster, India, links such smallcommunity health programs together to build NGO capacity, increase visibility and betterlink to the government schemes and the formal healthcare system. This research, undertakenbetween 1998 and 2011, aims to examine barriers and facilitators to such linking, orclustering, and the effectiveness of this clustering approach.
Methods:
Interviews, indicator surveys and participant observation were used to document the processand explore the enablers, the barriers and the effectiveness of networks improvingcommunity health.
Results:
The analysis revealed that when activating, framing, mobilising and synthesizing theUttarakhand Cluster, key brokers and network players were important in bridging betweenorganisations. The ties (or relationships) that held the cluster together included homophilyaround common faith, common friendships and geographical location and common mission.Self interest whereby members sought funds, visibility, credibility, increased capacity andaccess to trainings was also a commonly identified motivating factor for networking. Barriersto network synthesizing included lack of funding, poor communication, limited time and lackof human resources. Risk aversion and mistrust remained significant barriers to overcome forsuch a network.
Conclusions:
In conclusion, specific enabling factors allowed the clustering approach to be effective atincreasing access to resources, creating collaborative opportunities and increasing visibility,credibility and confidence of the cluster members. These findings add to knowledgeregarding social network formation and collaboration, and such knowledge will assist in theconceptualisation, formation and success of potential health networks in India and otherdeveloping world countries.