The network coordinators

A network coordinator is the only coordination structure in place in every HPH network, since the existence of this function is a precondition for a national / regional HPH network to be recognized by the international HPH network. However, apart from specifying the respon-sibilities of national / regional HPH networks in the standard agreement between the interna-tional network and the nainterna-tional / regional HPH networks, the internainterna-tional HPH network does not provide a role description or specific requirements for network coordinators, so that this role, in practice, takes many different forms in the observed networks.

Within the sample of 28 national / regional networks that participated in the PRICES-HPH network survey, the median time of PRICES-HPH coordinators being in service was 8.5 years, with a maximum of 17 years, and a minimum of 2 year in service in 2011. This distribution mirrors the average age of the networks in the sample. 13 coordinators (46%) reported to be on their job since the foundation of their network, 15 (54%) had taken over from a predeces-sor. Because of the over-representation of older networks amongst the vulnerable networks, the time of coordinators in service was higher in this group (median of 10 years, as opposed to a median of 7 years amongst the sustainable networks), and the proportion of networks that had experienced changes in coordination was also higher (71.4% versus 53.6% amongst the sustainable networks).

42,9 28,6

14,3 14,3

19,0 14,3

42,9 23,8

0,0 10,0 20,0 30,0 40,0 50,0

None Partly Widely Fully

Percent

sustainable vulnerable

With regard to the organizational affiliation of coordination (compare chapter 6), the pro-portion of networks coordinated by expert organizations was 28.6% both amongst the 7 vul-nerable and the 28 sustainable networks, the percentage of networks whose coordination was based at a health administration unit was considerably higher amongst the sustainable net-works (52% versus 29% of the vulnerable netnet-works), and the proportion of hospital-coordinated networks was over-represented amongst the vulnerable networks (43% versus 19% of sustainable networks). These differences are however not significant according to a chi²-test (sig. = .400) (compare Figure 64 below).

Figure 64: Percentages of networks with health administration-, hospital-, and expert organization- based network coordination in sustainable (n=21) and vulnerable networks (n=7)

Coordinators were asked in an open question to describe their professional background and career. Most coordinators listed several fields of training or expertise. An executive or quality management background (19 coordinators or 68%), an MD background (18 coordina-tors or 64%), and training or experience in health promotion / public health and prevention (17 coordinators or 61%) were mentioned most often. Less common were trainings or experi-ences in education (8 coordinators or 29%), human sciexperi-ences (5 coordinators or 18%) and nursing (2 coordinators or 7%). 3 coordinators (11%) listed other qualifications, including jurisdiction, journalism, and dental therapy. According to their own statements, 10 coordina-tors (36%) had 2 fields of professional training or experience, 8 coordinacoordina-tors (29%) had 3, 6 coordinators /21%) had 4, and 4 (14%) had 1. The most common combinations of qualifica-tions were between management and MD (13 coordinators or 46%), between MD and public health / health promotion (12 coordinators or 43%), and between management and health promotion / public health (11 coordinators or 39%). Because of the high variation amongst the coordinators’ job profiles, differences between the sustainable and the vulnerable networks are not provided.

With regard to the work time coordinators could, on average, invest in networking per week (compare chapter 6), the median weekly work time amongst the sustainable networks was 15% but only 10% in the vulnerable networks. This difference was not significant accord-ing to a Mann-Whitney rank-sum test (sig. = .796).

52,4

28,6

19

28,6

28,6

42,9

0 10 20 30 40 50 60

Health administration

Expert organization

Hospital

Sustainable Vulnerable

Interestingly enough, of the 9 coordinators (32% of the total sample) that got paid for this function, 43% came from a vulnerable network but only 29% from a sustainable network.

This distribution probably indicates that the vulnerable networks, since they were older on average, had been more successful in securing resources for network coordination. However, data suggest that this condition alone is obviously not sufficient to secure network viability.

With regard to the (central or de-central) position of the coordinator in his / her network⁵³, most coordinators (20 or 71%) saw themselves in a “central type” relation to their network members, indicating that they were the main facilitators of information, cooperation and ex-change within their network, while there was also ongoing cooperation and exex-change between the network members. 3 coordinators (11%), respectively, described themselves as being in a

“dominant” role (comparable to a CEO) and a ”monopolist” role (central, but with hardly any contact between the network members). 2 coordinators (7%) saw themselves as being in an ”egalitarian” position within their network, characterized by a “primus inter pares” position which, in one network, was the result of a rotation system in network coordination (see Figure 65 below; compare Dietscher et al. 2011a).

Figure 65: HPH coordinators’ centrality in HPH networks according to four coordination types (n=28)

No. of coordinators describing their network’s coordination type as …

3 3 20 2

a. Dominant type b. Monopolistic type c. Central type d. Egalitarian type

All vulnerable networks had described their networks’ coordination type as “central” which is probably due to the fact that all are located in Western and Southern European countries, whereas the other coordination styles described by the coordinators were reported from Northern and Eastern European, as well as non-European countries. However, it seems diffi-cult to relate the coordination style to network viability. Rather, it seems to mirror the cooper-ation style of the country / region in which the network is located.

53 The literature is quite controversial about coordination centrality in networks. While some health promo-tion scholars consider a central posipromo-tion of the coordinator as adverse to cooperapromo-tion in the network (e.g.

Brößkamp-Stone 2004), other network researchers frame central coordination as essential for network effective-ness (e.g. Janssen 2002).

8.2.2.2 Network coordination structures in addition to the coordinator