Research Article

Health Brokers: How Can They Help Deal with the Wickedness of Public Health Problems?

Table 2

Quotations to illustrate the components of the “Health Broker Wheel”.

ComponentsQuotations regarding the health brokers’ behaviours, their determinants and the different contexts of the health brokers’ work

Behaviours

Recognising opportunities“A health broker in The Hague consistently said: ‘I’m not going to commit myself to a particular activity or theme or whatever. I’m going to look what is going on here, how I can help and how I can convey the residents’ wishes to the policy official.’… I thought that this health broker in The Hague had the purest role, because she was not tied to anybody.” (Former project leader)
Agenda setting“It is important to show that there is a benefit to be gained for the other sector. If you can make that click, then you have somebody on board.” (Former project leader)
Implementing“We have said to the professionals that if there had been no health broker, things would not have changed, because things would not get started and would not be sustainable.” (Health Broker)
Network formation“You need to have people who know really intuitively how to get others involved and how to build networks, how to deal with these processes and how to get citizens involved.” (Manager at PHS)
Intersectoral collaboration“We particularly try to motivate the officials to engage in conversations with other departments and we give them tools to do so.” (Senior policy functionary)
Adaptive management“I think that you always need to connect with the culture, circumstances and opportunities of a particular setting.” (Health Broker)
Leadership“I think it is very important that health brokers have the focus on making things sustainable. How do we, if we initiated a couple of things, get people to take autonomy and carry on with it themselves?” (Manager at PHS)

COM

Capability“Someone who understands what residents’ say in their local dialect and who can explain this to the relevant officials.” (Former project leader)
Opportunity“There has to be willingness on the part of different parties to collaborate. Otherwise, it’s like flogging a dead horse. And there has to be willingness to share data.” (Public health consultant)
Motivation“I liked to initiate the discussion and let people think about ‘What could I do’ and ‘What can I contribute to health’.” (Former health broker)

Context

National context“You can say that major structural barriers are the elections, the fact that health is currently not an issue in the coalition, the fact that the left-wing green party is no longer part of the coalition… Those are stumbling blocks.” (Former health broker)
Local context“What makes it more difficult is that no two aldermen are the same, and they stay only for four years. If you want to eliminate the socioeconomic health disparities, you need to work in a much longer term. And yes, it is supported by the alderman and the municipal executive. But speeding it up and to keeping it high on the political agendas of all aldermen, that is quite difficult.” (Health broker)

Note. COM is an abbreviation of capability, opportunity and motivation.