Multi-sectoral governance for health: a scoping review and typology development

Multi-sectoral governance is widely recognised as necessary to address health challenges, but approaches vary in different settings. We aimed to examine the representation and attributes of multi-sectoral governance for health in the peer-reviewed literature and develop a descriptive typology. We conducted a scoping literature review, using Arksey & O'Malley's method that included 34 articles for analysis. Most were published in 2020-25 (77%), used qualitative methods (68%), and addressed wide ranging health issues across all geographic regions. Multi-sectoral governance for health was assessed to be either single-lead (i.e. when one sector leads) or distributed (i.e. when all sectors share in governance). Single-lead multi-sectoral governance for health was further classified as: (1) deliberate, when the lead sector is clearly tasked with governing collaboration from the outset; or (2) organic, when the lead sector emerges as the sector naturally responsible for governing collaboration. Distributed multi-sectoral governance for health can be further classified as: (1) committed, when all sectors have sustained interest in contributing to collaboration; (2) flexible, when the involvement of sectors shifts depending on changing priorities and available resources; or (3) fragile, when sectors do not commit sufficiently, resulting in sub-optimal collaboration. Our findings can advance thinking on what multi-sectoral governance for health looks like, guide policymakers and other stakeholders to explicitly consider governance arrangements when planning and implementing multi-sectoral governance for health and recommend future research to explore how variations in types of multi-sectoral governance for health relate to its effectiveness.