In MSCs the backbone function is an important aspect of governance, since dedicated staff can devote time and attention to the processes needed for aligning, like connecting and convening partners.
Although MSCs should be collaboratively governed by diverse and representative partners, dedicated staff can keep aligning efforts on track and carry out the administrative functions needed for effective governance.

Throughout this site, we will refer to “backbone organizations.” In multisector collaboratives, (MSCs), backbone organizations “[serve] as the key facilitator to convene and connect” [1] partners and community members with the MSC’s collaborative structure and initiatives. In other words, backbone organizations typically take care of the day-to-day work of collaboration in MSCs. They receive funds from grant awards, introduce partners to one another, and give a platform to community members who are unable to connect with other organizations in their healthcare system. The convening and connecting work that backbone organizations perform enables once disconnected groups of people (who could use each other’s help) to work together, get to know one another, listen to each other, and work in a systematic way.

In research on multisector collaboration, much emphasis has been placed on leadership. Inspirational leaders can encourage entire communities to try new and innovative practices, resulting in real change. Backbone organizations are often seen as the leaders in multisector collaboration, the organization at the center of collaboration that keeps the work alive.

These backbone organizations come in different forms, such as local health departments or non-profit organizations, but their role in collaborative leadership looks similar across MSCs. They create the structures that enable the work to continue. This might include a governing board that makes decisions about funding and projects, grant opportunities that fund local initiatives, community meetings that keep the MSC relevant to community issues, or contracts that facilitate partnerships between organizations.

Without backbone organizations, the difficult task of coordinating partnerships would be left to individuals at different organizations, who typically have many other responsibilities relevant to their specific organization. Backbone organizations take much of the administrative work away from individual organizations and centralize it into one place where dedicated staff can focus on facilitating lasting relationships.

Related Resources

Powering Change Curriculum: Building Healthy, Equitable Communities Together, a Population Health Innovation Lab (PHIL) and California Accountable Community for Health Initiative (CACHI) curriculum for multisector collaboratives (2021)
Accountable Community for Health (ACH) Start Up Guide, a Population Health Innovation Lab (PHIL) guide (2019)
ACH Resource Inventory, a Population Health Innovation Lab (PHIL) inventory (2020)
Backbone Organizations, a Population Health Innovation Lab (PHIL) web discussion (2021)

View all references for the Data Walk.