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Rural Health Information Hub

Challenges and Approaches


Bringing together multiple stakeholders with a variety of expertise and perspectives to work out agreed-upon goals is wise, but often difficult to accomplish. Even if the goal of the network is largely understood when a group first convenes, it can be difficult to know where to begin to tackle the issue at hand. Once that happens, it is not uncommon for there to be challenges and barriers as the network moves forward in carrying out its strategic plan.

Each network or coalition will inevitably face unique challenges specific to their circumstances, yet there are some challenges that are commonly encountered by all networks. In Using Rural Health Networks to Address Local Needs: Five Case Studies, Moscovice and Elias highlight these challenges and break them down in the following ways:

Limited time
Networks take time to develop and mature. The value of relationship development between network members cannot be overstated, nor can this process be rushed. Network and coalition work is often time-sensitive, however, which can minimize the organic process of relationship development.

Limited finances
There is almost always tension between the amount of work that needs to be done and the amount of available resources.

Other limited resources
Depending on the issues being addressed by the network, the underlying shortage of resources, such as staffing, time, and operational infrastructure, can overshadow the goals of the network.

Political pushback
Community members and member organizations may be concerned about political retaliation and negative funding implications if local politicians do not have the same priority areas as the network or coalition. This may result in network members and potential network members being reluctant to accept a network's vision and goals.

Community leaders
In order to execute the strategic plan, having network members hold upper level leadership positions within the community may be beneficial. Having these types of stakeholders is preferable, but also often unrealistic as they are often overscheduled and difficult to recruit.

Clear plans
Networks must have well-organized strategic, business (tactical), and operational plans in place for efficiency and focus. Without clear plans, network members may be inclined to place the needs of the organization they are representing ahead of the network's needs.


Challenges will be encountered. When they are, there are some key concepts that may help network members stay focused and moving in the right direction. In his report Principles of Rural Health Network Development, Bonk describes the following strategies when challenges are encountered:

Stay focused
Developing new objectives is necessary for a network to survive long-term, yet successful networks maintain a clear understanding of their overarching goals. Although the objectives may change over time, members can focus their energies on the individual objectives with which they are charged.

Be flexible
Implementation rarely mirrors projected plans. Although interruptions will occur, successful rural health networks rely on clear communication between members, which helps to keep the focus on achieving goals and allow for adjustments in the work as necessary.

Work together
It's common for larger, more established network members to be perceived by less established members as having more power or influence within the network. This should not be the case in a network context. Collaboration and consensus between all members is key to the success of the network. Members must be provided with equal opportunities to succeed, which will lead to them embracing their influence.

Embrace diversity
If all network partners share the same weaknesses and strengths, they may be no stronger together than if they were working independently. Networks should capitalize on the diversity of expertise and perspectives to grow and expand their work.

Cultivate mutual success through compromise
Compromise is a fundamental piece of networking. Although no partner accomplishes every one of their goals, they may gain more by prioritizing the network's agendas than promoting their own.

Preserve optimism
Because of the nature of the work, it's easy for network members to feel defeated or caught in a monotonous cycle at times. To encourage members, network leaders may consider organizing small celebrations of milestones or accomplishments for the network. These successes build trust among members and the belief that the network as a whole is greater than the sum of its parts.

Grow strong relationships
Open communication promotes trust between members and the executive director of the network. Trust among members will more easily lead to bonding.

For more information on challenges rural community face in terms of programming, see Common Implementation Challenges in the Rural Community Health Toolkit.

Resources to Learn More

Barriers to Starting a Coalition
Coalition membership often includes a wider variety of stakeholders, representing community leaders to executive leaders and every step in between. There may be a cultural divide between members that is somewhat different to the issues networks may face. Barriers can be found about 1/4 way down the page.
Author(s): Rabinowitz, P.
Organization(s): Community Tool Box