Do Networks facilitate innovation, learning and sharing? An evaluation of the Quality-of-Care Network (QCN) in Bangladesh, Ethiopia, Malawi, and Uganda

Abstract

The Quality-of-Care Network (QCN), launched by WHO and partners, links global and national actors across several countries to improve maternal and newborn health. We examine if QCN facilitated learning, sharing and innovations within and between network countries.We evaluated the QCN in Bangladesh, Ethiopia, Malawi and Uganda. We conducted a total 227 qualitative interviews with QCN actors iteratively across a 3-year period from October 2019 to March 2022. We also reviewed all accessible QCN documents.Sharing and learning opportunities were evident through a number of virtual and in-person platforms such as meetings, conferences, webinars, and websites. Conferences and webinars have been hosted on online resource libraries such as the quality-of-care network website. These provided access to materials on strategies and approaches shared by different countries and actors. Innovations were also evident in some countries like Ethiopia. Innovative software applications aimed at boosting the capacity of service providers were developed and these were adopted by countries such as Bangladesh. Locally, there had been strengthening of learning collaborative meetings, coaching and mentorship. Regular meetings such as Stakeholder Coordination Meetings and Learning Collaborative Sessions provided an opportunity for stakeholders to strategize, as well as share and learn approaches within the network.The network has promoted coordination among stakeholders. Similar approaches to sharing and learning such as Learning Collaborative Sessions were evident across the study countries. Innovations were not as apparent across countries and most of the learning and sharing approaches were similar to those from broader, pre-existing maternal health approaches, adopted from an era preceding the QCN. There was evidence that the introduction of the QCN improved the functionality and visibility of learning and sharing platforms.

Factors shaping network emergence: A cross-country comparison of quality of care networks in Bangladesh, Ethiopia, Malawi, and Uganda

“…Studying QCN emergence drawing on social science scholarship [ 23 – 29 ] — provides critical insights as to why some well-intentioned top-down global health networks do not materialize in some country contexts and have relatively quick uptake in others. The pattern, speed, and extent of a network’s initial emergence is likely to reflect and have implications on a network’s legitimacy, configurations and interactions among involved actors, effectiveness in producing stated objectives, and sustainability—each of which are discussed respectively by Akter et al, [ 30 ] Mukinda et al, [ 31 ] Tesfa et al, [ 32 ] Mwandira et al, [ 33 ] Djellouli et al, [ 34 ] and Lemma et al, [ 35 ] in this paper series concerned with QCN [ S1 Text ]. An understanding of the key factors shaping variable network emergence across these countries is critical to WHO and global partners, as they seek to establish QCN activities in other countries, but also more broadly for policymakers seeking to initiate global health networks and partnerships across various contexts.…”