Individual interactions in a multi-country implementation-focused quality of care network for maternal, newborn and child health: A social network analysis.

Autor:	Mukinda FK; School of Public Health, University of the Western Cape, Cape Town, South Africa., Djellouli N; Institute for Global Health, University College London, London, United Kingdom., Akter K; Perinatal Care Project, Diabetic Association of Bangladesh, Dhaka, Bangladesh., Sarker M; Perinatal Care Project, Diabetic Association of Bangladesh, Dhaka, Bangladesh., Tufa AA; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Mwandira K; Parent and Child Health Initiative PACHI, Lilongwe, Malawi., Seruwagi G; School of Public Health, Makerere University, Kampala, Uganda., Kyamulabi A; School of Public Health, Makerere University, Kampala, Uganda., Mwaba K; Institute for Global Health, University College London, London, United Kingdom., Marchant T; Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom., Shawar YR; Department of International Health, School of Public Health, John Hopkins University, Baltimore, MD, United States of America.; School of Advanced International Studies, John Hopkins University, Baltimore, MD, United States of America., English M; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom., Namakula H; School of Public Health, Makerere University, Kampala, Uganda., Gonfa G; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Colbourn T; Institute for Global Health, University College London, London, United Kingdom., Kinney MV; School of Public Health, University of the Western Cape, Cape Town, South Africa.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Sep 21; Vol. 3 (9), pp. e0001769. Date of Electronic Publication: 2023 Sep 21 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001769
Abstrakt:	The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) was established to build a cross-country platform for joint-learning around quality improvement implementation approaches to reduce mortality. This paper describes and explores the structure of the QCN in four countries and at global level. Using Social Network Analysis (SNA), this cross-sectional study maps the QCN networks at global level and in four countries (Bangladesh, Ethiopia, Malawi and Uganda) and assesses the interactions among actors involved. A pre-tested closed-ended structured questionnaire was completed by 303 key actors in early 2022 following purposeful and snowballing sampling. Data were entered into an online survey tool, and exported into Microsoft Excel for data management and analysis. This study received ethical approval as part of a broader evaluation. The SNA identified 566 actors across the four countries and at global level. Bangladesh, Malawi and Uganda had multiple-hub networks signifying multiple clusters of actors reflecting facility or district networks, whereas the network in Ethiopia and at global level had more centralized networks. There were some common features across the country networks, such as low overall density of the network, engagement of actors at all levels of the system, membership of related committees identified as the primary role of actors, and interactions spanning all types (learning, action and information sharing). The most connected actors were facility level actors in all countries except Ethiopia, which had mostly national level actors. The results reveal the uniqueness and complexity of each network assessed in the evaluation. They also affirm the broader qualitative evaluation assessing the nature of these networks, including composition and leadership. Gaps in communication between members of the network and limited interactions of actors between countries and with global level actors signal opportunities to strengthen QCN. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Mukinda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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