Effectiveness of a multi-country implementation-focused network on quality of care: Delivery of interventions and processes for improved maternal, newborn and child health outcomes.

Autor:	Djellouli N; Institute for Global Health, University College London, London, United Kingdom., Shawar YR; Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, United States of America.; Paul H. Nitze School of Advanced International Studies, John Hopkins University, Washington, DC, United States of America., Mwaba K; Institute for Global Health, University College London, London, United Kingdom., Akter K; Perinatal Care Project, Diabetic Association of Bangladesh, Dhaka, Bangladesh., Seruwagi G; School of Public Health, Makerere University, Kampala, Uganda., Tufa AA; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Gonfa G; Ethiopian Public Health Institute, Addis Ababa, Ethiopia., Mwandira K; Parent and Child Health Initiative PACHI, Lilongwe, Malawi., Kyamulabi A; School of Public Health, Makerere University, Kampala, Uganda., Shiffman J; Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, United States of America.; Paul H. Nitze School of Advanced International Studies, John Hopkins University, Washington, DC, United States of America., English M; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom., Colbourn T; Institute for Global Health, University College London, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2024 Mar 04; Vol. 4 (3), pp. e0001751. Date of Electronic Publication: 2024 Mar 04 (Print Publication: 2024).
DOI:	10.1371/journal.pgph.0001751
Abstrakt:	The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) aims to work through learning, action, leadership and accountability. We aimed to evaluate the effectiveness of QCN in these four areas at the global level and in four QCN countries: Bangladesh, Ethiopia, Malawi and Uganda. This mixed method evaluation comprised 2-4 iterative rounds of data collection between 2019-2022, involving stakeholder interviews, hospital observations, QCN members survey, and document review. Qualitative data was analysed using a coding framework developed from underlying theories on network effectiveness, behaviour change, and QCN proposed theory of change. Survey data capturing respondents' perception of QCN was analysed with descriptive statistics. The QCN global level, led by the WHO secretariat, was effective in bringing together network countries' governments and global actors via providing online and in-person platforms for communication and learning. In-country, various interventions were delivered in 'learning districts', however often separately by different partners in different locations, and pandemic-disrupted. Governance structures for quality of care were set-up, some preceding QCN, and were found to be stronger and better (though often externally) resourced at national than local levels. Awareness of operational plans and network activities differed between countries, was lower at local than national levels, but increased from 2019 to 2022. Engagement with, and value of, QCN was perceived to be higher in Uganda and Bangladesh than in Malawi or Ethiopia. Capacity building efforts were implemented in all countries-yet often dependent on implementing partners and donors. QCN stakeholders agreed 15 core monitoring indicators though data collection was challenging, especially for indicators requiring new or parallel systems. Accountability initiatives remained nascent in 2022. Global and national leadership elements of QCN have been most effective to date, with action, learning and accountability more challenging, partner or donor dependent, remaining to be scaled-up, and pandemic-disrupted. Competing Interests: The authors have declared that no competing interests exist (Copyright: © 2024 Djellouli 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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