Opportunities to sustain a multi-country quality of care network

Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda

Bibliographic Data

ID19591980
AuthorsSeblewengel Lemma (0000-0001-5910-3723, Africa Centres for Disease Control and Prevention, corresponding author), Callie Daniels-Howell (0000-0003-3238-9375, University College London, corresponding author), Asebe Amenu Tufa (0000-0001-9541-4393, Ethiopian Public Health Institute, corresponding author), Mithun Sarker (0009-0000-0405-7424, corresponding author), Kohenour Akter (0000-0002-0409-1099, corresponding author), Catherine Nakidde (0000-0001-8965-3582, Makerere University, corresponding author), Gloria Seruwagi (0000-0002-7280-6164, Makerere University, corresponding author), Albert Dube (0000-0002-6392-0475, Public Health Institute of Malawi, corresponding author), Kondwani Mwandira (0000-0001-8362-7156, Public Health Institute of Malawi, corresponding author), Desalegn Bekele (0000-0002-5154-2155, Government of Ethiopia, corresponding author), Mike English (0000-0002-7427-0826, Johns Hopkins University, corresponding author), Yusra Ribhi Shawar (0000-0002-9539-0341, Johns Hopkins University, corresponding author), Kasonde Mwaba (0000-0001-9972-8664, University College London, corresponding author), Nehla Djellouli (0000-0003-4200-2314, University College London, corresponding author), Trevor Colbourn (0000-0002-6917-6552, Africa Centres for Disease Control and Prevention, corresponding author), Tanya Marchant (0000-0002-4228-4334, Africa Centres for Disease Control and Prevention)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2023
Volume3
Issue9
Pagese0001672
Publication date2023-09-12
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001672
PMID37698985
OpenAlexW4386691697
LanguageEN
Citations received6
References cited22

The Quality of Care Network (QCN) is a global initiative that was established in 2017 under the leadership of WHO in 11 low-and- middle income countries to improve maternal, newborn, and child health. The vision was that the Quality of Care Network would be embedded within member countries and continued beyond the initial implementation period: that the Network would be sustained. This paper investigated the experience of actions taken to sustain QCN in four Network countries (Bangladesh, Ethiopia, Malawi, and Uganda) and reports on lessons learned. Multiple iterative rounds of data collection were conducted through qualitative interviews with global and national stakeholders, and non-participatory observation of health facilities and meetings. A total of 241 interviews, 42 facility and four meeting observations were carried out. We conducted a thematic analysis of all data using a framework approach that defined six critical actions that can be taken to promote sustainability. The analysis revealed that these critical actions were present with varying degrees in each of the four countries. Although vulnerabilities were observed, there was good evidence to support that actions were taken to institutionalize the innovation within the health system, to motivate micro-level actors, plan opportunities for reflection and adaptation from the outset, and to support strong government ownership. Two actions were largely absent and weakened confidence in future sustainability: managing financial uncertainties and fostering community ownership. Evidence from four countries suggested that the QCN model would not be sustained in its original format, largely because of financial vulnerability and insufficient time to embed the innovation at the sub-national level. But especially the efforts made to institutionalize the innovation in existing systems meant that some characteristics of QCN may be carried forward within broader government quality improvement initiatives

Business · Developing country · Economic growth · Economics · Health care · Political science · Public relations · Qualitative research · Sociology · Sustainability · Thematic analysis · Global Maternal and Child Health · Health Systems, Economic Evaluations, Quality of Life · Primary Care and Health Outcomes