Multi-actor collaborations in primary health care implementation
A Social Network Analysis of the primary health care strategy in Ghana
Dados Bibliográficos
Bottom-up theory demonstrates that networks of actors play important roles in policy implementation, yet limited attention has so far been paid to the influence that actor networks might have on the implementation of primary health care (PHC) strategies and outcomes. This study examined the roles actor networks play in the implementation of Community-based Health Planning and Services (CHPS) in Ghana, focusing on the nature and patterns of relations and structure and strength of prevailing collaborations. This was a cross-sectional study using a social network analysis methodology in eight districts across two regions in Ghana. The study population was implementers of CHPS from the community, district, regional, national, and development partners. Data were obtained using a modified pretested closed-ended social network questionnaire. To establish collaborative relationships, knowledge of other actors and the degree of communication on issues related to CHPS implementation were surveyed. Data were analysed using Gephi software version 0.9.2. The analysis demonstrated existing actor networks of Community Health Committees (CHCs), Community Health Officers (CHOs), Community Health Volunteers (CHVs), Sub-district, and district-level networks, including local government actors and political leaders, as well as regional, national, and development partner actors in CHPS implementation. The nature of relations showed isolated networks of CHCs, CHVs, and sub-districts across both regions. Patterns of interactions revealed that CHO networks collaborate with each other, while CHCs primarily collaborate with CHOs. Overall, weak collaborative relationships were noted among the actor networks (network density <10%). The results suggest segmented, decentralized networks with limited involvement of critical actors, including community-level, local government, political leaders, national-level, and development partners in CHPS implementation. The network analysis highlights weak collaborative relationships among actor networks in CHPS implementation, a practice which negatively impacts its implementation experience. The study highlights pathway to strengthen cohesion and improve collaborative relationships in addressing CHPS as a PHC strategy
Actor–network theory · Community health · Government (linguistics) · Health care · Network analysis · Politics · Population · Social network (sociolinguistics) · Social network analysis · Community Health and Development · Global Maternal and Child Health · Health Policy Implementation Science
Implementation Structures
Bridges, brokers and boundary spanners in collaborative networks
Role of actor networks in primary health care implementation in low- and middle-income countries
How to do (or not to do) … a social network analysis in health systems research
Social Network Analysis as a Methodological Approach to Explore Health Systems
Global health systems partnerships
The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery innovation
Application of social network analysis in the assessment of organization infrastructure for service delivery
The Performance of Policy Networks
Ghana's community-based primary health care
Exploring the use of social network analysis to measure communication between disease programme and district managers at sub-national level in South Africa
The Strength of Weak Ties
The Strength of Weak Ties
| Velocidade de citação | historical |
|---|---|
| Altamente citado | Não |