Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda.
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 conti...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001672 |
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| author | Seblewengel Lemma Callie Daniels-Howell Asebe Amenu Tufa Mithun Sarker Kohenour Akter Catherine Nakidde Gloria Seruwagi Albert Dube Kondwani Mwandira QCN Evaluation Group Desalegn Bekele Taye Mike English Yusra Ribhi Shawar Kasonde Mwaba Nehla Djellouli Tim Colbourn Tanya Marchant |
| author_facet | Seblewengel Lemma Callie Daniels-Howell Asebe Amenu Tufa Mithun Sarker Kohenour Akter Catherine Nakidde Gloria Seruwagi Albert Dube Kondwani Mwandira QCN Evaluation Group Desalegn Bekele Taye Mike English Yusra Ribhi Shawar Kasonde Mwaba Nehla Djellouli Tim Colbourn Tanya Marchant |
| author_sort | Seblewengel Lemma |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-07c1eede4c0b41b4aaec9f6404822a12 |
| institution | OA Journals |
| issn | 2767-3375 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-07c1eede4c0b41b4aaec9f6404822a122025-08-20T02:38:25ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0139e000167210.1371/journal.pgph.0001672Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda.Seblewengel LemmaCallie Daniels-HowellAsebe Amenu TufaMithun SarkerKohenour AkterCatherine NakiddeGloria SeruwagiAlbert DubeKondwani MwandiraQCN Evaluation GroupDesalegn Bekele TayeMike EnglishYusra Ribhi ShawarKasonde MwabaNehla DjellouliTim ColbournTanya MarchantThe 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.https://doi.org/10.1371/journal.pgph.0001672 |
| spellingShingle | Seblewengel Lemma Callie Daniels-Howell Asebe Amenu Tufa Mithun Sarker Kohenour Akter Catherine Nakidde Gloria Seruwagi Albert Dube Kondwani Mwandira QCN Evaluation Group Desalegn Bekele Taye Mike English Yusra Ribhi Shawar Kasonde Mwaba Nehla Djellouli Tim Colbourn Tanya Marchant Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. PLOS Global Public Health |
| title | Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. |
| title_full | Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. |
| title_fullStr | Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. |
| title_full_unstemmed | Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. |
| title_short | Opportunities to sustain a multi-country quality of care network: Lessons on the actions of four countries Bangladesh, Ethiopia, Malawi, and Uganda. |
| title_sort | opportunities to sustain a multi country quality of care network lessons on the actions of four countries bangladesh ethiopia malawi and uganda |
| url | https://doi.org/10.1371/journal.pgph.0001672 |
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