Mwandira Kondwani, Lemma Seblewengel, Dube Albert, Akter Kohenour, Tufa Asebe Amenu, Kyamulabi Agnes, Seruwagi Gloria, Nakidde Catherine, Mwaba Kasonde, Djellouli Nehla, Makwenda Charles, Colbourn Tim, Shawar Yusra Ribhi
Parent and Child Health Initiative Trust, Lilongwe, Malawi.
Department of Disease Control, London School of Hygiene & Tropical Medicine, based at the Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
PLOS Glob Public Health. 2025 Jan 29;5(1):e0002720. doi: 10.1371/journal.pgph.0002720. eCollection 2025.
The Quality-of-Care Network (QCN), launched by WHO and partners, links global and national actors across several countries to improve maternal and newborn health. We conducted a prospective qualitative study to examine how QCN in Bangladesh, Ethiopia, Malawi and Uganda facilitated learning, sharing, and innovation within and between network countries. We conducted 227 key informant interviews with QCN actors at global, national, and facility levels iteratively in two to four rounds from June 2019 to March 2022. We also reviewed all accessible QCN documents. Drawing on knowledge sharing theory, we thematically analysed the qualitative data according to three themes: sharing, learning, and innovations. Sharing and learning were evident through virtual and in-person platforms including conferences and webinars, held on online resource libraries such as the QCN website. This provides access to strategies and approaches shared by countries and actors. Locally, there was a strengthening of learning collaborative meetings, coaching, and mentorship. Regular meetings, such as stakeholder coordination meetings and learning collaborative sessions, provided opportunity for stakeholders to strategize, share and learn maternal and child health approaches. The network also promoted coordination among stakeholders. Common sharing and learning approaches, such as learning collaborative sessions, were evident across QCN countries. However, innovation was not as apparent across countries. While there were some exceptions, such as the development and adoption of innovative software applications aimed at boosting the capacity of service providers in network countries, these were limited. Most innovation approaches were similar to pre-existing maternal health approaches, adopted from an era preceding the QCN. Nevertheless, there was evidence that QCN improved their functionality. We provide evidence of how learning, sharing, and innovation among and within countries can be fostered for improving maternal and child health; and limitations. This understanding may help country efforts to achieve targets for ending preventable maternal and neonatal deaths.
由世界卫生组织及其合作伙伴发起的医疗质量网络（QCN），将多个国家的全球和国家行为体联系起来，以改善孕产妇和新生儿健康。我们进行了一项前瞻性定性研究，以考察孟加拉国、埃塞俄比亚、马拉维和乌干达的QCN如何促进网络国家内部以及之间的学习、分享和创新。从2019年6月至2022年3月，我们分两到四轮，对全球、国家和机构层面的QCN行为体进行了227次关键信息人访谈。我们还查阅了所有可获取的QCN文件。借鉴知识共享理论，我们根据分享、学习和创新这三个主题对定性数据进行了主题分析。通过虚拟和面对面平台（包括会议和网络研讨会）以及QCN网站等在线资源库进行的分享和学习很明显。这提供了获取各国和行为体分享的策略和方法的途径。在地方层面，学习协作会议、辅导和指导得到了加强。定期会议，如利益相关者协调会议和学习协作会议，为利益相关者提供了制定战略、分享和学习孕产妇和儿童健康方法的机会。该网络还促进了利益相关者之间的协调。常见的分享和学习方法，如学习协作会议，在QCN国家中很明显。然而，创新在各国并不那么明显。虽然有一些例外情况，如开发和采用旨在提高网络国家服务提供者能力的创新软件应用程序，但这些都很有限。大多数创新方法与QCN之前时代采用的现有孕产妇健康方法相似。尽管如此，有证据表明QCN改善了其功能。我们提供了关于如何在国家之间以及国家内部促进学习、分享和创新以改善孕产妇和儿童健康的证据；以及局限性。这种理解可能有助于各国努力实现消除可预防的孕产妇和新生儿死亡的目标。
