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Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network

The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) is intended to facilitate learning, action, leadership and accountability for improving quality of care in member countries. This requires legitimacy—a network’s right to exert power within national contexts. This...

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Autores principales: Akter, Kohenour, Shawar, Yusra Ribhi, Tesfa, Anene, Howell, Callie Daniels, Seruwagi, Gloria, Kyamulabi, Agnes, Dube, Albert, Gonfa, Geremew, Mwaba, Kasonde, Kinney, Mary, English, Mike, Shiffman, Jeremy, Djellouli, Nehla, Colbourn, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10662733/
https://www.ncbi.nlm.nih.gov/pubmed/37988328
http://dx.doi.org/10.1371/journal.pgph.0001742
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author Akter, Kohenour
Shawar, Yusra Ribhi
Tesfa, Anene
Howell, Callie Daniels
Seruwagi, Gloria
Kyamulabi, Agnes
Dube, Albert
Gonfa, Geremew
Mwaba, Kasonde
Kinney, Mary
English, Mike
Shiffman, Jeremy
Djellouli, Nehla
Colbourn, Tim
author_facet Akter, Kohenour
Shawar, Yusra Ribhi
Tesfa, Anene
Howell, Callie Daniels
Seruwagi, Gloria
Kyamulabi, Agnes
Dube, Albert
Gonfa, Geremew
Mwaba, Kasonde
Kinney, Mary
English, Mike
Shiffman, Jeremy
Djellouli, Nehla
Colbourn, Tim
author_sort Akter, Kohenour
collection PubMed
description The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) is intended to facilitate learning, action, leadership and accountability for improving quality of care in member countries. This requires legitimacy—a network’s right to exert power within national contexts. This is reflected, for example, in a government’s buy-in and perceived ownership of the work of the network. During 2019–2022 we conducted iterative rounds of stakeholder interviews, observations of meetings, document review, and hospital observations in Bangladesh, Ethiopia, Malawi, Uganda and at the global level. We developed a framework drawing on three models: Tallberg and Zurn which conceptualizes legitimacy of international organisations dependent on their features, the legitimation process and beliefs of audiences; Nasiritousi and Faber, which looks at legitimacy in terms of problem, purpose, procedure, and performance of institutions; Sanderink and Nasiritousi, to characterize networks in terms of political, normative and cognitive interactions. We used thematic analysis to characterize, compare and contrast institutional interactions in a cross-case synthesis to determine salient features. Political and normative interactions were favourable within and between countries and at global level since collective decisions, collaborative efforts, and commitment to QCN goals were observed at all levels. Sharing resources and common principles were not common between network countries, indicating limits of the network. Cognitive interactions—those related to information sharing and transfer of ideas—were more challenging, with the bi-directional transfer, synthesis and harmonization of concepts and methods, being largely absent among and within countries. These may be required for increasing government ownership of QCN work, the embeddedness of the network, and its legitimacy. While we find evidence supporting the legitimacy of QCN from the perspective of country governments, further work and time are required for governments to own and embed the work of QCN in routine care.
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spelling pubmed-106627332023-11-21 Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network Akter, Kohenour Shawar, Yusra Ribhi Tesfa, Anene Howell, Callie Daniels Seruwagi, Gloria Kyamulabi, Agnes Dube, Albert Gonfa, Geremew Mwaba, Kasonde Kinney, Mary English, Mike Shiffman, Jeremy Djellouli, Nehla Colbourn, Tim PLOS Glob Public Health Research Article The Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) is intended to facilitate learning, action, leadership and accountability for improving quality of care in member countries. This requires legitimacy—a network’s right to exert power within national contexts. This is reflected, for example, in a government’s buy-in and perceived ownership of the work of the network. During 2019–2022 we conducted iterative rounds of stakeholder interviews, observations of meetings, document review, and hospital observations in Bangladesh, Ethiopia, Malawi, Uganda and at the global level. We developed a framework drawing on three models: Tallberg and Zurn which conceptualizes legitimacy of international organisations dependent on their features, the legitimation process and beliefs of audiences; Nasiritousi and Faber, which looks at legitimacy in terms of problem, purpose, procedure, and performance of institutions; Sanderink and Nasiritousi, to characterize networks in terms of political, normative and cognitive interactions. We used thematic analysis to characterize, compare and contrast institutional interactions in a cross-case synthesis to determine salient features. Political and normative interactions were favourable within and between countries and at global level since collective decisions, collaborative efforts, and commitment to QCN goals were observed at all levels. Sharing resources and common principles were not common between network countries, indicating limits of the network. Cognitive interactions—those related to information sharing and transfer of ideas—were more challenging, with the bi-directional transfer, synthesis and harmonization of concepts and methods, being largely absent among and within countries. These may be required for increasing government ownership of QCN work, the embeddedness of the network, and its legitimacy. While we find evidence supporting the legitimacy of QCN from the perspective of country governments, further work and time are required for governments to own and embed the work of QCN in routine care. Public Library of Science 2023-11-21 /pmc/articles/PMC10662733/ /pubmed/37988328 http://dx.doi.org/10.1371/journal.pgph.0001742 Text en © 2023 Akter et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Akter, Kohenour
Shawar, Yusra Ribhi
Tesfa, Anene
Howell, Callie Daniels
Seruwagi, Gloria
Kyamulabi, Agnes
Dube, Albert
Gonfa, Geremew
Mwaba, Kasonde
Kinney, Mary
English, Mike
Shiffman, Jeremy
Djellouli, Nehla
Colbourn, Tim
Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title_full Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title_fullStr Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title_full_unstemmed Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title_short Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: The roles and legitimacy of a multi-country network
title_sort influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in bangladesh, ethiopia, malawi and uganda: the roles and legitimacy of a multi-country network
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10662733/
https://www.ncbi.nlm.nih.gov/pubmed/37988328
http://dx.doi.org/10.1371/journal.pgph.0001742
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