ArticleSocial science & medicine (1982)2017
'Pastoral practices' for quality improvement in a Kenyan clinical network.
Article in Social science & medicine (1982), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Pastoral Practices of Ethical Negotiation: Community Nurses and Implementation of Patient Self-Management.Sociology of health & illness · 2025Article
- Deconcentrating regulation in low- and middle-income country health systems: a proposed ambidextrous solution to problems with professional regulation for doctors and nurses in Kenya and Uganda.Human resources for health · 2024Article
- Factors shaping network emergence: A cross-country comparison of quality of care networks in Bangladesh, Ethiopia, Malawi, and Uganda.PLOS global public health · 2024Article
- The Meso-Level in Quality Improvement: Perspectives From a Maternal-Neonatal Health Partnership in South Africa.International journal of health policy and management · 2024Article
- Understanding networks in low-and middle-income countries' health systems: A scoping review.PLOS global public health · 2023Article
- How to do no harm: empowering local leaders to make care safer in low-resource settings.Archives of disease in childhood · 2021Article
- Cost-effectiveness of community health systems strengthening: quality improvement interventions at community level to realise maternal and child health gains in Kenya.BMJ global health · 2021Article
- Collective sensemaking for action: researchers and decision makers working collaboratively to strengthen health systems.BMJ (Clinical research ed.) · 2021Article
- Programme theory and linked intervention strategy for large-scale change to improve hospital care in a low and middle-income country - A Study Pre-Protocol.Wellcome open research · 2020Article
- Variability in the use of pulse oximeters with children in Kenyan hospitals: A mixed-methods analysis.PLoS medicine · 2019Article
- Magnitude and pattern of improvement in processes of care for hospitalised children with diarrhoea and dehydration in Kenyan hospitals participating in a clinical network.Tropical medicine & international health : TM & IH · 2019Observational
- Approaching quality improvement at scale: a learning health system approach in Kenya.Archives of disease in childhood · 2018Article
- Between empowerment and self-discipline: Governing patients' conduct through technological self-care.Social science & medicine (1982) · 2018Article
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3 authors.
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Abstract
We explain social and organisational processes influencing health professionals in a Kenyan clinical network to implement a form of quality improvement (QI) into clinical practice, using the concept of 'pastoral practices'. Our qualitative empirical case study, conducted in 2015-16, shows the way practices constructing and linking local evidence-based guidelines and data collection processes provided a foundation for QI. Participation in these constructive practices gave network leaders pastoral status to then inscribe use of evidence and data into routine care, through championing, demonstrating, supporting and mentoring, with the support of a constellation of local champions. By arranging network meetings, in which the professional community discussed evidence, data, QI and professionalism, network leaders also facilitated the reconstruction of network members' collective professional identity. This consequently strengthened top-down and lateral accountability and inspection practices, disciplining evidence and audit-based QI in local hospitals. By explaining pastoral practices in this way and setting, we contribute to theory about governmentality in health care and extend Foucauldian analysis of QI, clinical networks and governance into low and middle income health care contexts.
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