Do global health networks facilitate innovation, learning and sharing? A qualitative analysis of the Quality-of-Care Network in Bangladesh, Ethiopia, Malawi, and Uganda.

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.