Understanding networks in low-and middle-income countries’ health systems: A scoping review

Abstract

Networks are an often-employed approach to improve problems of poor service delivery and quality of care in sub-optimally functioning health systems. There are many types of health system networks reported in the literature and despite differences, there are identifiable common characteristics, uses, purposes, and stakeholders. This scoping review systematically searched the literature on networks in health systems to map the different types of networks to develop an understanding of what they are, when and what they are used for, and the purposes they intend to achieve. Peer-reviewed literature was systematically searched from six databases (Medline (Ovid), EMBASE (Ovid), Global Health (Ovid), the Cochrane Library, Web of Science Core Collection, Global Index Medicus’s Africa Index Medicus) and grey literature was purposively searched. Data from the selected literature on network definitions, characteristics, stakeholders, uses, and purposes were charted. Drawing on existing frameworks and refining with the selected literature, a five-component framework (form and structure, governance and leadership, mode of functioning, resources, and communication), broadly characterizing a network, is proposed. The framework and mapping of uses, purposes, and stakeholders is a first step towards further understanding what networks are, when and what they are used for, and the purposes they intend to achieve in health systems.

Regional determinants of quality of care for sick children: A multilevel analysis in four countries

“…For example, large facilities might enhance care quality in the region by facilitating knowledge and experience sharing through organised activities or events. Health system networks that connect hospitals with lower-level facilities are increasingly being used as an approach to improve care quality via efficient care coordination and the sharing of knowledge, information, education, and learning activities [ 47 ]. In contrast, the lack of a similar positive effect from a greater proportion of private-for-profit facilities suggests that these facilities do not contribute to regional service quality through positive spillover effects, despite providing higher quality care than public facilities.…”

Hospital care for critical illness in low-resource settings: lessons learned during the COVID-19 pandemic

“…We propose a five-part strategy to guide development and implementation of EECC as part of the broader strengthening of health systems to address the needs of the critically ill patients. This strategic approach draws on well-established organisational change frameworks and more recent global health thinking and is outlined in table 1 33–36. The strategy recognises the inherent complexity of health systems and therefore that achieving meaningful change goals requires alignment of efforts combined with sustained, skilled day-to-day leadership and management across levels of the health system.…”

“…This strategic approach draws on well-established organisational change frameworks and more recent global health thinking and is outlined in table 1. [33][34][35][36] The strategy recognises the inherent complexity of health systems and therefore that achieving meaningful change goals requires alignment of efforts combined with sustained, skilled day-to-day leadership and management across levels of the health system. The five parts are therefore not a proscriptive recipe for action but a set of guiding principles that could inform more context-specific planning and action.…”

Optimising HIV drug resistance testing laboratory networks in Kenya: insights from systems engineering modelling

“…In addition, missing data and inconsistencies were observed to varying degrees depending on the characteristic 37. As a result, there are no established standards in the literature for such estimations at the country level or within smaller geographic areas 38. It is necessary to use estimated proportion of receiving DRT among people living with HIV to approximate the DRT demand.…”