Using a Multicountry Learning Network to Harvest and Rapidly Spread Implementation Knowledge across Programs Aimed to Reduce Mother-to-Child Transmission of HIV and Improve Nutrition: Perspectives and Lessons Learned for Similar Large-Scale Initiatives

Webster, Patty D; Deka, Sidhartha; Ismail, Anisa; Stern, Amy F.; Barker, Pierre

doi:10.1177/2325958219847452

Cited by 4 publications

(15 citation statements)

References 10 publications

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“…Teams were able through local engagement to leverage existing local resources, which aided in conducting and sustaining projects in resource-constrained settings [ 24 – 26 , 31 , 48 , 59 , 61 , 89 , 103 , 104 ]. A common theme across QI projects was the community and frontline staff ownership of the system improvements [ 23 , 36 , 44 , 49 , 74 , 86 , 105 – 111 ], which often led to a high uptake of interventions [ 29 , 112 , 113 ], and sustainable changes [ 75 , 114 , 115 ]. For example, in one program in Zimbabwe aimed at eradicating malaria, the program focused specifically on empowering frontline workers to take ownership, solve problems, and act on decisions, and deliberately worked to increase ownership and accountability by conducting team building, awarding best performing districts, and providing peer support visits [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Iroz,

Ramaswamy,

Bhutta

et al. 2024

BMC Health Serv Res

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Background Public–private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs. Methods We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author. Results We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five key themes for successful QI projects in LMICs: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components and their follow-up. Few papers formally reported on actual deployment of private-sector capital, and either provided insufficient information or did not follow the formal PPP model, which involves capital investment for a explicit return on investment. Few studies discussed the response to their findings and the organizational willingness to change. Conclusions Many of the same factors that impact the success of QI in healthcare in high-income countries are relevant for PPP in LMICs. Vague descriptions of the structure and financial arrangements of the PPPs, and the roles of public and private entities made it difficult to draw meaningful conclusions about the impacts of the organizational governance on the outcomes of QI programs in LMICs. While we found many articles in the published literature on PPP-funded QI partnerships in LMICs, there is a dire need for research that more clearly describes the intervention details, implementation challenges, contextual factors, leadership and organizational structures. These details are needed to better align incentives to support the kinds of collaboration needed for guiding accountability in advancing global health. More ownership and power needs to be shifted to local leaders and researchers to improve research equity and sustainability.

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Section: Resultsmentioning

confidence: 99%

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Iroz,

Ramaswamy,

Bhutta

et al. 2024

BMC Health Serv Res

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“…Authors of the included studies described the importance of engaging frontline staff, who understand the context and culture of the community, as well as the unique problems and solutions that were likely to nd acceptable and sustainable (25, 31, 43, 102,103). A common theme across projects was the community and frontline staff ownership of the system improvements (22,33,42,47,73,85,(104)(105)(106)(107)(108)(109)(110), which often led to high uptake of interventions (40,111,112), and sustainable changes (74,113,114). Improvements led by the community and frontline staff were more effective in contrast to external audits which were viewed as punitive (53).…”

Section: Theme Ii: Local Ownership and Engagement Of Frontline Teamsmentioning

confidence: 99%

“…Improvements led by the community and frontline staff were more effective in contrast to external audits which were viewed as punitive (53). Teams were able to build trusting relationships (50,54,110,115) by working closely with communities to implement QI efforts and focusing on problem-solving rather than fault-nding (12,(116)(117)(118).…”

Section: Theme Ii: Local Ownership and Engagement Of Frontline Teamsmentioning

confidence: 99%

“…Ongoing sharing of meaningful data and authentic lessons learned were described as common bene ts of collaborative QI programs. Team members valued the opportunities for peer-to-peer learning and the ability to learn directly from others working on similar projects in different settings (31,33,42,52,75,81,88,94,107,110,(118)(119)(120)(121). QI tools could be applied to a wide variety of disciplines, and the teams bene tted from building QI capacity and learning techniques rather than focusing solely on one improvement project (33, 45,…”

Section: Theme Iii: Shared Learning Of Lessons Across Teamsmentioning

confidence: 99%

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Quality Improvement in Public-Private Partnerships in Low- and Middle-Income Countries: A Systematic Review

Iroz,

Ramaswamy,

Bhutta

et al. 2023

Preprint

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Background Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMIC). We therefore aimed to systematically review the literature about the aim and impact of quality improvement (QI) approaches in PPP in LMIC. Methods We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. Study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed by a second author. Results We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We identified five themes for successful QI projects in LMIC: 1) leadership support and alignment with overarching priorities, 2) local ownership and engagement of frontline teams, 3) shared authentic learning across teams, 4) resilience in managing external challenges, and 5) robust data and data visualization to track progress. We found great heterogeneity in QI tools, study designs, participants, and outcome measures. Most studies had diffuse aims and poor descriptions of the intervention components. Few studies discussed the response to the finding and their willingness to change. Conclusions Empirical research is needed to explore the implementation challenges and contextual factors that influence how a PPP can best be implemented to improve population health. Vague descriptions of the structure of the PPPs and roles of public and private entities made it difficult to draw conclusions about the impact of the organizational governance on the outcomes of QI programs in LMIC. We outline a rich area future research, including the need for a clearer description of the interventions, uniform outcome measures, and focus on response to the findings. To improve research equity, more ownership and power should be shifted to local leaders and researchers.

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“…The Partnership of HIV-Free Survival is a learning health network comprising 6 countries with the goal of improving the survival of infants born to mothers with HIV [138]. Through collaborative efforts, this network has demonstrated effective best practices mechanisms for preventing mother-tochild transmission [139].…”

Section: Characteristics and Examples Of Learning Networkmentioning

confidence: 99%

Addressing the Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hematopoietic Cell Transplantation: Learning Networks as a Means for Sharing Best Practices

Ardura¹,

Hartley²,

Dandoy³

et al. 2020

Biology of Blood and Marrow Transplantation

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The full impact of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the field of hematopoietic cell transplantation (HCT) is unknown. This perspective paper reviews the following: current COVID-19 epidemiology, diagnosis, and potential therapies; care considerations unique to HCT recipients; and the concept of a learning network to assimilate emerging guidelines and best practices and to optimize patient outcomes through facilitating shared learning and experience across transplantation centers.

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Using a Multicountry Learning Network to Harvest and Rapidly Spread Implementation Knowledge across Programs Aimed to Reduce Mother-to-Child Transmission of HIV and Improve Nutrition: Perspectives and Lessons Learned for Similar Large-Scale Initiatives

Cited by 4 publications

References 10 publications

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Quality improvement in public–private partnerships in low- and middle-income countries: a systematic review

Quality Improvement in Public-Private Partnerships in Low- and Middle-Income Countries: A Systematic Review

Addressing the Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hematopoietic Cell Transplantation: Learning Networks as a Means for Sharing Best Practices

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