TY - JOUR
T1 - Role of actor networks in primary health care implementation in low- and middle-income countries
T2 - a scoping review
AU - Gadeka, Dominic Dormenyo
AU - Akweongo, Patricia
AU - Whyle, Eleanor
AU - Aryeetey, Genevieve Cecilia
AU - Aheto, Justice Moses
AU - Gilson, Lucy
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Background: Primary health care (PHC) improvement is often undermined by implementation gaps in low- and middle-income countries (LMICs). The influence that actor networks might have on the implementation has received little attention up to this point. Objective: This study sought to offer insights about actor networks and how they support PHC implementation in LMICs. Methods: We reviewed primary studies that utilised social network analysis (SNA) to determine actor networks and their influence on aspects of PHC in LMICs following the five-stage scoping review methodological framework by Arksey and O’Malley. Narrative synthesis was applied to describe the included studies and the results. Results: Thirteen primary studies were found eligible for this review. Ten network types were identified from the included papers across different contexts and actors: professional advice networks, peer networks, support/supervisory networks, friendship networks, referral networks, community health committee (CHC) networks, inter-sectoral collaboration networks, partnership networks, communications networks, and inter-organisational network. The networks were found to support PHC implementation at patient/household or community-level, health facility-level and multi-partner networks that work across levels. The study demonstrates that: (1) patient/household or community-level networks promote early health-seeking, continuity of care and inclusiveness by enabling network members (actors) the support that ensures access to PHC services, (2) health facility-level networks enable collaboration among PHC staff and also ensure the building of social capital that enhances accountability and access to community health services, and (3) multi-partner networks that work across levels promote implementation by facilitating information and resource sharing, high professional trust and effective communication among actors. Conclusion: This body of literature reviewed suggests that, actor networks exist across different levels and that they make a difference in PHC implementation. Social Network Analysis may be a useful approach to health policy analysis (HPA) on implementation.
AB - Background: Primary health care (PHC) improvement is often undermined by implementation gaps in low- and middle-income countries (LMICs). The influence that actor networks might have on the implementation has received little attention up to this point. Objective: This study sought to offer insights about actor networks and how they support PHC implementation in LMICs. Methods: We reviewed primary studies that utilised social network analysis (SNA) to determine actor networks and their influence on aspects of PHC in LMICs following the five-stage scoping review methodological framework by Arksey and O’Malley. Narrative synthesis was applied to describe the included studies and the results. Results: Thirteen primary studies were found eligible for this review. Ten network types were identified from the included papers across different contexts and actors: professional advice networks, peer networks, support/supervisory networks, friendship networks, referral networks, community health committee (CHC) networks, inter-sectoral collaboration networks, partnership networks, communications networks, and inter-organisational network. The networks were found to support PHC implementation at patient/household or community-level, health facility-level and multi-partner networks that work across levels. The study demonstrates that: (1) patient/household or community-level networks promote early health-seeking, continuity of care and inclusiveness by enabling network members (actors) the support that ensures access to PHC services, (2) health facility-level networks enable collaboration among PHC staff and also ensure the building of social capital that enhances accountability and access to community health services, and (3) multi-partner networks that work across levels promote implementation by facilitating information and resource sharing, high professional trust and effective communication among actors. Conclusion: This body of literature reviewed suggests that, actor networks exist across different levels and that they make a difference in PHC implementation. Social Network Analysis may be a useful approach to health policy analysis (HPA) on implementation.
KW - Policy implementation
KW - actor networks
KW - health policy analysis
KW - primary health care
KW - social network analysis
UR - http://www.scopus.com/inward/record.url?scp=85158017799&partnerID=8YFLogxK
U2 - 10.1080/16549716.2023.2206684
DO - 10.1080/16549716.2023.2206684
M3 - Review article
C2 - 37133244
AN - SCOPUS:85158017799
SN - 1654-9880
VL - 16
JO - Global Health Action
JF - Global Health Action
IS - 1
M1 - 2206684
ER -