Networks of Practice in Ghana : Learning from Implementation in Two Districts Key Lessons from Research in Dormaa Central and Hohoe Districts

Overview & Synopsis

The research conducted in Dormaa Central and Hohoe districts in Ghana provided several key findings regarding the Networks of Practice (NoP) program. The study included Patient Pathway Analysis (PPA) and Summative Network Analysis (SNA) to understand and compare patient journeys and network configurations between districts with NoPs and those without. In Dormaa Central, four NoPs were established in November 2020 with USAID/R4D support, while in Hohoe, three NoPs were started in January 2021 with KOFIH support. The research revealed notable positive effects of NoPs in the delivery of health services, including facility-level improvements, service enhancements, and increased collaboration between health facilities. However, some key goals of NoPs, such as strong referral gatekeeping to reduce the patient load at higher-tier facilities, were not fully achieved. Patient preference for higher-tier facilities persisted due to perceived quality and the spectrum of services available at different levels of care. Despite this, districts with NoPs showed a shift towards increased utilization of health centers that were NoP hubs. The study also highlighted improved awareness of the hub and spoke model of care, willingness, and evidence of cross-facility collaboration and sharing of resources.