Selected study facilities.

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.医疗照护质量网络（Quality-of-Care Network, QCN）由世界卫生组织（WHO）及其合作伙伴发起，旨在联结多国的全球与国家级行动者，以改善孕产妇与新生儿健康水平。本研究开展了一项前瞻性定性研究，旨在探究孟加拉国、埃塞俄比亚、马拉维及乌干达境内的QCN如何推动网络成员国之间及内部的学习、经验共享与创新实践。研究于2019年6月至2022年3月期间，分2至4轮迭代开展了227次关键知情人访谈，访谈对象覆盖全球、国家及设施层面的QCN行动者；同时梳理审查了所有可获取的QCN相关文件。本研究基于知识共享理论，围绕"共享""学习""创新"三大主题对定性数据开展主题分析。研究发现，虚拟与线下平台（涵盖各类会议与网络研讨会）以及QCN官网等在线资源库，为各国及行动者分享策略与方法提供了渠道，由此可见经验共享与学习实践的开展情况。在地方层面，学习协作会议、辅导与指导机制得到了强化。定期召开的利益相关方协调会议与学习协作会议等活动，为利益相关方制定策略、共享并学习妇幼健康相关方法提供了契机。该网络同时推动了利益相关方之间的协调协作。跨QCN成员国普遍存在类似的共享与学习模式，例如学习协作会议。不过，各国间的创新实践却并不显著。尽管存在少数例外情况，例如开发并采用了旨在提升网络成员国服务提供者能力的创新性软件应用，但此类实践仍较为有限。多数创新方法与QCN发起前已存在的孕产妇健康相关方法并无二致，仅是沿用了此前的实践策略。不过，有证据表明QCN改善了这些方法的功能性。本研究阐明了如何通过成员国间及内部的学习、共享与创新实践来改善妇幼健康状况，并分析了相关局限。该研究成果或可为各国落实可预防性孕产妇与新生儿死亡零目标的相关工作提供参考。