The role of social networks in the governance of health systems : the case of eye care systems in Ghana

Blanchet, K and James, P ORCID: 2013, 'The role of social networks in the governance of health systems : the case of eye care systems in Ghana' , Health Policy and Planning, 28 (2) , pp. 143-156.

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Efforts have been increasingly invested to improve local health systems’capacities in developing countries. We describe the application of innovative methods based on a social network analysis approach. The findings presented refer to a study carried out between July 2008 and January 2010 in the Brong Ahafo region of Ghana. Social network analysis methods were applied in five different districts using the software package Ucinet to calculate the various properties of the social network of eye care providers. The study focused on the managerial decisions made by Ghanaian district hospital managers about the governance of the health system. The study showed that the health system in the Brong Ahafo region experienced significant changes specifically after a key shock, the departure of an international organization. Several other actors at different levels of the network disappeared, the positions of nurses and hospital managers changed, creating new relationships and power balances that resulted in a change in the general structure of the network. The system shifted from a centralized and dense hierarchical network towards an enclaved network composed of five sub-networks. The new structure was less able to respond to shocks, circulate information and knowledge across scales and implement multi-scale solutions than that which it replaced. Although the network became less resilient, it responded better to the management needs of the hospital managers who now had better access to information, even if this information was partial. The change of the network over time also showed the influence of the international organization on generating links and creating connections between actors from different levels. The findings of the study reveal the importance of creating international health connections between actors working in different spatial scales of the health system.

Item Type: Article
Additional Information: First published online March 12
Themes: Health and Wellbeing
Schools: Schools > School of Environment and Life Sciences > Ecosystems and Environment Research Centre
Journal or Publication Title: Health Policy and Planning
Publisher: Oxford University Press
Refereed: Yes
ISSN: 0268-1080
Related URLs:
Funders: Swiss Red Cross
Depositing User: Professor Philip James
Date Deposited: 19 Mar 2012 10:40
Last Modified: 21 Mar 2022 09:51

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