A scoping review of the relational aspects of networks of care for maternal and newborn health: informing a revised operational framework

Journal article

Objective: We investigated the relational aspects of the “Networks of Care” (NOC) approach to define their role and highlight their importance. These relational aspects distinguish NOCs from other health system-strengthening approaches that aim to enhance the quality of MNH care. NOCs include functional and relational aspects, as defined in the WHO NOC for MNH framework, and offer a promising strategy for enhancing maternal and newborn health (MNH) by strengthening care coordination at an operational level. Methods: We conducted a cross-disciplinary (healthcare, business, military, aviation, education) scoping review of 95 papers and consulted with key stakeholders (21 people) to identify and synthesize insights about relational aspects and the associated barriers and facilitators for implementation. We then used the literature review findings and stakeholder feedback to revise the Networks of Care Operational framework. Results: The revised framework highlights teamwork attributes—trust, respect, shared goals, shared values, and psychological safety, and behaviors - leadership, communication, shared decision-making, situation monitoring, and mutual support. To mitigate barriers and strengthen teamwork facilitators, organizational enablers (role clarity and policies, performance management, and coordination) were identified as crucial for NOCs. Conclusion: The resulting framework centers on relational coordination, including teamwork supported by organizational enablers, in enhancing care coordination between health workers, system administrators, and other users and non-health actors in the NOC. By targeting relational elements in intervention design and evaluation, the revised Operational NOC Framework for MNH may be valuable in strengthening NOC effectiveness and driving quality improvements, leading to improved MNH outcomes and resilient health systems.

Authors: Fasawe, O; Jenny, A; Bertozzi, S; Kalaris, K; Churchill, R

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Discover Public Health
• Volume: 22
• Issue: 1
• Article number: 749
• Publication date: 2025-11-27
• Acceptance date: 2025-11-18
• DOI: 10.1186/s12982-025-01155-8
• EISSN: 3005-0774
• ISSN: 3005-0774
• Language: English
• Keywords: Framework; Networks of care; Teamwork; Relational coordination; Maternal health