Application of social network analysis in the assessment of organizational infrastructure for service delivery: A case study from post-conflict northern Uganda

Application of social network analysis in the assessment of organizational infrastructure for service delivery: A case study from post-conflict northern Uganda

In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization infrastructures. The objective of this study was to identify and examine the organization-level infrastructure that supports the provision of selected health services in post-conflict northern Uganda. Applied social network analysis was used to establish the structure, size and function among organizations supporting the provision of: 1) HIV treatment; 2) maternal delivery services; and 3) workforce strengthening.

Overall, 87 organizations were identified from 48 respondent organizations in the three post-conflict districts in northern Uganda. A two-stage snowball approach was used starting with service provider organizations in each district. Data included a list of organizations and key attributes related to the provision of each service for the year 2012 - 2013. The findings show that inter-organization networks are mostly focused on HIV treatment and least for workforce strengthening. The networks for HIV treatment and maternal services were about 3 to 4 times more dense relative to the network for workforce strengthening. The network for HIV treatment accounted for 69 to 81 percent of the aggregated network in Gulu and Kitgum districts. In contrast, the network for workforce strengthening contributed the least (6% and 10%) in these two districts. Likewise, the networks supporting a young district (Amuru) was under invested with few organizations and sparse connections. Overall, fund-holder organizations exhibited a broad range of functional roles that support HIV treatment. Basic information about the organization setup and relationships (networks) - can contribute to knowledge for building organizational networks that are dispersed more equitably as well as leveraging them in terms of communication, resource flow and boosting the delivery of health services.

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