Community embeddedness is a critical element influencing the sustainability potential of health programming. Around the world, community actors including civil society and the private sector play key implementation and oversight roles in health service delivery. To sustain high coverage and positive outcomes, countries must nurture these community health systems and foster their effective engagement with the government-affiliated organizations, groups, and providers operating alongside them. Network analysis can provide a wealth of data about the positions and interactions that community- and faith-based organizations have in the multisectoral systems to which they contribute, including large-scale health programs. These data help tell the story of how health programs are transitioning toward self-sustaining models. This includes findings about the relationship quality associated with community organizations in states’ health program networks, the level of connectivity between community-based and government entities, the extent to which reaching everyone in the network relies on community organizations (i.e., betweenness centrality), and estimates of reciprocity in the relationships between community and government actors. Presenters will describe how organizational network analysis is being used in a longitudinal mixed methods evaluation of three distinct health program models operating at the state level in Nigeria, share analysis results, and discuss the evolution of the researchers’ thinking about network measures as potential proxies for program sustainability. Participants will leave the session with ideas and tools for incorporating network analysis into their own stories about the interplay between community-based and other health program actors and countries’ progress toward institutionalized solutions to health and development challenges.
