Public Health Knowledge Management – One size does not fit all (paper by Sarah Harlan et al.)

(picture copyright by DFID on flickr)

In a recently published paper about knowledge management in family planning in Ethiopa, Sarah Harlan (of Johns Hopkins) et al. dig deep into the knowledge networks that connect the national and local government agencies with women and men on the ground. They combined Net-Map with focus group discussions and other interviews. Among their findings is the insight that actors on different levels have different knowledge needs and these are best supported by different network structures. I am especially interested in how high centralization impacts on a networks ability to deliver.

No network structure is perfect and every structure has pros and cons. If you have a highly centralized knowledge network, basically Ministry of Health in the middle, distributing information to everyone, this can be great in some respect, because you are in control of the message. In a context such as reproductive health, where traditional beliefs and modern medicine might be contradictory, having one central distributor of information can help to make sure the message that local women receive is consistent. Also, centralized systems are easy to understand for people within and outside the system, users know who to turn to, donors know whom to support. However, centralization also has a number of risks: They put a high burden on the central node – if the Ministry of Health is overloaded or does not perform well, nothing will happen. Also, they are weak at producing and sharing locally adapted solutions. So, while they work well in situations where there is one clear correct answer, they are weak, slow and not very creative in situations where many different solutions will work. For example, if the question is: How do we get village women to give birth in a hospital instead of at home, there can be many different solutions that work and that could inspire others – if you have a system that is designed to share information in a decentralized manner.

Do you have a Net-Map paper, report, blog post that you want to share? Send me a note and I am happy to include you here.