In the mid-2000s, child health policy actors were faced with persistently high rates of child mortality and disappointing findings of the Integrated Management of Childhood Illness (IMCI) evaluation. Facility-based approaches such as IMCI were not reaching children where they died – at home and in their communities – and NGOs were beginning to experiment with the integrated treatment of childhood malaria, diarrhea, and pneumonia by lay or community health workers. The idea for integrated community case management of childhood illnesses (iCCM) caught on and became popular among a global epistemic community of child health policy elites, and by 2013 28 African countries had adopted an iCCM program, although at unequal rates. This case study, based on interviews and social network data from policy actors at the global level and in Burkina Faso, describes how evidence and policy ideas were disseminated through global and national networks, and how network structure both constrained and facilitated the adoption of iCCM policy in Burkina Faso. We will see that networks matter in policy change, and that social network analysis is a promising tool to study whether and why policies change. Quantitative approaches to studying policy change are feasible but require accompanying qualitative data for interpretation.  


Jessica Shearer is a Senior Technical Officer (Monitoring & Evaluation) at PATH. Her research applies mixed methods, including network analysis, to the study of policy change, policy implementation, and the use of evidence in policymaking. Her past research has mapped the professional and information-sharing networks of child health, malaria, and HIV policy actors in Burkina Faso, and sought to understand the ascendance of integrated community case management on the global child health policy agenda. Her current work on the GAVI Full Country Evaluations seeks to understand whether the structure of immunization partnerships affects program implementation or performance. Dr. Shearer has published analyses of decision-making and adoption of new vaccines, and their effect on the coverage of existing vaccines. She has a PhD (Health Policy) from McMaster University and a MHS (International Health) from the Johns Hopkins Bloomberg School of Public Health.