| Summary: | <p><strong>Purpose</strong></p> <p>This paper presents a case study of the WHO’s Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness and evolution to over a 10-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH).</p> <p><strong>Design/methodology/approach</strong></p> <p>Methods included (1) a review of published literature on HRH governance and current practice in the field and (2) an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff and stakeholders. Sampling was purposive and at a senior level, focusing on Board members, Executive Directors, funders and academics. Data were analysed thematically with reference to systems theory and Shiffman’s theory of network development.</p> <p><strong>Findings</strong></p> <p>Five key lessons emerged: (1) effective management and leadership are critical; (2) networks need to balance “tight” and “loose” approaches to their structure and processes; (3) an active communication strategy is key to create and maintain support; (4) the goals, priorities, and membership must be carefully focused; and (5) the network needs to support shared measurement of progress on agreed-upon goals. Shiffman’s middle-range network theory is a useful tool when guided by the principles of complex systems that illuminate dynamic situations and shifting interests as global alliances evolve.</p> <p><strong>Research Limitations</strong></p> <p>The study was implemented at the end of the 10-year funding cycle. A more continuous evaluation throughout the term would have provided richer understanding of issues. Experience and perspectives at the country level were not assessed.</p> <p><strong>Practical Implications</strong></p> <p>Design and management of large, complex networks requires ongoing attention to key issues like leadership, and flexible structures and processes to accommodate the dynamic reality of these networks.</p> <p><strong>Originality/value</strong></p> <p>This case study builds on growing interest in the role of networks to foster large-scale change. The particular value rests on the longitudinal perspective on the evolution of a large, complex global network, and the use of theory to guide understanding.</p>
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