Summative evaluation of the rural surgical obstetrical networks initiative: Findings from a five year retrospective qualitative study

Findings underscore the importance of a wrap-around approach to health service interventions to reflect the complexity of healthcare delivery and the importance of coordinated, context sensitive efforts that work in synergy with other initiatives. The RSON initiative precipitated a cultural change in key determinants of stability at individual site levels, a necessary precursor to long-lasting change. The combination of this retrospective assessment of RSON and the program evaluation findings suggest the need for long-term funding to support rural surgical and obstetrical services.