Beyond Compliance: Understanding the Role of Peer Review Through a Theory of Change

Peer review visits are more effective when perceived as opportunities for learning rather than compliance monitoring. The study offers a novel Theory of Change and visual model to guide future evaluation and practice, emphasising the importance of relational dynamics and sustained follow-up. These insights should inform both implementation and policy by supporting a shift toward trust-based, developmental peer review models that strengthen organisational learning and align with the goals of a learning health system.