Investing in the health workforce is vital to face climate change: A new report shares insights from over 1,200 on the frontline

Investing in the health workforce is vital to tackle climate change: A new report shares insights from over 1,200 on the frontline

Reda SadkiGlobal health, The Geneva Learning Foundation

Geneva, Switzerland (1 December 2023) – The Geneva Learning Foundation has published a new report titled “On the frontline of climate change and health: A health worker eyewitness report.” The report shares first-hand experiences from over 1,200 health workers in 68 countries who are first responders already battling climate consequences on health.

As climate change intensifies health threats, local health professionals may offer one of the most high-impact solutions.

Charlotte Mbuh of The Geneva Learning Foundation, said: “Local health workers are trusted advisers to communities. They are first to observe health consequences of climate change, before the global community is able to respond. They can also be first to respond to limit damage to health.”

“Health workers are already taking action with communities to mitigate and respond to the health effects of climate change, often with little or no recognition,” said Reda Sadki, President of The Geneva Learning Foundation (TGLF). “If we want to build and maintain trust in climate science, policy, and action, we need to invest in the workforce, as they are the ones that communities rely on to make sense of what is changing.” 

The report vividly illustrates the profound impacts climate change is already having on health, as shared by health workers themselves.

The wide-ranging health consequences directly observed by health workers include malnutrition due to crop failures, increasing incidence of infectious diseases, widespread mental health impacts, and reduced access to health services. Here are three examples.

  • Bie Lilian Mbando, a health worker in Cameroon: “Where I live in Buea, the flood from Mount Cameroon took away all belongings of people in my neighbourhood and killed a secondary school student who was playing football with his friends.”
  • Cecilia Nabwirwa, a nurse in Nairobi, Kenya: “I remember my grand-child getting sick after eating vegetables grown along sewage areas. Since then I resolved to growing my own vegetables to ensure healthy eating.”
  • Alhassan Kenneth Mohammed, health facility worker in Ghana: “During the rainy season, it is very difficult for people to seek care for their health needs. They wait for the condition to get worse before coming to the facility.”

Surprising insights from these experiences include:

  • Climate change worsens menstrual hygiene: Scarce water access brought by droughts can severely affect women’s ability to maintain proper menstrual hygiene. “Women and girls have challenges during menstruation as there is limited water,” noted one community health worker.
  • Respiratory disease spikes with prolonged dust storms: Multiple health workers traced a rise in chronic coughs and other respiratory illness directly back to longer dry seasons and dust storms in areas turned to desert by climate shifts.
  • Crop failure drives up alcohol abuse among men: In farming regions struggling with drought, women health practitioners connected livelihood loss to a stark rise in substance abuse, specifically alcoholism among men. “There has been job loss, low income, and depression. Also, men became alcoholics, which is now a national menace,” described one district-level worker.

Reda Sadki explains: “The experiences shared provide vivid illustrations of the human impacts of climate change. By giving a voice to health workers on the front lines, the report highlights the urgent need to support local action with communities to build resilience. This report is only a first step that needs to lead to action.”

Beyond the report, an opportunity to scale locally-led action using innovative approaches 

As John Wabwire Shikuku, a community health worker from Port Victoria Sun County Hospital in Kenya, explains: “What gives me hope and keeps me going in my work is witnessing the growing awareness and mobilization of young people to address climate change, the development of sustainable solutions, and the potential for global collaboration to safeguard their future.”

We need new approaches to supporting climate and health action. We need to go directly to those on climate change’s frontlines – connecting local health workers globally not just to share struggles but lead action.

  • Rather than siloed programs, we need radically participatory solutions that distill and share hyperlocal innovations across massive peer groups in real-time.
  • Through new approaches, we can rapidly distill hyperlocal insights and multiplier solutions no top-down program matches.

The Geneva Learning Foundation’s proven peer learning model provides one such solution to connect and amplify local action across boundaries, offering those on the frontline tailored support and capabilities to lead context-specific solutions.

How to access the report

The report “On the frontline of climate change and health: A health worker eyewitness report” is available here: An abridged Summary report and an At a glance executive summary are also available, together with a compendium of 50 health worker experiences.

What happens next?

  • Register here to receive email updates from The Geneva Learning Foundation about climate and health.
  • During COP28, health workers are answering this question: “If you could ask the leaders at COP28 to do one thing right now to keep your community healthy, what would it be?”. You can find their responses on LinkedInTwitter/XFacebook, and Instagram.

Media contacts

Reda Sadki (Switzerland)
Phone: +41 22 575 4110

Charlotte Mbuh (Cameroon)
Phone: +237 97355945

About The Geneva Learning Foundation

Learn more about The Geneva Learning Foundation:

Created by a group of learning innovators and scientists with the mission to discover new ways to lead change, TGLF’s team combines over 70 years of experience with both country-based (field) work and country, region, and global partners.

  • Our small, fully remote agile team already supports over 60,000 health practitioners leading change in 137 countries.
  • We reach the front lines: 21% face armed conflict; 25% work with refugees or internally-displaced populations; 62% work in remote rural areas; 47% with the urban poor; 36% support the needs of nomadic/migrant populations.

TGLF’s unique package:

  1. Helps local actors take action with communities to tackle local challenges, and
  2. provides the tools to build a global network, platform, and community of health workers that can scale up local impact for global health.

In 2019, research showed that TGLF’s approach can accelerate locally-led implementation of innovative strategies by 7X, and works especially well in fragile contexts.

Health worker voices and agenda at COP28

Before, during, and after COP28: Climate crisis and health, through the eyes of health workers from Africa, Asia, and Latin America 

Reda SadkiEvents, Global health

Samuel Chukwuemeka Obasi, a health professional from Nigeria:

“Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.”

In July 2023, more than 1200 health workers from 68 countries shared their experiences of changes in climate and health, at a unique event designed to shed light on the realities of climate impacts on the health of the communities they serve.

Before, during and after COP28, we are sharing health workers’ observations and insights.

Follow The Geneva Learning Foundation to learn how climate change is affecting health in multiple ways:

  • How extreme weather events can lead to tragic loss of life.
  • How changing weather patterns are leading to crop failures and malnutrition, and forcing people to abandon their homes.
  • How infectious diseases are surging as mosquitoes proliferate and water sources are contaminated.
  • How climate stresses are particularly problematic for those with existing health conditions, like cardiovascular disease and diabetes.
  • How climate impacts are having a devastating effect on mental health as people’s ways of life are destroyed.
  • How climate change is changing the very fabric of society, driving displacement and social hardship that undermines health and wellbeing.
  • How a volatile climate is disrupting the delivery of essential health services and people’s ability to access them.
  • We will finish the series with  inspiring stories of how health workers are already responding to such challenges, working with communities to counter the effects of a changing climate.

On 1 December 2023, TGLF will be publishing a compendium and analysis of these 1200 contributions – On the frontline of climate change and health: A health worker eyewitness report. Get the report

This landmark report – a global first – kickstarts our campaign to ensure that health workers in the Global South are recognized as:

  • The people already having to manage the impacts of climate change on health.
  • An essential voice to listen to in order to understand climate impacts on health.
  • A potentially critical group to work with to protect the health of communities in the face of a changing climate.

Before, during, and after COP28, we are advocating for the recognition and support of health workers as trusted advisers to communities bearing the brunt of climate change effects on health.

Rethinking Workplace Learning and Development

Learning-based complex work: how to reframe learning and development

Reda SadkiAbout me, Global health, Interviews, Published articles, The Geneva Learning Foundation

The following is excerpted from Watkins, K.E. and Marsick, V.J., 2023. Chapter 4. Learning informally at work: Reframing learning and development. In Rethinking Workplace Learning and Development. Edward Elgar Publishing.

This chapter’s final example illustrates the way in which organically arising IIL (informal and incidental learning) is paired with opportunities to build knowledge through a combination of structured education and informal learning by peers working in frequently complex circumstances.

Reda Sadki, president of The Geneva Learning Foundation (TGLF), rethought L&D for immunization workers in many roles in low- and middle-income countries (LMICs).

Adapting to technology available to participants from the countries that joined this effort, Sadki designed a mix of experiences that broke out of the limits of “training” as it was often designed.

He addressed, the inability to scale up to reach large audiences; difficulty to transfer what is learned; inability to accommodate different learners’ starting places; the need to teach learners to solve complex problems; and the inability to develop sufficient expertise in a timely way. (Marsick et al., 2021, p. 15)

This led his organization, to invite front-line staff from all levels of immunization systems in low- and middle-income countries (LMICs) to create and share new learning in response to the social and behavioral challenges they faced.

Sadki designed L&D for “in-depth engagement on priority topics,” insights into “the raw, unfiltered perspectives of frontline staff,” and peer dialogue that “gives a voice to front-line workers” (The Geneva Learning Foundation, 2022).

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What learning science underpins peer learning for Global Health?

What learning science underpins peer learning for Global Health?

Reda SadkiEvents, Global health

Most significant learning that contributes to improved performance takes place outside of formal training.

It occurs through informal and incidental forms of learning between peers.

Effective use of peer learning requires realizing how much we can learn from each other (peer learning), experiencing the power of defying distance to solve problems together (remote learning), and feeling a growing sense of belonging to a community (social learning), emergent across country borders and health system levels (networked learning).

At the ASTMH annual meeting Symposium organized by Julie Jacobson, two TGLF Alumnae, María Monzón from Argentina and Ruth Allotey from Ghana, will be sharing their analyses and reflections of how they turned peer learning into action, results, and impact.

In his presentation, Reda Sadki, president of The Geneva Learning Foundation (TGLF), will explore:

  1. What do we need to understand about digital learning?
  2. Networked learning: rethinking learning architecture in the Digital Age
  3. Social learning: peer learning is about making human connections
  4. Practical examples of TGLF peer learning systems for WHO, Wellcome, UNICEF, and Bridges to Development that connect learning to change, results, and impact.
  5. Emergent peer learning systems driven by local practitioner and community needs and priorities.

Watch Reda Sadki’s presentation at the Annual Meeting of the American Society for Tropical Medicine and Hygiene (ASTMH) Symposium on 19 October 2023

Join this Peer Learning symposium on Day 2 of the Annual Meeting of the American Society for Tropical Medicine and Hygiene (ASTMH).

TechNet conference how to to open access to global health conferences-small

What did we learn from the Movement for Immunization Agenda 2030 (IA2030) in its first two years?

Reda SadkiGlobal health, Innovation, The Geneva Learning Foundation

At a World Health Organization conference in Panama, The Geneva Learning Foundation is hosting an Innovations Café today.

The session’s title is “Connected learning to accelerate local impact at global scale: Year 1 of the Movement for Immunization Agenda 2030 (IA2030)”.

Immunization Agenda 2030 (IA2030) is the world’s strategy, adopted by the World Health Assembly in 2020, to achieve the global goals for immunization.

In March 2022, The Geneva Learning Foundation (TGLF) launched a call to form a movement in support of IA2030.

By June 2023, over 16,000 health workers were participating.

More than 80% work in districts and health facilities and over half are government workers.

70% work in fragile contexts such as armed conflict, remote areas, urban poverty, and other challenges.

This ground-up commitment has the potential to complement the top-down work of the IA2030 global partners, if this community of practitioners is recognized, empowered, and listened to by global health agencies and donors.

In today’s session, you will hear first-hand from IA2030 Movement Members.

How has participation in this Movement helped them to better serve the immunization and primary health care needs of the local communities they serve?

In Year 1 of this Movement, we demonstrated the feasibility of establishing a global peer learning platform for immunization practitioners, with the creation of a movement of more than 10,000 health workers in support of IA2030 goals. Learn more about Year 1 outcomes.

In Year 2, as the Movement continued to grow rapidly in over 100 countries, we generated evidence of practitioner demand and public health impact, captured in academic papers and multiple detailed case studies. Request your invitation to the IA2030 Movement’s Knowledge-to-Action Hub to get access to research outputs.

Learn more about how new digital learning approach can open access to international global health conferences otherwise restricted to the select few.

Health performance management in complex adaptive systems

How do we reframe health performance management within complex adaptive systems?

Reda SadkiGlobal health, Learning, Research

We need a conceptual framework that situates health performance management within complex adaptive systems.

This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to performance management in a given context.

Existing performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies.

Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change.

In my view, this important paper mends an important broken link in theories of change that try to consider learning beyond training.

The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to be balanced with enabling approaches that foster collective responsibility and empower teams to self-organise and use data for shared sensemaking and decision-making.

Directive approaches may be more effective where workers are primarily extrinsically motivated, in less complex systems where there is higher certainty over how outcomes should be achieved, where there are sufficient resources and decision space, and where informal relationships do not subvert formal management levers.

Enabling approaches may be more effective in contexts of higher complexity and uncertainty and where there are higher levels of trust, teamwork, and intrinsic motivation, as well as appropriate leadership.

Directive and enabling approaches are not ‘either-or’: designers of performance management systems must strive for an appropriate balance between them.

The greater the dissonance between designing a performance management system and the real context in which it is implemented, the more likely it is to trigger perverse, unintended consequences.

Interventions must be carefully calibrated to the context of the health system, the culture of its organisations, and the motivations of its individuals.

By considering each factor and their interdependencies, actors can minimise perverse unintended consequences while attaining a contextually appropriate balance between directive or enabling approaches.

The complexity of the framework and the interdependencies it describes reinforce that there is no ‘one-size-fits-all’ blueprint for performance management.

For higher-order learning and whole-system improvement to occur, practical and tacit knowledge needs to flow among system actors and organisations, thus leveraging the power of networks and social connections (eg, learning exchanges and communities of practice).

Read the full paper: Newton-Lewis, T., Munar, W., Chanturidze, T., 2021. Performance management in complex adaptive systems: a conceptual framework for health systems. BMJ Glob Health 6, e005582.

Collective Intelligence Cambridge Digital Education Futures Initiative

The COVID-19 Peer Hub as an example of Collective Intelligence (CI) in practice

Reda SadkiGlobal health, The Geneva Learning Foundation

A new article by colleagues at the Cambridge Digital Education Futures Initiative (DEFI) illustrates academic understanding of Collective Intelligence (CI) through the COVID-19 Peer Hub, a peer learning initiative organized by over 6,000 frontline health workers in Africa, Asia, and Latin America, with support from The Geneva Learning Foundation (TGLF), in response to the initial shock of the pandemic on immunization services that placed 80 million children at risk of missing lifesaving vaccines. Learn more about the COVID-19 Peer Hub

From the abstract:

Collective Intelligence (CI) is important for groups that seek to address shared problems.

CI in human groups can be mediated by educational technologies.

The current paper presents a framework to support design thinking in relation to CI educational technologies.

Our framework is grounded in an organismic-contextualist developmental perspective that orients enquiry to the design of increasingly complex and integrated CI systems that support coordinated group problem solving behaviour.

We focus on pedagogies and infrastructure and we argue that project-based learning provides a sound basis for CI education, allowing for different forms of CI behaviour to be integrated, including swarm behaviour, stigmergy, and collaborative behaviour.

We highlight CI technologies already being used in educational environments while also pointing to opportunities and needs for further creative designs to support the development of CI capabilities across the lifespan.

We argue that CI education grounded in dialogue and the application of CI methods across a range of project-based learning challenges can provide a common bridge for diverse transitions into public and private sector jobs and a shared learning experience that supports cooperative public-private partnerships, which can further reinforce advanced human capabilities in system design.

Article excerpt:

As an example of CI in practice, in 2020–2021, more than 6000 health workers joined The Geneva Learning Foundation (TGLF) COVID-19 Peer Hub.

Participants shared more than 1200 ideas or practices for managing the pandemic in their contexts within 10 days. Relevant peer ideas and practices were then referenced as participants produced individual, context-specific action plans that were then reviewed by peers before finalisation and implementation.

Mapping of action plan citations (C3L 2022) demonstrate patterns of peer learning, between countries, organisations and system levels.

In parallel, TGLF synthesises data generated by peer learners in formats legitimised by the global health knowledge system (e.g. Moore et al. 2022).

The biggest challenge to CI in this context remains one of legitimacy: how can collective intelligence compete with the perceived gold standard of academic publication within this expert-led culture?

We argue that as CI education is further developed and extends across the lifespan from school learning environment to work and organisational environments, CI technologies and practices will be further developed, evaluated, and refined and will gain legitimacy as part of broader societal capabilities in CI that are cultivated and reinforced on an ongoing basis.

References cited in this excerpt:

C3L. 2022. The Power of Learning Networks for Global Health. The Geneva Learning Foundation COVID-19 Peer Hub Project Report.

Moore, Katie, Barbara Muzzulini, Tamara Roldán, Juliet Bedford, and Heidi Larson. 2022. Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers (1.0). The Geneva Learning Foundation.

Full article: Hogan, M.J., Barton, A., Twiner, A., James, C., Ahmed, F., Casebourne, I., Steed, I., Hamilton, P., Shi, S., Zhao, Y., Harney, O.M., Wegerif, R., 2023. Education for collective intelligence. Irish Educational Studies 1–30.

Teach to Reach

Teach to Reach: peer learning at scale

Reda SadkiThe Geneva Learning Foundation

Teach to Reach are fast-paced, dynamic digital events connecting local and global practitioners to each other in a new, potentially transformative shared dialogue. 

Teach to Reach and other TGLF special events rally thousands, serving as powerful moments of inspiration, providing the amazing sensation of being connected with thousands of fellow, like-minded people and the impetus to transform this feeling into shared purpose and action. 

Meet, network, and learn with colleagues from all over the world 

Successive editions of TGLF’s flagship event series, “Teach to Reach: Connect”, enabled a cumulative total of 27,000 health professionals to share experiences, test approaches, and identify solutions with international experts listening and learning with them. 

To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

Honoring health professionals as leaders of change

Honoring health professionals as leaders of change

Reda SadkiGlobal health

We honor everyone who is joining the Special Event “From community to planet: Health professionals on the frontlines of climate change”: health staff from immunization and other areas of health – environmental health and One Health, but also those who fight neglected tropical diseases (NTDs), HIV, and other ailments. We also honor allies, including human rights advocates, those working to decolonize global health, fighting for gender and racial equity as well as economic justice.

Since 2016, the Geneva Learning Foundation (TGLF) has supported a global peer learning network and platform, built by and for immunization staff from all over the world. This is because we believe that practitioner-led peer education is a powerful philosophy for change in the Digital Age. 

In 2020, when the COVID-19 pandemic, at least 80 million children under one were placed at risk of vaccine-preventable diseases such as diphtheria, measles and polio as COVID-19 disrupted immunization service as worldwide. Over 6,000 immunization staff om TGLF’s immunization network worked together to build the COVID-19 Peer Hub, collaborating on early-learning recovery plans and then preparing strategies to engage communities ahead of the introduction of the COVID-19 vaccines.

In March 2022, this network and platform helped launch the Movement for Immunization Agenda 2030 (IA2030), transforming the world’s strategy into local action. IA2030 Movement Leaders are accelerating progress by learning from each other, sharing successes, lessons learned, and challenges, forging together new ways of thinking, learning, and doing to meet the complex challenges ahead. Learn more about the Movement

We honor these IA2030 Leaders, primarily government workers from districts and facilities, who were the first to respond to the Call to Action of the Special Event “From community to planet: Health professionals on the frontlines of climate change”.

What does immunization have to do with climate change? Read this blog post.

Learning from Front-line Health Workers in the Climate Change Era

Learning from Frontline Health Workers in the Climate Change Era

Reda SadkiGlobal health, Writing

By Julie Jacobson, Alan Brooks, Charlotte Mbuh, and Reda Sadki

The escalating threats of climate change cast long shadows over global health, including increases in disease epidemics, profound impacts on mental health, disruptions to health infrastructure, and alterations in the severity and geographical distribution of diseases.

Mitigating the impact of such shadows on communities will test the resilience of health infrastructure in low- and middle-income countries (LMICs) and especially challenge frontline health workers. The need for effective and cost-efficient public health interventions, such as immunization, will evolve and grow.

Health workers, approximately 70% of which are women, that provide immunization and other health services will be trusted local resources to the communities they serve, further amplifying their centrality in resilient health systems.

Listening to and building upon the experiences and insights of frontline health workers as they live with and increasingly work to address the manifestations of climate change on health is pivotal to the collective, global response today and in the years to come.

We imagine a future of health workers connected to each other, learning directly from the successes and challenges of others by choosing to engage in digital, peer-supported, peer-learning networks regardless of the remoteness or location of their communities. Success will lie in a nimbleness and ability to quickly see new emerging patterns and respond to evolving needs of individuals and communities.

Such a future shines a light on the importance of new ways of thinking about global health, leadership, who should have a “voice”, starting from a position of equity not hierarchy, and the value that peers ascribe to each other. The hyperlocal impact of climate change on health cannot be mitigated only through global pronouncements and national policies. It requires local knowledge and understanding.

Recognizing this unique position of health workers, Bridges to Development and The Geneva Learning Foundation, two Swiss non-profits, are supporting this first-ever, large peer-learning event for frontline health workers to share their experiences and insights on climate change and health.

More than 1,100 health workers have already shared their observations of changes in climate and health affecting the communities they serve in over 60 countries. They will be sharing their stories and insights at the Special Event: From community to planet: Health professionals on the frontlines of climate change, but you can already read short summaries from Guatemala; India and Mongolia; Bénin, Gambia, and Kenya.

Starting from a Call to Action shared through the Movement for Immunization Agenda (IA2030), the call has “gone viral” through local communities and districts: over 4,500 people – most of them government workers involved in primary health care services in LMICs – registered to participate and contribute.

Almost every health worker responding says that they are very worried about climate change, and that, for them, it is already a grave threat to the health of the communities they serve.

Taken together, their observations, while imperfect, paint a daunting picture. This picture, consistent with global statistics and other data, helps to bring to life global pronouncements of the dire implications of climate change for health in LMICs.

Amid this immense and dire challenge lies an opportunity to shift from a rigid, academically-dominated approach to a decentralized, democratized recognition and learning about the health impacts of climate change. This shift underscores the importance of amplifying insights from those who are bearing the brunt of the consequences of climate change, and recognizing the special role of health service workers as bridges between their communities and those working elsewhere to address similar challenges.

This perspective requires those of us working at the global level to critically evaluate and challenge our biases and assumptions. The notion that only climate or health specialists can offer meaningful insights or credible solutions should be questioned. The understanding of climate change’s impact on epidemiology of disease, mental health and other manifestations – and the strategies employed to mitigate them – can be substantially enriched and sharpened by welcoming the voices of those on the frontlines. By doing so, we can foster a more comprehensive, inclusive, equitable and effective response to the challenges posed by climate change.

The thousands of members of the Movement for the Immunization Agenda 2030 (IA2030) and others who have initiated this global dialogue around climate and health may be forging a new path, showing the feasibility and value of the global health community listening to and supporting the potential of frontline health workers to shine the brightest of lights into the shadow cast worldwide by climate change.

This editorial is a contribution to the Special Event: From community to planet: Health professionals on the frontlines of climate change.

About the authors

Julie Jacobson and Alan Brooks are co-founders and managing partners of Bridges to Development. Jacobson was the president of the American Society for Tropical Medicine and Hygiene (ASTMH) in 2020-2021. Bridges to Development, a nonprofit founded in 2018 based in Europe and the US, strives to build on the world’s significant progress to date towards a stronger and more resilient future.

Reda Sadki and Charlotte Mbuh lead the Geneva Learning Foundation (TGLF). The Geneva Learning Foundation (TGLF) is a non-profit implementing its vision to catalyze transformation through large scale peer and mentoring networks led by frontline actors facing critical threats to our societies. Learn more:

Illustration: The Geneva Learning Foundation Collection © 2023. All rights reserved.