On learning, leadership, and impact: a new kind of dialogue to tackle the challenges that threaten our societies

Reda Sadki Writing

The Geneva Learning Foundation’s new Dialogue is an invitation-only global conversation exploring learning, leadership, and impact. Our aim is to explore new ways to connect individuals who are tackling the challenges that threaten our societies.

In the past, one observation has been that conversations around learning and leadership tend to happen between nearly-identical peers.

One of the bets we are making is that to progress our understanding on leadership, diversity is a necessary condition.

And, indeed, I am struck by the radical diversity of the Dialogue’s participants so far.

My conviction is that such improbable connections could create new possibilities for facilitated dialogue to surface new insights into the nature of leadership in the Digital Age.

Below are three examples, connecting a disease control student from Ghana, an engineer working on a water pipeline in Libya, and an NGO worker from New Zealand.

Time travel

What lies beyond the event horizon of the ‘webinar’?

Reda Sadki Learning design, Learning strategy, Thinking aloud

It is very hard to convey to learners and newcomers to digital learning alike that asynchronous modes of learning are proven to be far more effective. There is an immediacy to a sage-on-the-stage lecture – whether it is plodding or enthralling – or to being connected simultaneously with others to do group work.

Asynchronous goes against the way our brains work, driven by prompts, events, and immediacy. But people get the benefit of “time-shifting” their TV shows and “on demand” is the norm for media consumption now.

Most webinars still require you to show up at a specific time. With live streaming of the Foundation’s events, we are observing growing appreciation for asynchronous “I’ll watch it when I want to” availability of recorded events. The behavior seems different from the intention of viewing a recorded webinar, which almost never happens. (This is, in part, the motivation question: does anyone watch recordings of webinars without being forced to?)

It is wonderful that the big video platforms immediately make the recording available, at the same URL, after a livestreamed event. Right now, this is better than Zoom, which does not (yet) offer a simple, automated way to share the recording with everyone who missed a live session, nor a mechanism for post-event viewers to contribute comments or questions.

Image: Time travel (Wikipedia Commons).

Two false dichotomies: quality vs. quantity and peer vs. global expertise

Reda Sadki Global health, Global public health

The national EPI manager of the Expanded Programme for Immunization (EPI) of the Democratic Republic of the Congo (DRC), just addressed the COVID-19 Peer Hub Teams from DRC and Ivory Coast, saluting both teams for their effort to prepare and strengthen COVID-19 vaccine introduction. I am honored to have been invited and pleased to see how this initiative is not only country-led but truly owned and led by its participants.

She has joined the Inter-Country Peer Exchange (reserved for COVID-19 Peer Hub Members) organized by the Peer Hub’s DRC Team to share rapid learning from COVID-19 vaccine introduction.

In the room are immunization professionals, primarily those working for the Ministries of Health, directly involved in vaccine introduction from both countries and from all levels of the health system.

Other COVID-19 Peer Hub country teams are organizing similar inter-country exchanges, in response to their own needs, building on what they have learned as Scholars about the value of digital networks to strengthen and accelerate their response to the pandemic, from recovery to vaccine introduction.

Today’s exchange is reserved for COVID-19 Peer Hub Members from the two countries, following a public meeting on 27 March 2021. (Short recaps in French and in English are available below. The full recording of the inaugural 27 March 2021 exchange is available on The Geneva Learning Foundation’s social media channels.)

The Inter-Country Peer Exchange is only possible because, in response to the pandemic in 2020, we co-designed the Peer Hub and rapidly doubled the size of what was already the largest platform for immunization managers. We combined the best of both worlds: the best available global technical expertise with the field-based expertise of thousands of participants.

In this way, we do not need to choose between false dichotomies that seek to oppose quality to quantity or peer versus global expertise.

COVID-19 vaccine introduction: Recaps below in English and French about the first COVID-19 Peer Hub Inter-Country Peer Exchange between the Peer Hub teams from the Democratic Republic of the Congo (DRC) and Ivory Coast

Walled garden

Can the transformation of global health education for impact rely on input-based accreditation?

Reda Sadki Education business models, Global health, Learning strategy

Burck Smith wrote in 2012 what remains one of the clearest summaries of how accreditation is based primarily on a higher education institution’s inputs rather than its outcomes, and serves to create an “iron triangle” to maintain high prices, keep out new entrants, and resist change.

It is worth quoting Smith at length (see this link) as we think through the proposal that the transformation of global health education for impact should rely on accredited institutions. Global health efforts are focused on outcomes and aim to achieve impact. Of necessity, this requires rethinking a broad swath of fairly fundamental issues, from how to construct education to what philosophy should underpin what we design and develop. And the focus on results makes the prevailing input-based accreditation criteria unlikely to be the most useful ones to help achieve global health goals.

The call for a “revolution” in education for public health is unlikely to be answered by institutions that form a protected monopoly. The most exciting and promising innovations in education are happening on the fringes of the education landscape, in bootcamps, edtech startups, and other non-traditional organizations that are catalyzing change. Such change remains primarily seen as a threat by established institutions that, in a protected market buttressed by accreditation, are seeking to preserve gross margins that hover at around sixty percent in some countries.

Of course, there is a very real problem with the proliferation of degree mills and other shady profit-first organizations that sell the promise of career development and opportunities but cannot deliver them. Unfortunately, many such outfits are, it turns out, accredited ones. This explains why, alongside accreditation, a parallel industry of quality labels and certifications is supposed to help potential “customers” make better purchasing decision.

Instead, we should rethink what determines the value of a credential. Moving toward competency-based degrees is one necessary but insufficient step that has already been explored. But could we invent a “lifelong credential” that would increase in value over time, as its holder applies what was learned in order to progress and ultimately achieve measurable impact? The tools (blockchain, AI, etc.) to support this already exist. A reductive obsession with legitimacy based on accreditation and the prestige and rankings it supposedly confers will only serve to hinder those of us who are working toward new forms of credentialing, grounded in the needs of people working in countries and guided by what will actually save lives and improve health.

Image: Walled garden, New College (Oxford). Photo by Elaine Heathcote on Flickr.

What does the changing nature of knowledge mean for global health?

Reda Sadki Global public health, Learning strategy

Charlotte Mbuh and I will be welcoming Julie Jacobson, one of the founders of Bridges to Development, for our 15-minute Global Health Symposium about neglected needs of women’s health, and specifically the upcoming Female Genital Schistosomiasis (FGS) workshop being organized by the FAST package, a group of international and country partners. Join the Symposium on Facebook, YouTube, or LinkedIn. (If you miss the live stream, the recording is immediately available afterward, via these same links.)

During the Ebola crisis response of 2014-2015, I sweet-talked Panu Saaristo into doing the first “15-minute global health symposium”, giving him just 6 minutes for an update about the complex work he was leading. (You can read about it here.) I still remember every point of his presentation and the emotion associated with it, as he described how Red Cross volunteers were risking their own lives to help families bury their dead safely.

It turns out that the 60-minute webinar is both boring and ineffective for a reason: in a world of knowledge abundance, we are wasting the precious moments when we are connected to each other if we only use that time to present information. “Zoom fatigue” is due not so much to the technology as it is to missing the point about what has changed about the nature of knowledge in the Digital Age.

Featured image: Figure 23. Knowledge as a river, not reservoir, found in Siemens, G., 2006. Knowing knowledge.

Learning, leadership, and impact in the Digital Age: In dialogue with Karen Watkins

Reda Sadki Writing

Listen in on the Foundation’s first invitation-only Clubhouse chat.

Karen Watkins and I chatted about the Foundation’s unique approach to this triptych of learning, leadership, and impact in the Digital Age.

We shared some of the insights we gained about resilience during the first year of COVID-19, learning from the Foundation’s immunization programme that connected thousands of health professionals during the early days of the pandemic.

It was informal in ways intended to provoke incidental learning. No stilted panel, rigid agenda, or dull slides.

And, most important, we opened up the dialogue to include real-world challenges, successes, and lessons learned that were shared before the chat by invitees. Those we discussed include:

  • Children adapting to digital learning in Lebanon during the COVID-19 period with involvement of girls actually increasing because of the use of digital technology.
  • How to deal with resistance against peer-supported learning in pyramid organizational hierarchy.
  • Bringing a single digital infrastructure for data collection across a global network.
Social network and citation network in the COVID-19 Peer Hub

Disseminating rapid learning about COVID-19 vaccine introduction

Reda Sadki Global health, Global public health, Learning strategy

In July 2019, barely six months before the pandemic, we worked with alumni of The Geneva Learning Foundation’s immunization programme to build the Impact Accelerator in 86 countries. This global community of action for national and sub-national immunization staff pledged, following completion of one of the Foundation’s courses, to support each other in other to achieve impact.

Closing the loop from learning to impact produced startling results, accelerating the rate at which locally-resourced projects were implemented and fostering new forms of collaborative leadership. Alumni launched what immediately became the largest network of immunization managers in the world.

Then the pandemic dramatically raised the stakes: 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.

Alumni were amongst the first in their countries to respond, leveraging the power of being connected to each other to create a virtuous circle of peer support that became the COVID-19 Peer Hub. As a result, the pace of growth keeps increasing. Membership doubled during the summer of 2020.

The network effect cannot be replicated by smaller platforms built on top-down legacy models of the past. Nor can the trust and friendship that bind members to each other.

Members are telling their own stories of the COVID-19 pandemic, disseminating rapid learning, first about recovery of immunization services and, more recently, about COVID-19 vaccine introduction.

There is no upper limit to the number of participants or stories. Rather than painstakingly collecting a few stories so highly curated that they seem too sanitized to be authentic or meaningful, we created the conditions for each person to share their story and learn from the stories of others. We do not require you to be “exemplary” to experience or share significant learning. Some of the most powerful lessons learned, in fact, come from the experience of failure.

In November 2020, for example, members worked together to produce in just four weeks over 700 detailed, peer-reviewed case studies of vaccine hesitancy in health facilities and districts. These were used to inform the COVID-19 Peer Hub’s early scenario planning for vaccine introduction and are now being analyzed for the unique insights they contain, available by no other means.

These stories are about collaboration and learning from each other, within and across borders and all levels of the health system, in new ways to do new things required to face the pandemic. I do not believe it is an overstatement to say that participants are writing history.

Visualization of the sharing ideas and practices across borders, roles, and system levels in the COVID-19 Peer Hub

Co-design as a networked practice of continuous invention, innovation, and learning

For COVID-19 vaccine introduction to succeed, we need new ways to disseminate rapid learning. Through co-design with members of our platform, we invented two in the first three months of this year: Teach to Reach: Connect and the COVID-19 Peer Hub Inter-Country Learning Collaborative to support vaccine introduction.

We already knew that presentation webinars do little more than replicate classroom training in a digital format. Yet they proliferate, despite the dearth of evidence about their effectiveness, with unsubstantiated claims that they are somehow “collaborative” or that 10 minutes of attendees asking the experts a few questions qualifies as “peer learning”. Social Network Analysis (SNA) of the COVID-19 Peer Hub by Sasha Poquet and Vitomir Kovanovic at the Centre for Complexity and Change in Learning helped us to understand that the power of the network lies in the relationships between its members, not only in our ability to convene or call to action, and certainly not in one-way information transmission.

So, on Friday 26 March 2021, 1,372 immunization professionals attended Teach to Reach: Connect to meet, network, and learn about COVID-19 vaccine introduction, how to improve immunization training, and how to reach “zero-dose” children. The feedback received from participants has been incredible, starting with their own surprise that they had so much to learn from each other. (You can catch the opening ceremony on our YouTube channel, and we will soon be sharing what we learned in upcoming live-streamed events on our Facebook page.)

My first networking meeting during Teach to Reach: Connect. Wasnam Faye is a district midwife in Senegal. I remembered her sharing powerful testimonial about how she took practical steps to ensure safe vaccination and explained the words she used to reassure caregivers, when the pandemic first hit.

An inter-country peer learning collaborative to accelerate COVID-19 vaccine introduction

The next day, the COVID-19 Peer Hub team from the Democratic Republic of the Congo (DRC) invited their colleagues from Ivory Coast to learn from the latter’s experience of vaccine introduction. Participants compared the enthusiasm to that for a football match, only this time, they said, the purpose was to “kick out the Coronavirus”. The meeting, hosted by DRC Peer Hub team leader Franck Monga and facilitated by a brilliant young doctor from Burkina Faso, Palenfo Dramane, drew over 1,000 attendees from 20 francophone countries. Panelists from Ivory Coast were alumni of Foundation programmes directly involved in vaccine introduction, working at various levels of the system. They shared first-hand experience from the first few weeks of vaccine introduction. Attendance barely declined even though the meeting ran over time by more than 90 minutes.

Our ‘grand challenge’

Our biggest challenge, so far, has been to explain the power, significance, potential, and value of such events to our global partners. This is ironic given that the global immunization community agrees that it is sub-national immunization staff who make the difference needed to achieve Immunization Agenda 2030, the new strategy adopted last year by the World Health Assembly. Some global colleagues did take the time to apologize, explaining that they were too busy on Friday afternoon due to COVID-19 vaccine introduction to take 15 minutes to meet, network, and learn with immunization staff from the countries they serve and who are actually introducing the vaccine. (To be fair, a few colleagues did attend and loved it.) Last but not least, donors remain risk-adverse, preaching innovation while repeatedly choosing conventional approaches and traditional partners, even when they have failed in the past, seemingly driven by considerations other than scale, results, or demand from countries. In some cases, they have even expressed disbelief, doubting our results as too good to be true, flummoxed by how a new entrant with limited immunization experience could achieve them when better-funded, far-more-legitimate institutions have simply not been able to do so.

Solidarity across public health and medicine silos during a pandemic

Reda Sadki Education business models, Global health, Global public health, Learning strategy

We are launching a new Scholar programme about environmental threats to health, with an initial focus on radiation. (I mapped out what this might look like in 2017.) As part of the launch, we are enlisting support of immunization colleagues.

Our immunization programme is our largest and most advanced programme, and still growing fast since its inception in 2016. At The Geneva Learning Foundation, we have spent 5 years pouring mind, body, and soul into building what has become the largest digital platform for national and sub-national immunization leaders.

Along the way, we discovered that it is not only about scale. Social Network Analysis (SNA) by colleagues Sasha Poquet and Vitomir Kovanovic at the Centre for Complexity and Change in Learning is now helping us to understand the power in the relationships not just one-to-many but many-to-many across the network.

Yes, there is a linkage as most vaccines are for children, and our first course in the new programme (with WHO) is about communicating radiation risks in paediatric imaging. But I was not sure if our request for help would make sense to the immunization network, especially when so many immunization staff are overwhelmed by COVID-19 vaccine introduction.

Yet, in less than 2 hours, immunization colleagues had already shared the announcement over 300 times. This is an impressive display of solidarity across public health and medicine silos.

This bodes well for the Foundation’s work as we are developing new programmes in other areas of global health, such as non-communicable diseases (NCDs) or neglected tropical diseases (NTDs) like female genital schistomiosis (FGS).

Until this morning, I was not sure to what extent one programme’s members would be willing to support others, outside their field of specialty.

Image: Accelerating train leaves Philadelphia for Washington, D.C. (Personal collection)

Patterns of flow

What if you build it and they do not come?

Reda Sadki Design

We understand the yearning to find a low-cost or no-cost way to spontaneously create a thriving community of practice in which participants engage intensively, volunteer undue amounts of time and effort to keeping the community alive, support other members, and make use of the resources and sharing that emerge.

I have seen many ambitious projects assume that establishing a digital platform will, in and of itself, enable the processes that are needed.

This almost never happens, except in rare circumstances when a fortuitous but accidental sequence of events has prompted stakeholders in exactly the right order, at the right time, and at the point of need.

In our experience, a significant upfront investment is needed for a community to be forged successfully. This investment is not required for the technology platforms but, rather, to support the intensive design and facilitation required to crack the complex equation between motivation, demand and context.

We believe that high-quality facilitation and speed are both vital to demonstrate relevance. If ‘members’ do not quickly see a tangible return for their business needs when they invest time, they will just as quickly stop responding to calls for action.

Image: Flow patterns in Trigonos, by Reda Sadki.

Colorful paint splash

Imagining a new kind of community of practice

Reda Sadki Design, Writing

Busy managers may enjoy connecting socially and exchanging informally with their peers. However, they are likely to find it difficult to justify time doing so. They may say “I’m too busy” but what they usually mean is that the opportunity cost is too high. The Achilles heel of communities of practice is that – just like formal training – they require managers to stop work in order to learn. They break the flow of learning in work. Incentives or perks may help substitute for intrinsic motivation, but these will be counter-productive, if only because they establish expectations that are difficult to meet over time.

Instead, we earn trust and establish relevance by providing services in ways that save time and help solve their business problems. During the inaugural phase, this is similar to a ‘conciergerie’ service, at the beck and call of the managers who just need to ‘push a button’ to get assistance. The key is that this assistance will rely on the network to gradually build meaningful connections, until managers realize that they can actually call and rely on each other, at the point of need. Bypassing the structure we establish will be the indicator of success.

We are building a human-machine interface to augment networked business problem-solving capability.

While there will be ‘social space’, this space only becomes viable if we first succeed in establishing the human-machine interface to respond to manager needs. We expect the initial focus to be on identifying problems that managers are trying to solve. Success is contingent on establishing a structure and process that provides the ability to interrogate the network, collecting and curating responses that are most likely to be helpful to the problem originator.

  • The point is to demonstrate that participation and contribution to the network augments individual capabilities and their ability to deliver results, rather than be perceived as a time-suck with high opportunity cost.
  • We do this in ways, grounded in our successful practice, to foster trust and mutual recognition between managers, leading to their growing engagement with each other as they identify commonalities and their own reasons for deepening collaboration.
  • We rely on the latest innovative tools, using open source AI (machine learning) and performance support, knowledge management, and feedback systems.

The network itself becomes a Co-Agent, a cybernetic performance, data, and decision support system combining both human and machine elements.