The funding crisis solution hiding in plain sight

The funding crisis solution hiding in plain sight

Reda SadkiGlobal health

“I did not realize how much I could do with what we already have.”

A Nigerian health worker’s revelation captures what may be the most significant breakthrough in global health implementation during the current funding crisis. While organizations worldwide slash programs and lay off staff, a small Swiss non-profit, The Geneva Learning Foundation (TGLF), is demonstrating how to achieve seven times greater likelihood of improved health outcomes while cutting costs by 90 percent.

The secret lies not in new technology or additional resources, but in something deceptively simple: health workers learning from and supporting each other.

Nigeria: Two weeks to connect thousands, four weeks to change, and six weeks to outcomes

On June 26, 2025, representatives from 153 global health and humanitarian organizations gathered for a closed-door briefing seeking proven solutions to implementation challenges they knew all too well. TGLF presented evidence from the Nigeria Immunization Agenda 2030 Collaborative that sounds almost too good be true to senior leaders who have to make difficult decisions given the funding cuts: documented results at unprecedented speed and scale – and at lower cost.

Working with Gavi, Nigeria’s Primary Health Care Development Agency, and UNICEF, they facilitated connections among 4,300 health workers and more than 600 local organizations across all Nigerian states, in just two weeks. Not fleeting digital clicks, but what Executive Director Reda Sadki calls “deep, meaningful engagement, sharing of experience, problem solving together.”

The challenge was reaching zero-dose children in fragile areas affected by armed conflict. The timeline was impossible by traditional standards. The results transformed many skeptics into advocates – including those who initially said it sounded too good to be true.

A civil society organization (CSO) volunteer reported that government staff initially dismissed the initiative: “They heard about this, thought it was just another CSO initiative. Two weeks in, they came back asking how to join.”

How does sharing experience lead to better outcomes?

What happened next addresses the most critical question about peer learning approaches: do health workers learning from each other actually improve health outcomes?

TGLF’s comparative research demonstrated that groups using structured peer learning are seven times more likely to achieve measurable health improvements versus conventional approaches.

In Nigeria, health workers learned the “five whys” root cause analysis from each other. Many said no one had ever asked them: “What do you think we should do?” or “Why do you think that is?” The transformation was both rapid and measurable.

For example, at the program start, only 25 percent knew their basic health indicators for local areas. “I collect these numbers and pass them on, but I never realized I could use them in my work,” participants reported.

Four weeks in, they had produced 409 root cause analyses. Many realized that their existing activities were missing these root causes. After six weeks, health workers began credibly reporting attribution of new activities that led to finding and vaccinating zero-dose children.

Given limited budget, TGLF had to halt development. But here is the key point: more than half of participating have maintained and continued the peer support network independently, addressing sustainability concerns that plague traditional capacity-building efforts.

The snowball effect at scale

The breakthrough emerged from what Sadki describes as reaching “critical mass” where motivated participants pull others along. “This requires clearing the rubble of all the legacy of top-down command and control systems, figure out how to negotiate hierarchies, especially because government integration is systematically our goal.”

Nigeria represents one of four large-scale implementations demonstrating consistent results. In Côte d’Ivoire, 501 health workers from 96 districts mapped out 3.5 million additional vaccinations in four weeks. Global initiatives are likely to cost no more than a single country-specific program: the global Teach to Reach network has engaged 24,610 participants across more than 60 countries. The global Movement for Immunization Agenda 2030, launched in March 2022, grew from 6,186 to more than 15,000 members in less than four months.

The foundation tracks what they call a “complete measurement chain” from individual motivation through implementation actions to health outcomes. Cost efficiency stems from scale and sustainability, with back-of-envelope calculations suggesting 90 percent cost reduction compared to traditional methods.

Solving the abundance paradox

“You touched upon an important issue that I am struggling with—the abundance of guidance that my own organization produces and also guidance that comes from elsewhere,” noted a senior manager from an international humanitarian network during the briefing. “It really feels intriguing to put all that material into a course and look at what I am going to do with this. It is a precious process and really memorable and makes the policies and materials relevant.”

This captures a central challenge facing global health organizations: not lack of knowledge, but failure to translate knowledge into action. The peer learning model transforms existing policies and guidelines into peer learning experiences where practitioners study materials to determine specific actions they will take.

“Learning happens not simply by acquiring knowledge, but by actually doing something with it,” Sadki explained.

For example, a collaboration with Save the Children converted a climate change policy brief into a peer learning course accessed by more than 70,000 health workers, developed and deployed in three days with initial results expected within six weeks.

Networks that outlast funding

The foundation’s global network now includes more than 70,000 practitioners across 137 countries, with geographic focus on nations with highest climate vulnerability and disease burden. More than 50 percent are government staff. More than 80 percent work at district and community levels.

Tom Newton-Lewis, a leading health systems researcher and consultant who attended the briefing, captured what makes this approach distinctive: “I am always inspired by the work of TGLF. There are very few initiatives that work at scale that walk the talk on supporting local problem solving, and mobilize systems to strengthen themselves.”

This composition ensures that peer learning initiatives operate within rather than parallel to official health systems. More than 1,000 national policy planners connect directly with field practitioners, creating feedback loops between strategy development and implementation reality.

Networks continue functioning when external support changes. The foundation has documented continued peer connections through network analysis, confirming that established relationships maintain over time.

Three pathways forward

The foundation outlined entry points for organizations seeking proven implementation approaches. First, organizations can become program partners, providing their staff access to existing global programs while co-developing new initiatives. Available programs include measles, climate change and health, mental health, non-communicable diseases, neglected tropical diseases, immunization, and women’s leadership.

Second, using the model to connect policy and implementation at scale and lower cost. Timeline: three days to build, four to six weeks for initial results. Organizations gain direct access to field innovations while receiving evidence-based feedback on what actually works in practice.

Third, testing the model on current problems where policy exists but implementation remains inconsistent. Organizations can connect their staff to practitioners who have solved similar problems without additional funding. Timeline: six to eight weeks from start to documented results.

The foundation operates through co-funding partnerships rather than grant-making, with flexible arrangements tailored to partner capacity and project scope. What they call “economy of effort” often delivers initiatives spanning more than 50 countries for the cost of single-country projects.

Adaptability across contexts

The model has demonstrated remarkable versatility across different contexts and challenges. The foundation has successfully adapted the approach to new geographic areas like Ukraine and thematic areas like mental health and psychosocial support. Each adaptation requires understanding specific contexts, needs, and goals, but the fundamental peer learning principles remain consistent.

An Indian NGO raised a fundamental challenge: “Where we struggle with program implementation post-funding is without remuneration frontline workers. Although they want to bring change in the community, are motivated, and have enough data, cannot continue.”

Sadki’s response: “By recognizing the capabilities for analysis, for adaptation, for carrying out more effective implementation because of what they know, because they are there every day, that should contribute to a growing movement for recognition that CHWs in particular should be paid for the work that they do.”

The path forward

The Nigerian health worker’s realization—discovering untapped potential in existing resources—represents more than individual transformation. It demonstrates how peer learning unlocks collective intelligence already present within communities and health systems.

In two weeks, health workers connected with each other across Nigeria’s most challenging regions, facilitated by the foundation’s proven methodology. By the sixth week, they had begun reporting credible, measurable health improvements. The model works because it values local knowledge, creates peer support systems, and integrates with government structures rather than bypassing them.

With funding cuts forcing difficult choices across global health, this model offers documented evidence that better health outcomes can cost less, sustainable networks continue without external support, and local solutions scale globally. For organizations seeking proven implementation approaches during resource constraints, the question is not whether they can afford to try peer learning, but whether they can afford not to.

Image: The Geneva Learning Foundation Collection © 2025

When funding shrinks, impact must grow the economic case for peer learning networks-small

When funding shrinks, impact must grow: the economic case for peer learning networks

Reda SadkiGlobal health, The Geneva Learning Foundation

Humanitarian, global health, and development organizations confront an unprecedented crisis. Donor funding is in a downward spiral, while needs intensify across every sector. Organizations face stark choices: reduce programs, cut staff, or fundamentally transform how they deliver results.

Traditional capacity building models have become economically unsustainable. Technical assistance, expert-led workshops, international travel, and venue-based training are examples of high-cost, low-volume activities that organizations may no longer be able to afford.

Yet the need for learning, coordination, and adaptive capacity has never been greater.

The opportunity cost of inaction

Organizations that fail to adapt face systematic disadvantage. Traditional approaches cannot survive current funding constraints while maintaining effectiveness. Meanwhile, global challenges intensify: climate change drives new disease patterns; conflict disrupts health systems; demographic transitions strain capacity.

These complex, interconnected challenges require adaptive systems that respond at the speed and scale of emerging threats. Organizations continuing expensive, ineffective approaches will face programmatic obsolescence.

Working with governments and trusted partners that include UNICEF, WHO, Gates Foundation, Wellcome Trust, and Gavi (as part of the Zero-Dose Learning Hub), the Geneva Learning Foundation’s peer learning networks have consistently demonstrated they can deliver measurably superior outcomes while reducing costs by up to 86% compared to conventional approaches.

Peer learning networks offer both immediate financial relief and strategic positioning for long-term sustainability. The evidence spans nine years, 137 countries, and collaborations with the most credible institutions in global health, humanitarian response, and research.

The unsustainable economics of traditional capacity building

A comprehensive analysis reveals the structural inefficiencies of conventional approaches. Expert consultants command daily rates of $800 or more, plus travel expenses. International workshops may require $15,000-30,000 for venues alone. Participant travel and accommodation averages $2,000 per person. A standard 50-participant workshop costs upward of $200,000.

When factoring limited sustainability, the economics become even more problematic. Traditional approaches achieve measurable implementation by only 15-20% of participants within six months. This translates to effective costs of $10,000-20,000 per participant who actually implements new practices.

A rudimentary cost-benefit analysis demonstrates how peer learning networks restructure these economics fundamentally.

ComponentTraditional approachPeer learning networksEfficiency gain
Cost per participant$1,850$26786% reduction
Implementation rate15-20%70-80%4x higher success
Duration of engagement2-3 days90+ days30x longer
Post-training supportNoneContinuous networkSustained capacity
Cost per implementer$10,000-20,000$334-38195% reduction

Learn more: Calculating the relative effectiveness of expert coaching, peer learning, and cascade training

Evidence of measurable impact at scale

Value for money requires clear attribution between investments and outcomes.

In January 2020, we compared outcomes between two groups. Both had intent to take action to achieve results. Health workers using structured peer learning were seven times more likely to implement effective strategies resulting in improved outcomes, compared to the other group that relied on conventional approaches.

What about speed and scale?

In July 2024, working with Nigeria’s National Primary Health Care Development Agency (NPHCDA) and UNICEF, we connected 4,300 health workers across all states and 300+ local government areas within two weeks. Over 600 local organizations including government facilities, civil society, faith-based groups, and private sector actors joined this Immunization Collaborative.

With two more weeks, participants produced 409 peer-reviewed root cause analyses. By Week 6, we began to receive credible vaccination coverage improvements after six weeks, especially in conflict-affected northern regions where conventional approaches had consistently failed. The total programme cost was equivalent to 1.5 traditional workshops for 75 participants. Follow-up has shown that more than half of the participants are staying connected long after TGLF’s “jumpstarting” activities, driven by intrinsic motivation.

Côte d’Ivoire demonstrates crisis response capability. Working with Gavi and the Ministry of Health, we recruited 501 health workers from 96 districts (85% of the country) in nine days ahead of the country’s COVID-19 vaccination campaign in November 2021. Connected to each other, they shared local solutions and supported each other, contributing to vaccination of an additional 3.5 million additional people at $0.26 per vaccination delivered.

TGLF’s model empowers health workers to share knowledge, solve local challenges, and implement solutions via a digital platform. Unlike top-down training and technical assistance, it fosters collective intelligence, enabling rapid adaptation to crises. Since 2016, TGLF has mobilized networks for immunization, COVID-19 response, neglected tropical diseases (NTDs), mental health and psychosocial support, noncommunicable diseases, and climate-health resilience.

These cases illustrate the ability of TGLF’s model to address strategic global priorities—equity, resilience, and crisis response—while maximizing efficiency. This model offers a scalable, low-cost alternative that delivers measurable impact across diverse priorities.

Our mission is to share such breakthroughs with other organizations and networks that are willing to try new approaches.

Resource allocation for maximum efficiency

Our partnership analysis reveals optimal resource allocation patterns that maximize impact while minimizing cost:

  • Human resources (85%): Action-focused approach leveraging human facilitation to foster trust, grow leadership capabilties, and nurture networks with a single-minded goal of supporting implementation to rapidly and sustainably achieve tangible outcomes.
  • Digital infrastructure (10%): Scalable platform development enabling unlimited concurrent participants across multiple countries.
  • Travel (5%): Minimal compared to 45% in traditional approaches, limited to essential coordination where social norms require face-to-face meetings, for example in partnership engagement with governments.

This structure enables remarkable economies of scale. While traditional approaches face increasing per-participant costs, peer learning networks demonstrate decreasing unit costs with growth. Global initiatives reaching 20,000+ participants across 60+ countries operate with per-participant costs under $10.

Sustainability through combined government and civil society ownership

Sustainability is critical amidst funding cuts. TGLF’s networks embed organically within government systems, involving both central planners in the capital as well as implementers across the country, at all levels of the health system.

Country ownership: Programs work within existing health system structures and national plans. Networks include 50% government staff and 80% district/community-level practitioners—the people who actually deliver services. In Nigeria, 600+ local organizations – both private and public – collaborated, embedding learning in both civil society and government structures.

Sustainability: In Côte d’Ivoire, 82% sustained engagement without incentives, fostering self-reliant networks. 78% said they no longer needed any assistance from TGLF to continue.

This approach enhances aid effectiveness, reducing dependency on external funding.

Aid effectiveness: Rather than bypassing systems, peer learning strengthens existing infrastructure. Networks continue functioning when external funding decreases because they operate through established government channels linked to civil society networks.

Transparency: Digital platforms create comprehensive audit trails providing unprecedented visibility into program implementation and results for donor oversight.

Implementation pathways for resource-constrained organizations

Organizations can adopt peer learning approaches through flexible pathways designed for immediate deployment.

  1. Rapid response initiatives (2-6 weeks to results): Address critical challenges requiring immediate mobilization. Suitable for disease outbreaks, humanitarian emergencies, or longer-term policy implementation.
  2. Program transformation (3-6 months): Convert existing technical assistance programs to peer learning models, typically reducing costs by 80-90% while expanding reach, inclusion, and outcomes.
  3. Cross-portfolio integration: Single platform investments serve multiple technical areas and geographic regions simultaneously, maximizing efficiency across donor portfolios with marginal costs approaching zero for additional countries or topics.

The strategic choice

The funding environment will not improve. Economic uncertainty in traditional donor countries, competing domestic priorities, and growing skepticism about aid effectiveness create permanent pressure for better value for money.

Organizations face a fundamental choice: continue expensive approaches with limited impact, or transition to emergent models that have already shown they can achieve superior results at dramatically lower cost while building lasting capability.

The question is not whether to change—budget constraints mandate adaptation. The question is whether organizations will choose approaches that thrive under resource constraints or continue hoping that some donors will fill the gaping holes left by funding cuts.

The evidence demonstrates that peer learning networks achieve 86% cost reduction while delivering 4x implementation rates and 30x longer engagement. These gains are not theoretical—they represent verified outcomes from active partnerships with leading global institutions.

In an era of permanent resource constraints and intensifying challenges, organizations that embrace this transformation will maximize their mission impact. Those that do not will find themselves increasingly unable to serve the communities that depend on their work.

Image: The Geneva Learning Foundation Collection © 2025

PanoramAI Reda Sadki artificial intelligence

The business of artificial intelligence and the equity challenge

Reda SadkiArtificial intelligence, The Geneva Learning Foundation

Since 2019, when The Geneva Learning Foundation (TGLF) launched its first AI pilot project, we have been exploring how the Second Machine Age is reshaping learning. Ahead of the release of the first framework for AI in global health, I had a chance to sit down with a group of Swiss business leaders at the PanoramAI conference in Lausanne on 5 June 2025 to share TGLF’s insights about the significance and potential of artificial intelligence for global health and humanitarian response. Here is the article posted by the conference to recap a few of the take-aways.

The Global Equity Challenger

At the Panoramai AI Summit, Reda Sadki, leader of The Geneva Learning Foundation, delivered provocative insights about AI’s impact on global equity and the future of human work. Drawing from humanitarian emergency response and global health networks, he challenged comfortable assumptions about AI’s societal implications.

The job displacement reality

Reda directly confronted panel optimism about job preservation: “One of the things I’ve heard from fellow panelists is this idea that we can tell employees AI is not coming for your job. And I struggle to see that as anything other than deceitful or misleading at best. ”

Eliminating knowledge worker positions in education

“In one of our programmes, after six months we were able to use AI to replace key functions initially performed by humans. Humans helped us figure out how to do it. We then refocused a smaller team on tasks that we cannot or do not want to automate. We tried to do this openly.”

What’s left for humans to do?

“These machines are already learning faster and better than us, and they are doing so exponentially. Right now, what’s left for humans currently is the facilitation, facilitating connections in a peer learning system. We do not yet have agents that can facilitate, that can read the room, that can help humans understand.”

Global access inequities

Reda highlighted three critical equity challenges: geographic access restrictions (‘geolocking’), transparency expectations around AI usage, and punitive accountability systems that discourage innovation in humanitarian contexts. “Somebody who uses AI in that context is more likely to be punished than rewarded, even if the outcomes are better and the costs are lower. ”

Emerging markets disconnect

“Even though that’s where the future markets are likely to be for AI, ” Reda observed limited engagement with Africa, Asia, and Latin America among attendees, highlighting a strategic blindness to global AI market evolution.

Organizational evolution question

Reda posed fundamental questions about future organizational structures, questioning whether traditional hierarchical models with management layers will remain dominant “two years or five years down the line. ”

Network-based innovation vision

“We’ve nurtured the emergence of a global network of health workers sharing their observations of climate change impacts on the health of communities they serve. This is already powerful for preparedness and response, but we’re trying to find ways to weave in and embed AI as co-workers and co-thinkers to help health workers harness messy, complex, large-volume climate data.”

Exponential learning challenge

“These machines are already learning faster and better than us and that, and they’re doing so exponentially better than us. It’s pretty clear what, you know, what keeps me awake at night is what what’s left for humans. ”

Key Achievement: Reda demonstrated how honest assessment of AI’s transformative impact requires abandoning comfortable narratives about job preservation, positioning global leaders to address equity challenges while identifying uniquely human capabilities in an AI-augmented world.

Reda Sadki serves as Executive Director of The Geneva Learning Foundation (TGLF), a Swiss non-profit. Concurrently, he maintains his position as Chief Learning Officer at Learning Strategies International (LSi) since 2013, where he helps international organizations improve their change execution capabilities. TGLF, under his guidance, catalyzes large-scale peer networks of frontline actors across 137 countries, developing learning experiences that transform local expertise into innovation and measurable results.

Image: PanoramAI (Raphaël Briner).

More with less

Global health: learning to do more with less

Reda SadkiGlobal health

In a climate of funding uncertainty, what if the most cost-effective investments in global health weren’t about supplies or infrastructure, but human networks that turn learning into action? In this short review article, we explore how peer learning networks that connect human beings to learn from and support each other can transform health outcomes with minimal resources.

The common thread uniting the different themes below reveals a powerful principle for our resource-constrained era: structured peer learning networks consistently deliver outsized impact relative to their cost.

Whether connecting health workers battling vaccine hesitancy in rural communities, maintaining essential immunization services during a global pandemic, supporting practitioners helping traumatized Ukrainian children, integrating AI tools ethically, or amplifying women’s voices from the frontlines – each case demonstrates how connecting practitioners across geographical and hierarchical boundaries transforms individual knowledge into collective action.

When health systems face funding shortfalls, these examples suggest that investing in human knowledge networks may be the most efficient approach available: they adapt to local contexts, identify solutions that work without additional resources, spread innovations rapidly, and build resilience that extends beyond any single intervention.

As one practitioner noted, “There’s a lot of trust in our network” – a resource that, unlike material supplies, grows stronger the more it’s used.

Sustaining gains in HPV vaccination coverage without additional resources

Recent analysis from TGLF’s Teach to Reach programme is providing valuable insights that both confirm and extend our understanding about what drives successful vaccination campaigns.

“Through peer learning networks, we discovered, for example, that tribal communities may show less vaccine hesitancy than urban populations, teachers could be more influential than health workers in driving vaccination acceptance, and religious institutions can become powerful allies,” explains TGLF’s Charlotte Mbuh. Other strategies include cancer survivors serving as advocates, WhatsApp groups connecting community health workers, and schoolchildren becoming effective messengers to initiate family conversations about vaccination

TGLF’s findings are based on analysis of implementation strategies shared by over 16,000 health professionals. Because they emerged through peer learning activities, participants got an immediate benefit. Now the real question is whether global partners and funders are recognize the significance and value of such field-based insights.

Most remarkably, analysis revealed that “success was often independent of resource levels” and “informal networks proved more important than formal ones” in sustaining high HPV vaccination coverage – suggesting that alongside material inputs, knowledge connections play a critical and often undervalued role.

Read the full article: HPV vaccination: New learning and leadership to bridge the gap between planning and implementation

5 years on: what the COVID-19 Peer Hub taught us about pandemic preparedness

When routine immunization services faced severe disruption in 2020, placing over 80 million children at risk, TGLF and the Bill & Melinda Gates Foundation (BMGF) supported a digital network connecting more than 6,000 frontline health workers across Africa, Asia, and Latin America. The results demonstrate why knowledge networks matter during crises.

Within just 10 days, the network generated 1,200+ ideas and developed 700 peer-reviewed action plans. Most significantly, implementation rates were seven times higher than conventional approaches, with collaborative participants achieving 30% better outcomes in maintaining essential health services.

“This approach complemented traditional models by recognizing frontline workers as experts in their own contexts,” says Mbuh. Quantitative assessment showed structured peer learning achieved efficacy scores of 3.2 on a 4-point scale, compared to 1.4 for traditional cascade training – providing evidence that practitioners benefit from both expert guidance and structured horizontal connections.

Read the full article: How can we reliably spread evidence-based practices at the speed and scale modern health challenges demand?

Peer learning for Psychological First Aid: Supporting Ukrainian children

The EU-funded programme on Psychological First Aid (PFA) for children affected by the humanitarian crisis in Ukraine reveals how peer learning creates value that enhances technical training.

During a recent ChildHub webinar, TGLF’s Reda Sadki outlined five unique benefits practitioners gain: contextual wisdom that complements standardized guidance, pattern recognition across diverse cases, validation of experiential knowledge, real-time problem-solving for urgent challenges, and professional resilience in difficult circumstances.

One practitioner, Serhii Federov, helped a frightened girl during rocket strikes by focusing on her teddy bear – illustrating how field adaptations enrich formal protocols. Another noted: “There is a lot of trust in our network,” highlighting how sharing experiences reduces isolation while building technical capacity.

With multiple entry points from microlearning modules to intensive peer learning exercises, this programme demonstrates how even in active crisis zones, structured knowledge sharing can deliver immediate improvements in service quality.

Artificial Intelligence as co-worker: Redefining power in global health

As technological tools transform global health practice, a new thought-provoking podcast (led, of course, by Artificial Intelligence hosts) examines how AI could reshape knowledge production in resource-constrained settings.

Based on TGLF’s Reda Sadki’s new article and framework for AI in global health, the podcast uses a specific case study to explore the “transparency paradox” practitioners face – navigating how to incorporate AI tools within existing global health accountability structures.

The podcast outlines TGLF’s framework for integrating AI responsibly in global health contexts, emphasizing: “It’s not about replacing human expertise, it’s about making it stronger.” This approach prioritizes local context and community empowerment while ensuring ethical considerations remain central.

As technological adoption accelerates across global health settings, frameworks that recognize existing dynamics become increasingly essential for ensuring equitable benefits.

Read the full article: Artificial intelligence, accountability, and authenticity: knowledge production and power in global health crisis

Women inspiring women: Amplifying voices from the frontlines

The “Women Inspiring Women” initiative amplifies the experiences of 177 women health workers from Africa, Asia, and Latin America through both a published book and peer learning course launched on International Women’s Day (IWD).

These women share personal stories and advice written as letters to their daughters, offering unique perspectives from cities, villages, refugee camps, and conflict zones. Dr. Eugenia Norah Chigamane from Malawi writes: “Pursuing a career in health work is not for the faint hearted,” while Kinda Ida Louise, a midwife from Burkina Faso, advises: “Never give up in the face of obstacles and difficulties, because there is always a positive point in every situation.”

The initiative follows TGLF’s proven methodology: immersion in stories, personal reflection, peer exchange, and developing action plans – transforming personal narratives into structured learning that drives institutional change. With women forming two-thirds of the global health workforce yet remaining underrepresented in leadership, this approach addresses both individual empowerment and systemic transformation.

Get the book “Women inspiring women” and enroll in the free learning course here.

As we face an era of unprecedented funding constraints in global health, these examples demonstrate a powerful truth: networked learning approaches consistently deliver remarkable outcomes across diverse contexts.

By connecting practitioners across boundaries, The Geneva Learning Foundation facilitates the transformation of individual knowledge into collective action – creating the resilience and adaptability our health systems urgently need.

The evidence is compelling: investing in human knowledge networks may be among the most efficient pathways to sustainable health impact.

Image: The Geneva Learning Foundation Collection © 2025

Equity matters: A practical approach to identify and eliminate biases

Patterns of prejudice: Connecting the dots helps health workers combat bias worldwide

Reda SadkiGlobal health

English | Français

“I noticed that every time he went to appointments or emergency services, he was often met with suspicion or treated as if he was exaggerating his symptoms,” shared a community support worker from Canada, describing how an Indigenous teenager waited three months for mental health services while non-Indigenous youth were seen within weeks.

This testimony was just one of hundreds shared during an unusual global gathering where frontline health workers confronted an uncomfortable truth: healthcare systems worldwide are riddled with biases that determine who lives and who dies.

“Equity Matters: A Practical Approach to Identify and Eliminate Biases,” a special event hosted by the Geneva Learning Foundation (TGLF) on 10-11 April 2025, drew nearly 5,000 health professionals from 72 countries. What made the event distinctive wasn’t just its scope, but its approach: creating a forum where community health workers from rural Nigeria could share insights alongside WHO officials from Switzerland, where district nurses from South Sudan could analyze cases with medical college professors from India.

When healthcare isn’t equal: Global patterns emerge

Despite working in vastly different contexts, participants described remarkably similar patterns of bias.

“A pregnant woman was about to deliver in the hospital, but the doctor said they need to deposit 500,000 naira before she can touch the woman,” recounted Onosi Chikaodiri Peter, a community health worker with Light Bringer’s Outreach in Nigeria. “The husband was begging, pleading, with 100,000 naira, telling the doctor that he could sell all his livestock to make sure that the wife was okay. But the doctor wouldn’t attend to the woman. Along the line, the woman gave up. The child died.”

Dr. Tusiime Ramadhan, who works with Humanitarian Volunteers International in Uganda, observed the same pattern: “People with money are referred to private clinics and hospitals for better health services often owned by the same government workers who sent them there.”

Some biases manifest in subtler ways. Hussainah Abba Ali, who works with Impact Santé Afrique in Cameroon, described seeking treatment for malaria during her university years: “Because I was a young woman, the nurse assumed I was just exaggerating. She barely examined me, gave me paracetamol and told me to rest. I later found out that several men who came in after me with similar symptoms were tested immediately for malaria.”

The stories came from everywhere—a physiotherapist in Nigeria whose expertise was ignored in favor of a male colleague; a nutritionist in DR Congo whose albino neighbor avoided vaccination clinics because of stigma; a public health specialist in Ethiopia’s Somali Region who explained how healthcare systems are designed for settled communities, leaving pastoralist populations behind.

Alina Onica, a psychologist with Romania’s Icar Foundation working with domestic violence survivors, noted: “Victims are often judged for ‘not leaving’ the abuser, as if staying means it’s not serious. This bias ignores the complex trauma and fear they live with every day.”

A framework for sense-making beyond single-issue analysis

What united these diverse testimonies was the application of the BIAS FREE Framework, a practical tool that helps identify and eliminate discriminatory patterns in health systems.

“Margaret Eichler and I started this work back in 1995 after developing some gender-based analysis tools,” explained Mary Anne Burke, the framework’s co-author. “We realized we had created something that could be applied to all social hierarchies. We’ve workshopped it on every continent but Antarctica and found it applicable everywhere.”

Unlike approaches that focus exclusively on gender, ethnicity, or disability, the BIAS FREE Framework examines how these factors intersect. Brigid Burke, a researcher who’s used and taught the framework for 15 years, explained how to identify three distinct problem types:

  • H problems: Where existing hierarchies are maintained
  • F problems: Where relevant differences between groups are ignored
  • D problems: Where different standards are applied to different groups

“It is easier to understand a hierarchy when you’re experiencing the oppression,” Burke told participants. “You can feel that you’re being treated in a way that takes away your dignity. It’s harder when you might be the one who is either consciously or unconsciously oppressing other people.”

During the event, participants first shared their own experiences, then began to analyze them using the framework. Abdoulie Bah, a regional Red Cross officer from The Gambia, offered his analysis: “Oppressive hierarchies suggest that certain groups experience more oppression than others, often leading to a competitive dynamic among marginalized groups.”

Solutions from the ground up

What distinguished this event from typical global health conferences was its emphasis on solutions developed by frontline workers themselves.

Dr. Orimbato Raharijaona, a medical doctor from Madagascar, described his team’s efforts to reach children in remote areas: “We prioritized areas with low vaccination coverage and strengthened birth follow-up to target zero-doses. Community dialogue helped raise awareness of the need for vaccination.”

In Mali, Bouréma Mounkoro, a public health medical assistant, discovered that simply rescheduling vaccination days to align with community availability dramatically improved coverage rates and reduced dropouts.

Dayambo Yendoukoua from Niger’s Red Cross developed an integrated approach addressing rural women’s exclusion from maternal care: “Women from villages and farming hamlets have three times less access to obstetric care than urban women. We grouped women into Mothers’ Clubs, provided literacy training, set up income-generating activities, and established traditional ambulances managed by women.”

This emphasis on community-based solutions resonated with Esther Y. Yakubu, a health worker with the Health and Development Support Programme in Nigeria: “This program will surely be of great value in the health sector. If put in place, it will make a huge difference and patients will receive quality treatment without any segregations.”

Practical action – not academic debates – to decolonize global health

The event itself embodied the principles it aimed to teach. Rather than positioning Western experts as authorities, TGLF structured the event to value diverse forms of expertise.

“Community health workers can see barriers that researchers miss. Global researchers spot patterns invisible at the local level. Policy makers understand system constraints that affect implementation,” explained Reda Sadki, TGLF’s Executive Director. “It’s when these perspectives connect that we find better solutions.”

On 24-25 April 2025, this community will reconvene to determine if there is enough interest and momentum to launch the Foundation’s Certificate peer learning programme for equity in research and practice. An inaugural course could be launched as early as June 2025.

“Your participation helps determine if we develop a full program on identifying and removing bias in health systems,” TGLF explained in its materials. “When more than 1,000 people participate, it shows enough interest to create a more comprehensive learning opportunity.”

The certificate program will bring together participants from across professional hierarchies—community health workers, district managers, national planners, and global researchers—creating a rare space where knowledge flows in all directions.

Across time zones and contexts, the conversation highlighted a shared understanding: addressing bias in healthcare isn’t just about fairness—it’s about survival. As Haske Akiti Joseph, a radiographer from Nigeria’s National Orthopaedic Hospital, reflected: “These issues are happening everywhere because governments will not provide free medical services to the people, and medical considerations come due to who you are, not based on priority.”

In a world where your chances of receiving timely, appropriate healthcare often depend on your gender, ethnicity, wealth, or location, the BIAS FREE Framework offers a practical way forward—one that begins with recognizing patterns of oppression that transcend borders and cultures.

Image: The Geneva Learning Foundation Collection © 2025

L’équité, ça compte: Une approche pratique pour identifier et éliminer les biais

L’équité compte: quand les soignants du monde entier témoignent des inégalités en santé

Reda SadkiGlobal health

English | Français

GENÈVE, le 11 avril 2025 – Une initiative internationale inédite a rassemblé près de 5000 professionnels de santé pour partager leurs expériences face aux discriminations dans l’accès aux soins

« Un enfant est mort parce que sa famille ne pouvait pas déposer 500 000 nairas [environ 300 francs suisses] avant le début des soins. Le père avait pourtant supplié qu’on s’occupe de l’enfant, proposant 100 000 nairas et promettant de vendre son bétail pour payer le reste. » Ce récit glaçant d’un professionnel de santé nigérian illustre la dure réalité des inégalités d’accès aux soins dont de nombreux témoignages ont été partagés lors d’un événement international consacré à l’équité en santé.

Le 11 avril dernier, la Fondation Apprendre Genève a créé un espace de dialogue sans précédent, rassemblant près de 5 000 professionnels de la santé de 72 pays, dont 1 830 francophones. Intitulé « L’équité compte: une approche pratique pour identifier et éliminer les biais », cet événement a permis à des médecins, infirmiers, agents de santé communautaires et autres acteurs du terrain de raconter, dans leurs propres mots, les discriminations qu’ils observent quotidiennement.

Des récits convergents malgré la diversité des contextes

« L’originalité de cette rencontre réside dans sa capacité à faire émerger des expériences habituellement invisibilisées », explique Reda Sadki, directeur exécutif de la Fondation. « Des praticiens qui n’ont jamais accès aux tribunes internationales ont pu témoigner des réalités qu’ils affrontent chaque jour. »

Ces témoignages, remarquablement similaires malgré la diversité des contextes, révèlent que le statut social détermine encore largement la qualité et la rapidité des soins. « Nous avions amené un enfant gravement malade à l’hôpital », raconte Neville Kasongo, du Corps des jeunes contre le paludisme en République démocratique du Congo. « Pendant que nous attendions plus de six heures, j’ai vu notre voisin arriver avec son enfant malade. Comme il avait des relations particulières dans cette institution, les cadres soignants se sont précipités pour s’occuper de son fils. Pour nous qui n’avions aucune connexion, quand ils sont finalement venus, l’enfant était déjà très affaibli. Une heure après, il est décédé. »

Brigitte Meugang, point focal du Programme élargi de vaccination au Cameroun, a observé un phénomène similaire lors d’une visite à l’hôpital: « J’avais un malade hospitalisé et je suis arrivée un peu en retard pendant les heures de visite. Le vigile m’a dit: “Tu n’entres pas parce que l’heure de visite est déjà passée.” Quelques minutes plus tard, un cousin militaire est arrivé en tenue. Le vigile a ouvert le portail et lui a dit d’entrer. » Quand elle a demandé pourquoi, on lui a répondu qu’il était en uniforme. C’est seulement après avoir présenté sa carte professionnelle qu’elle a été autorisée à entrer.

Les intervenants ont également souligné comment des groupes entiers sont systématiquement laissés pour compte. « Dans les zones de conflit au Burkina Faso, les femmes, les enfants et les personnes âgées déplacés subissent des violences basées sur le genre car leurs besoins spécifiques ne sont pas pris en compte », témoigne une spécialiste genre et inclusion sociale. « Les enfants souffrent de malnutrition, les femmes enceintes n’ont pas accès aux consultations prénatales, et les personnes âgées ne bénéficient pas de soins adaptés. »

Quand l’injustice touche même les soignants

Particulièrement frappants sont les témoignages de professionnels de santé ayant eux-mêmes subi des discriminations. Le Dr Balkissa Modibo Hama, coordonnatrice du programme mondial d’éradication de la poliomyélite pour l’OMS en Guinée, raconte: « Lors de l’accouchement de ma seconde fille, le personnel ne s’est pas occupé de moi jusqu’à ce que la sage-femme responsable arrive et leur dise qui j’étais. Soudain, tous se sont mobilisés autour de moi en me reprochant de ne pas m’être présentée. Après mon accouchement, j’ai convoqué tout le personnel pour les sensibiliser sur le fait qu’on ne devrait pas avoir besoin de dire qui on est pour recevoir des soins de qualité. »

Dans certains cas, c’est l’expérience personnelle de l’injustice qui a motivé l’engagement professionnel. « À 13 ans, j’ai accompagné ma mère à l’hôpital », poursuit le Dr Hama. « L’infirmière, qui connaissait ma mère, a voulu me faire passer avant une femme Bororo dont l’enfant était plus mal en point. J’ai refusé, mais j’ai ensuite constaté que cette femme et son enfant avaient été négligés. Cette expérience m’a profondément marquée et a motivé ma décision de devenir médecin. »

Christian Kpoyablé Clahin, infirmier en Côte d’Ivoire, a partagé un cas tragique: « Une femme est venue avec son enfant gravement malade. Elle n’avait pas d’argent pour payer les analyses. L’enfant a été mis à l’écart au laboratoire et cela a traîné jusqu’à ce qu’il soit trop tard. L’enfant est mort. J’ai interpellé le directeur de l’hôpital, mais les sanctions n’ont été que verbales. »

Des initiatives locales qui font la différence

Au-delà du constat, les participants ont partagé des solutions concrètes qu’ils ont développées face à ces inégalités. Arthur Fidelis Metsampito Bamlatol, coordinateur d’une association de santé au Cameroun, explique: « J’avais observé que les enfants Baka [pygmées] étaient insuffisamment vaccinés. Après avoir signalé ce problème au médecin-chef de district, nous avons cartographié les campements dans la forêt et institué des stratégies spéciales. Lors des campagnes suivantes, nous marchions parfois plusieurs heures à pied pour atteindre ces communautés isolées. »

D’autres adaptations créatives ont été mentionnées, comme celle rapportée par Bouréma Mounkoro, assistant médical au Mali: « Le planning des activités de vaccination n’était pas synchronisé avec la disponibilité de la communauté. Nous avons reprogrammé les jours de vaccination en tenant compte des réalités locales, ce qui a amélioré la couverture vaccinale et réduit considérablement les cas d’abandon. »

Pour Brice Alain Dakam Ncheuta, responsable de l’engagement communautaire à Médecins Sans Frontières au Niger, comprendre les dynamiques culturelles est essentiel: « Dans le Grand Sahel, pour réduire les biais dans la prise en charge des violences basées sur le genre, nous travaillons étroitement avec les leaders communautaires. Nous proposons des soins médicaux sans heurter la sensibilité culturelle, car cela fait partie de l’identité des personnes que nous accompagnons. »

Les solutions peuvent parfois être simples mais révolutionnaires, comme l’illustre l’initiative de Dayambo Yendoukoua, délégué de programme santé à la Croix-Rouge au Niger: « Dans les villages et hameaux agricoles, nous avons constaté que les femmes ont trois fois moins accès aux soins obstétricaux que les femmes urbaines. Nous avons créé des Clubs de Mères, offert des formations d’alphabétisation, mis en place des activités génératrices de revenus, et établi des ambulances traditionnelles gérées par les femmes elles-mêmes. »

Vers un partage de savoirs plus équitable

L’originalité de cet événement réside également dans sa méthodologie même. Plutôt que de suivre le schéma classique des conférences internationales où les experts occidentaux partagent leur savoir avec les praticiens du Sud, la Fondation Apprendre Genève a délibérément inversé cette logique. « Ce sont les professionnels de terrain qui ont pris la parole en premier », souligne Reda Sadki, directeur exécutif de la Fondation.

« Les agents de santé communautaire peuvent voir des obstacles que les chercheurs manquent. Les décideurs comprennent les contraintes systémiques qui affectent la mise en œuvre des politiques. C’est lorsque ces perspectives se connectent que nous trouvons de meilleures solutions », poursuit-il.

Pour faciliter l’analyse de ces expériences, Brigid Burke a accompagné la rencontre en tant que Guide. Burke est une chercheuse spécialisée dans le cadre BIAS FREE, un outil développé par Mary-Anne Burke et Margaret Eichler, permettant d’identifier différents types de biais. Cela a permis d’aller au-delà des constats en proposant une grille d’analyse des échanges entre participants qui ont constitué le cœur de la rencontre.

Le succès de cette approche pourrait conduire à la création d’un programme de formation international, dont le lancement sera discuté lors d’une nouvelle rencontre fin avril. « Nous souhaitons développer un espace où les connaissances circulent véritablement dans toutes les directions, plutôt que du Nord vers le Sud », précise M. Sadki.

La participation massive à cet événement – bien au-delà des attentes des organisateurs – témoigne d’un besoin urgent d’aborder ces questions. « Votre participation aide à déterminer si nous développons un programme plus complet sur ces questions », a expliqué la Fondation. « Quand près de 5000 personnes participent, cela montre qu’il y a suffisamment d’intérêt. »

« La meilleure stratégie pour corriger tous les biais reste l’installation partout dans nos pays d’une couverture maladie universelle », suggère le Dr Oumar Traoré, médecin de santé publique en Guinée. Une vision à laquelle fait écho Amadou Gueye, président du Malaria Youth Corps en Guinée: « Ces témoignages nous rappellent que l’équité en santé n’est pas qu’une question technique, mais aussi une question de justice fondamentale. »

Image: Collection de la Fondation Apprendre Genève © 2025

Why YouTube is obsolete

Why YouTube is obsolete: From linear video content consumption to AI-mediated multimodal knowledge production

Reda SadkiGlobal health, Learning

Does the educational purpose of video change with AI?

The purpose of video in education is undergoing a fundamental transformation in the age of artificial intelligence. This medium, long established in digital learning environments, is changing not just in how we consume it, but in its very role within the learning process.

Video has always been a problem in education

Video has always presented significant challenges in educational contexts. Its linear format makes it difficult to skim or scan content. Unlike text, which allows learners to quickly jump between sections, glance at headings, or scan for key information, video requires sequential consumption. This constraint has long been problematic for effective learning.

Furthermore, in many regions where our learners are based, internet access remains expensive, unreliable, or limited. Downloading or streaming video content can be prohibitively costly in terms of both data usage and time. The result is straightforward: few learners will watch educational videos, regardless of their potential value.

The bandwidth and attention divide

This reality creates a significant divide in educational access. While instructional designers and educators in high-resource settings continue to produce video-heavy content, learners in bandwidth-constrained environments have been systematically excluded from these resources. Even when videos are technically accessible, the time investment required to watch linear content often exceeds what busy professionals can allocate to learning activities.

Emergent AI platforms are scanning YouTube video transcripts to extract precisely what users need. This capability suggests a transformation for the role of video. YouTube and other video platforms are evolving into what might be called “interstitial processors”, mediating layers that support knowledge production and dissemination for subsequent extraction and analysis by both humans and machines.

A more inclusive workflow for knowledge extraction

This changing relationship with video content could enable more inclusive approaches to learning. When I discover a potentially valuable educational webinar, I now follow a structured approach to maximize efficiency and accessibility:

  1. Download the video file.
  2. Transcribe it using Whisper AI technology.
  3. Ask targeted questions to extract meaningful insights from the transcript.
  4. Request direct quotes as evidence of key points.

This method circumvents the traditional requirement to invest 60 minutes or more in viewing content that may ultimately offer limited value. More importantly, it transforms bandwidth-heavy video into lightweight text that can be accessed, searched, and processed even in low-connectivity environments.

I suspect that it is no accident that YouTube has recently placed additional restrictions on downloading videos from its platform.

Bridging the resource gap with AI

Current consumer-grade AI systems like Claude.ai have limitations: they cannot yet process full videos directly. For now, we are restricted to text-based interactions with video content, hence my transcription of downloaded content. However, this constraint will likely dissolve as AI capabilities continue to advance.

The immediate benefit is that this approach can help bridge the resource gap that has disadvantaged learners in bandwidth-constrained environments. By extracting the knowledge essence from videos, we could make educational content more accessible and equitable across diverse learning contexts.

The continuing value of educational video production

Despite these challenges, educational video production continues to be a relevant method for humans and machines that need a way to share what they know. Hence, what we are witnessing is not the diminishing relevance of educational video, but rather a transformation in how its knowledge value is extracted and utilized. The production of video content remains valuable. It is our methods of processing and consuming it that are evolving.

Aligning with effective networked learning theory

This shift aligns with contemporary understanding of effective learning. Research consistently demonstrates that passive consumption of information, whether through video or text, remains insufficient for meaningful learning. Genuine knowledge development emerges through active construction – the processes of questioning, connecting, applying, and adapting information within broader contexts.

The AI-enabled extraction of insights from video content represents a step toward more active engagement with educational materials – transforming passive viewing into targeted interaction with the specific knowledge elements most relevant to individual learning needs.

Knowledge networks trump media formats

Our experience with global learning networks demonstrates the importance of moving beyond media format limitations. When health professionals from diverse contexts share practices and adapt them to their specific environments, the medium of exchange becomes secondary to the knowledge being constructed.

AI tools that can extract and process information from videos help overcome the medium’s inherent limitations, turning static content into formats that can not only be read, viewed, or listened to – but that can also be remixed and fused with other sources. This approach allows learners to engage more directly with knowledge, freed from the constraints of linear consumption and bandwidth requirements.

Rethinking video as a dual-purpose knowledge production format

We are witnessing the development of new approaches to educational content where media exists simultaneously for direct human consumption and as structured data for AI processing. When the boundaries between content formats become increasingly permeable, with value residing not in the medium itself but in the knowledge that can be extracted and constructed from it.

Despite the consumption challenges, video remains an exceptional medium for content production that serves both humans and machines. For content creators, video offers unmatched richness in communicating complex ideas through visual demonstration, tone, and emotional connection.

What is emerging is not a devaluation of video creation but a transformation in how its knowledge is accessed. As AI tools evolve, video becomes increasingly valuable as a comprehensive knowledge repository where information is encoded in multiple dimensions – visual, auditory, and textual through transcripts.

This makes video uniquely positioned as a “dual-purpose” content format: rich and engaging for those who can consume it directly, while simultaneously serving as a structured data source from which AI can extract targeted insights.

In this paradigm, video production remains vital while consumption patterns evolve toward more efficient, personalized knowledge extraction.

The creator’s effort in producing quality video content now yields value across multiple consumption pathways rather than being limited to linear viewing

How to cite this article: Sadki, R. (2025). Why YouTube is obsolete: From linear video content consumption to AI-mediated multimodal knowledge production. Learning to make a difference. https://doi.org/10.59350/rfr2z-h4y93

References

Delello, J.A., Watters, J.B., Garcia-Lopez, A., 2024. Artificial Intelligence in Education: Transforming Learning and Teaching, in: Delello, J.A., McWhorter, R.R. (Eds.), Advances in Business Information Systems and Analytics. IGI Global, pp. 1–26. https://doi.org/10.4018/979-8-3693-3003-6.ch001

Guo, P.J., Kim, J., Rubin, R., 2014. How video production affects student engagement: An empirical study of MOOC videos, in: Proceedings of the First ACM Conference on Learning@ Scale Conference. ACM, pp. 41–50. https://doi.org/10.1145/2556325.2566239

Hansch, A., Hillers, L., McConachie, K., Newman, C., Schildhauer, T., Schmidt, P., 2015. Video and Online Learning: Critical Reflections and Findings from the Field. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.2577882

Kumar, L., Singh, D.K., Ansari, M.A., 2024. Role of Video Content Generation in Education Systems Using Generative AI:, in: Doshi, R., Dadhich, M., Poddar, S., Hiran, K.K. (Eds.), Advances in Educational Technologies and Instructional Design. IGI Global, pp. 341–355. https://doi.org/10.4018/979-8-3693-2440-0.ch019

Mayer, R.E., Fiorella, L., Stull, A., 2020. Five ways to increase the effectiveness of instructional video. Education Tech Research Dev 68, 837–852. https://doi.org/10.1007/s11423-020-09749-6

Netland, T., Von Dzengelevski, O., Tesch, K., Kwasnitschka, D., 2025. Comparing human-made and AI-generated teaching videos: An experimental study on learning effects. Computers & Education 224, 105164. https://doi.org/10.1016/j.compedu.2024.105164

Salomon, G., 1984. Television is “easy” and print is “tough”: The differential investment of mental effort in learning as a function of perceptions and attributions. Journal of Educational Psychology 76, 647–658. https://doi.org/10.1037/0022-0663.76.4.647

Sun, M., 2024. An Intelligent Retrieval Method for Audio and Video Content: Deep Learning Technology Based on Artificial Intelligence. IEEE Access 12, 123430–123446. https://doi.org/10.1109/ACCESS.2024.3450920

Image: The Geneva Learning Foundation Collection © 2025

Chilling effect

Chilling effect

Reda SadkiGlobal health

We reached out to senior decision makers working in global health about the new Certificate peer learning programme for equity in research and practice.

Crickets.

One CEO wrote: “We aren’t currently in a position to enter into new strategic partnerships on the topic.”

The chilling effect is real.

Many organizations are retreating from publicly championing equity work—even those with deep commitments to fairness and inclusion.

But here’s the opportunity: While public discourse faces headwinds, meaningful work continues through trusted networks and communities of practice.

This is precisely when innovation in equity approaches accelerates—away from the spotlight but with profound impact.

The evidence is clear: health systems that neglect equity waste resources and deliver poorer outcomes.

When research excludes key populations or policies overlook certain communities, we all lose—through inefficiency, increased costs, and diminished impact.

This moment calls for courage from those who understand that equity is fundamental to effective health systems.

“The ultimate measure of a person is not where they stand in moments of comfort, but where they stand at times of challenge.” – Martin Luther King Jr.

If you’re still committed to this essential work, you’re not alone.

Question: How are you maintaining momentum on equity work during challenging times?

Image: The Geneva Learning Foundation Collection © 2025

MOOC completion rates in context

Online learning completion rates in context: Rethinking success in digital learning networks

Reda SadkiGlobal health, Learning

The comprehensive analysis of 221 Massive Open Online Courses (MOOCs) by Katy Jordan provides crucial insights for health professionals navigating the rapidly evolving landscape of digital learning. Her study, published in the International Review of Research in Open and Distributed Learning, examined completion rates across diverse platforms including Coursera, Open2Study, and others from 78 institutions. 

  • With median completion rates of just 12.6% (ranging from 0.7% to 52.1%), traditional metrics may suggest disappointment. Jordan’s multiple regression analysis revealed that while total enrollments have decreased over time, completion rates have actually increased. 
  • The data showed striking patterns in how participants engage, with the first and second weeks proving critical—after which the proportion of active students and those submitting assessments remains remarkably stable, with less than 3% difference between them. 
  • The research challenges common assumptions about “lurking” as a participation strategy and provides compelling evidence that course design factors significantly impact learning outcomes. 

These findings reveal important patterns that can transform how we approach professional learning in global health contexts.

Beyond traditional completion metrics

For global health epidemiologists accustomed to face-to-face training with financial incentives and dedicated time away from work, these completion rates might initially appear appalling. In traditional capacity building programswhere participants receive per diems, travel stipends, and paid time away from work. Outcomes such as “completion” are rarely measured. Instead, attendance remains the key metric. In fact, completion rates are often confused with attendance. From this perspective, even the highest MOOC completion rate of 52.1% could be interpreted as a dismal failure.

However, this interpretation fundamentally misunderstands the different dynamics at play in digital learning environments. Unlike traditional training where external incentives and protected time create artificial conditions for participation, MOOCs operate in the reality of participants’ everyday professional lives. They typically do not require participants to stop work in order to learn, for example. The fact that up to half of enrollees in some courses complete them despite competing priorities, no financial incentives, and no dedicated work time represents remarkable commitment rather than failure.

What drives completion?

The data reveals three significant factors affecting completion:

  1. Course length: Shorter courses consistently achieved higher completion rates
  2. Assessment type: Auto-grading showed better completion than peer assessment
  3. Start date: More recent courses demonstrated higher completion rates

The critical engagement period occurs within the first two weeks—after which participant behavior stabilizes. This insight aligns with what emerging networked learning approaches have demonstrated in practice.

Rather than judging digital learning by metrics designed for classroom settings, we must recognize that participation patterns reflect authentic integration with professional practice. The measure of success is not just how many complete the formal course, but how learning connects to real-world problem-solving and contributes to sustained professional networks.

Moving beyond MOOCs: Health learning networks

The Geneva Learning Foundation’s approach offers a distinctly different model from traditional MOOCs. While MOOCs typically deliver standardized content to individual learners who progress independently, the Foundation’s digital learning initiatives are fundamentally network-based and practice-oriented. Rather than focusing on content consumption, their approach creates structured environments where health professionals connect, collaborate, and co-create knowledge while addressing real challenges in their work.

These learning networks differ from MOOCs in several key ways:

  • Participants engage primarily with peers rather than pre-recorded content
  • Learning is organized around actual workplace challenges rather than abstract concepts
  • The experience builds sustainable professional relationships rather than one-time course completion
  • Assessment occurs through peer review and real-world application rather than quizzes or assignments
  • Structure is provided through facilitation and process rather than predetermined pathways

The Foundation’s experience with over 60,000 health professionals across 137 countries demonstrates that when learning is connected to practice through networked approaches, different metrics of success emerge:

  • Knowledge application: Practitioners implement solutions directly in their contexts
  • Network formation: Sustainable learning relationships develop beyond formal “courses”
  • Knowledge creation: Participants contribute to collective understanding
  • System impact: Changes cascade through health systems

Implications for global health training

For epidemiologists and health professionals designing learning initiatives, these findings suggest several strategic shifts:

  1. Modular design: Create shorter, more connected learning units rather than lengthy courses
  2. Real-world integration: Link learning directly to participants’ practice contexts
  3. Peer engagement: Provide structured opportunities for health workers to learn from each other
  4. Network building: Focus on creating sustainable learning communities rather than isolated training events

The future of professional learning

The research and practice point to a fundamental evolution in how we approach professional learning in global health. Rather than replicating traditional per diem-driven training models online, the most effective approaches harness the power of networks, enabling health professionals to learn continuously through structured peer interaction.

This perspective helps explain why seemingly low completion rates should not necessarily be viewed as failure. When digital learning is designed to create lasting networks of practice—where knowledge emerges through collaborative action—completion metrics capture only a fraction of the impact.

For health systems facing complex challenges that include climate change, pandemic response, and health workforce shortages, this networked approach to learning offers a promising path forward—one that transforms how knowledge is created, shared, and applied to improve health outcomes globally.

Reference

Jordan, K., 2015. Massive open online course completion rates revisited: Assessment, length and attrition. IRRODL 16. https://doi.org/10.19173/irrodl.v16i3.2112

Sculpture: The Geneva Learning Foundation Collection © 2025

What is complex learning

What is complex learning?

Reda SadkiGlobal health

Complex learning happens when people solve real problems instead of just memorizing facts.

Think about the difference between reading about how to ride a bicycle and actually learning to ride one.

You cannot learn to ride a bicycle just by reading about it – you need to practice, fall, adjust, and try again until your body understands how to balance.

Health challenges work the same way.

Reading about how to respond to a disease outbreak is very different from actually managing one.

Complex learning recognizes this difference.

5 key features of complex learning:

  1. Learning by doing: People learn best when they work on real problems they face in their jobs. Instead of just listening to experts, they actively try solutions, see what works, and adjust their approach.
  2. No single right answer: Complex learning deals with situations where there is no perfect solution that works everywhere. What works in one community might fail in another because of different resources, cultures, or systems.
  3. Adapting to local reality: Rather than following fixed steps, complex learning helps people adapt general principles to their specific situation. A rural clinic and an urban hospital might need different approaches even when dealing with the same disease.
  4. Connecting different types of knowledge: Complex learning brings together technical knowledge (facts and procedures) with practical wisdom (experience and judgment). Both are needed to solve real health challenges.
  5. Learning from mistakes: In complex learning, mistakes are valuable opportunities to learn, not failures to be hidden. When something doesn’t work, the question becomes “What can we learn from this?” rather than “Who is to blame?”

Why it matters for health work:

Most health challenges are complex problems. Disease outbreaks, vaccination campaigns, and health system improvements all require more than just technical knowledge. They require the ability to:

  • Adapt to changing situations
  • Work with limited resources
  • Coordinate with different groups
  • Solve unexpected problems
  • Learn from experience

Complex learning builds these abilities by engaging people with real challenges, supporting them as they try solutions, and helping them reflect on what they learn.

Unlike traditional training that assumes knowledge flows from experts to learners, complex learning recognizes that knowledge emerges through practice and experience. When health workers engage with complex learning, they don’t just know more – they become better problem-solvers capable of addressing the unique challenges in their communities.