In a rural health center in Kenya, a community health worker develops an innovative approach to reaching families who have been hesitant about vaccination. Meanwhile, in a Brazilian city, a nurse has gotten everyone involved – including families and communities – onboard to integrate information about HPV vaccination into cervical cancer screening. These valuable insights might once have remained isolated, their potential impact limited to their immediate contexts. But through Teach to Reach – a peer learning platform, network, and community hosted by The Geneva Learning Foundation – these experiences become part of a larger tapestry of knowledge that transforms how health workers learn and adapt their practices worldwide. Since January 2021, the event series has grown to connect over 21,000 health professionals from more than 70 countries, reaching its tenth edition with 21,398 participants in June 2024. Scale matters, but this level of engagement begs the question: how and why does it …
Brevity’s burden: The executive summary trap in global health
It was James Gleick who noted in his book “Faster: The Acceleration of Just About Everything” the societal shift towards valuing speed over depth: “We have become a quick-reflexed, multitasking, channel-flipping, fast-forwarding species. We don’t completely understand it, and we’re not altogether happy about it.” In global health, there’s a growing tendency to demand ever-shorter summaries of complex information. “Can you condense this into four pages?” “Is there an executive summary?” These requests, while stemming from real time constraints, reveal fundamental misunderstandings about the nature of knowledge and learning. Worse, they contribute to perpetuating existing global health inequities. Here is why – and a few ideas of what we can do about it. We lose more than time in the race to brevity The push for shortened summaries is understandable on the surface. Some clinical researchers, for example, undeniably face increasing time pressures. Many are swamped due to underlying structural issues, …
The capability trap: Nobody ever gets credit for fixing problems that never happened
Here is a summary of the key points from the article “Nobody ever gets credit for fixing problems that never happened: creating and sustaining process improvement”. Overview Core causal loops The capability trap The “capability trap” refers to the downward spiral organizations can get caught in, where attempting to boost performance by pressuring people to “work harder” actually erodes process capability over time. This trap works through a few key mechanisms: Key takeaway for learning leaders Learning leaders must understand the systemic traps identified in the article that underly failed improvement initiatives and facilitate mental model shifts. This help build sustainable, effective learning programs to be realized through productive capability-enhancing cycles. Key takeaway for immunization leaders It is reasonable to hypothesize that poor health worker performance is a symptom rather than the cause of poor immunization programme performance. Short-term decisions, often responding to top-down targets and donor requirements, hurt capability …
Pandemic preparedness through connected transnational digital networks of local actors
In the Geneva Learning Foundation’s approach to effective humanitarian learning, knowledge acquisition and competency development are both necessary but insufficient. This is why, in July 2019, we built the first Impact Accelerator, to support local practitioners beyond learning outcomes all the way to achieving actual health outcomes. What we now call the Full Learning Cycle has become a mature package of interventions that covers the full spectrum from knowledge acquisition to implementation and continuous improvement. This package has produced the same effects in every area of work where we have been able to test it: self-motivated groups manifesting remarkable, emergent leadership, connected laterally to each other in each country and between countries, with a remarkable ability to quickly learn and adapt in the face of the unknown. In 2020, we got to test this package during the COVID-19 pandemic, co-creating the COVID-19 Peer Hub with over 6,000 frontline health professionals, …
Reinventing the path from knowledge to action in global health
At the Geneva Learning Foundation (TGLF), we have just begun to share a publication like no other. It is titled Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers. You can access the full report here in French and in English. Short summaries are also available in three special issues of The Double Loop, the Foundation’s free Insights newsletter, now available in both English and French. The report, prefaced by Heidi Larson who leads the Vaccine Confidence Project, includes DOI to facilitate citation in academic research. (The Foundation uses a repository established and maintained by the Geneva-based CERN for this purpose.) However, knowing that academic papers have (arguably) an average of three readers, we have a different aspiration for dissemination. As a global community, we recognize the significance of local action to achieve the global goals. The report documents vaccine confidence practices just …
Learning for Knowledge Creation: The WHO Scholar Program
Excerpted from: Victoria J. Marsick, Rachel Fichter, Karen E. Watkins, 2022. From Work-based Learning to Learning-based Work: Exploring the Changing Relationship between Learning and Work, in: The SAGE Handbook of Learning and Work. SAGE Publications. Reda Sadki of The Geneva Learning Foundation (TGLF), working with Jhilmil Bahl from the World Health Organization (WHO) and funding from the Bill and Melinda Gates Foundation, developed an extraordinary approach to blending work and learning. The program started as a series of digitally offered courses for immunization personnel working in various countries, connecting in-country central planners, frontline workers, and global actors. The program was designed to address five common problems in training (Sadki, 2018): the inability to scale up to reach large audiences; the difficulty in transferring what is learned; the inability to accommodate different learners’ starting places; the need to teach learners to solve complex problems; and the inability to develop sufficient expertise …
What is the value of strategy in the middle of a global crisis?
A new global vision and strategy titled ‘Immunization Agenda 2030: A Global Strategy to Leave No One Behind (IA2030)’ was endorsed by the World Health Assembly less than a year before the World Health Organization declared COVID-19 a Public Health Emergency of International Concern. Today, the cumulative tension of both urgent and longstanding challenges is stretching people who deliver vaccines. Challenges include immunization service recovery, COVID-19 vaccine introduction, and the persistence of epidemic outbreaks of diseases that can already be prevented by vaccines. Is this the right time to launch a global strategy – especially one developed before the pandemic – to achieve the immunization goals? Yes, immunization staff the world over – and the societies we live in – are still reeling from the shock of the COVID-19 pandemic. Nevertheless, in times of crisis, thinking and acting strategically can help each of us stay focused on the global immunization goals, keeping us on the path to equitable …
Accountability in learning
What if you were the key internal resource person with learning expertise? What if you advocated, recommended, and prescribed low-volume, high-cost face-to-face training? What if your advocacy was so successful that global partners invested hundreds of millions of dollars in what you prescribed – even in the absence of any standard to determine the return on that investment? What if your recommended approach resulted in zero measurable impact? What if partners nevertheless kept spending on training, entrenching perverse incentives like per diem to substitute for motivation, evidence, and results? What if you ignored and then dismissed, for as long as you possibly could, the relevance and potential of digital networks to support learning? What if you then managed to replicate the worst, least effective kinds of training through sterile digital formats of slides with voiceovers and a quiz at the end? What if you kept badgering managers to get their …
What lies beyond the event horizon of the ‘webinar’?
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 …
Can the transformation of global health education for impact rely on input-based accreditation?
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 (summary and references via this link) as we think through the proposal that the transformation of global health education for impact should rely solely on accredited institutions. Global health efforts are focused on outcomes and aim to achieve impact. The focus on results makes the prevailing input-based accreditation criteria unlikely to be the most useful ones to help achieve global health goals. This calls for rethinking a broad swath of fairly fundamental issues, from how to construct education to what philosophy should underpin what we design and develop. The call for a “revolution” in education for public …