Health performance management in complex adaptive systems

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

Reda SadkiGlobal health, Learning, Research

We need a conceptual framework that situates health performance management within complex adaptive systems. This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to performance management in a given context. Existing performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies. Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change. In my view, this important paper mends an important broken link in theories of change that try to consider learning beyond training. The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to …

Mindjourney-online learning network-abstract-colorful

Which is better for global health: online, blended, or face-to-face learning?

Reda SadkiLearning, Research, Theory

Question 1. Does supplementing face-to-face instruction with online instruction enhance learning? No. Positive effects associated with blended learning should not be attributed to the media, per se. (It is more likely that positive effects are due to people doing more work in blended learning, once online and then again in a physical space.) This is the conclusion of the U.S. Department of Education’s “Evaluation of evidence-based practices in online learning: a meta-analysis and review of online learning studies” in September 2010. You can find the full document here. Question 2. Is the final academic performance of students in distance learning programs better than that of those enrolled in traditional FTF programs, in the last twenty-year period? Yes. Distance learning results in increasingly better learning outcomes since 1991 – when learning technologies to support distance learning were far more rudimentary than they are now. This is the meta-analysis done by Mickey …