The capability trap

The capability trap: Nobody ever gets credit for fixing problems that never happened

Leadership, Learning strategy

Here is a summary of the key points about the capability trap, from the article “Nobody ever gets credit for fixing problems that never happened: creating and sustaining process improvement”. What is the capability trap? 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 …

Gender analysis of the World Health Organization online learning program on Immunization Agenda 2030

Gender analysis of the World Health Organization online learning program on Immunization Agenda 2030

Global health

The article “Gender analysis of the World Health Organization online learning program on Immunization Agenda 2030” is, according to the authors, “the first to showcase the positive inclusion of mainstreaming gender in a WHO capacity-building program.” Context: Key findings: This is consistent with the known effectiveness of peer feedback, as the rubric followed by each learner included specific instructions to “describe how your action plan has considered and integrated gender dimensions in immunization.” TGLF’s peer learning model focuses on generating and applying new knowledge. This appears to be conducive to raising awareness of issues like gender barriers to immunization. By giving and receiving feedback, participants build understanding. Whereas only around ten percent of learners participated in expert-led presentations offered about gender and immunization, every learner had to think through and write up gender analysis. And every learner had to give feedback on the gender analyses of three colleagues. The social …

Towards reimagined technical assistance Thinking beyond the current policy options

Towards reimagined technical assistance: thinking beyond the current policy options

Global health, Leadership

In the article “Towards reimagined technical assistance: the current policy options and opportunities for change”, Alexandra Nastase and her colleagues argues that technical assistance should be framed as a policy option for governments. It outlines different models of technical assistance: Governments may choose from this spectrum of roles for technical advisers in designing assistance programs based on the objectives, limitations, and tradeoffs involved with each approach: “The most common fallacy is to expect every type of technical assistance to lead to capacity development. We do not believe that is the case. Suppose governments choose to use externals to do the work and replace government functions. In that case, it is not realistic to expect that it will build a capability to do the work independently of consultants.” Furthermore, technical assistance should be designed through “meaningful and equal dialogue between governments and funders” to ensure it focuses on core issues and …

Protect Invest Together

Protect, invest, together: strengthening health workforce through new learning models

Global health

In “Prioritising the health and care workforce shortage: protect, invest, together,” Agyeman-Manu et al. assert that the COVID-19 pandemic aggravated longstanding health workforce deficiencies globally, especially in under-resourced nations.  With projected shortages of 10 million health workers concentrated in Africa and the Middle East by 2030, the authors urgently call for policymakers to commit to retaining and expanding national health workforces.  They propose common-sense solutions: increased, coordinated financing and collaboration across government agencies managing health, finance, economic development, education and labor portfolios. But how can such interconnected, long-term investments be designed for maximum sustainable impact? And what is the role of education? Rethinking health worker learning In a 2021 WHO survey across 159 countries, most health workers reported lacking adequate training to respond effectively to pandemic demands. This exposed systemic weaknesses in how health workforces develop skills at scale. Long before the COVID-19 pandemic, limitations of traditional learning approaches were …

The imperative for climate action to protect health and the role of education

The imperative for climate action to protect health and the role of education

Global health

“The Imperative for Climate Action to Protect Health” is an article that examines the current and projected health impacts of climate change, as well as the potential health benefits of actions to reduce greenhouse gas emissions. The authors state that “climate change is causing injuries, illnesses, and deaths, with the risks projected to increase substantially with additional climate change.”  Specifically, the article notes that approximately “250,000 deaths annually between 2030 and 2050 could be due to climate change–related increases in heat exposure in elderly people, as well as increases in diarrheal disease, malaria, dengue, coastal flooding, and childhood stunting.” The impacts will fall disproportionately on vulnerable populations, and climate change “could force more than 100 million people into extreme poverty by 2030.” The article discusses major exposure pathways that link climate hazards to health outcomes like “heat-related illness and death, illnesses caused by poor air quality, undernutrition from reduced food …

Prioritizing the health and care workforce shortage

Prioritizing the health and care workforce shortage: protect, invest, together

Global health

The severe global shortage of health and care workers poses a dangerous threat to health systems, especially in low- and middle-income countries (LMICs). The authors of the article “Prioritising the health and care workforce shortage: protect, invest, together”, including six health ministers and the WHO Director-General, assert that this workforce crisis requires urgent action and propose “protect, invest, together” to tackle it. Deep protection of the existing workforce, they assert, is needed through improved working conditions, fair compensation, upholding rights, addressing discrimination and violence, closing gender inequities, and implementing the WHO Global Health and Care Worker Compact to ensure dignified working environments. All countries must prioritize retaining workers to build resilient health systems. Significantly increased and strategic long-term investments are imperative in both training new health workers through educational channels and sustaining their employment. Countries should designate workforce development, especially at the primary care level, as crucial human capital investments …

Movement for Immunization Agenda IA2030

Movement for Immunization Agenda 2030 (IA2030): grounding action in local realities to reach the unreached

Global health

Three years after the launch of Immunization Agenda 2030 (IA2030), WHO’s 154th Executive Board meeting provided a sobering picture of how the COVID-19 pandemic reversed decades of progress in expanding global immunization coverage and controlling vaccine-preventable diseases. In response, the World Health Organization is calling for action “grounded in local realities”. Growing evidence supports fresh approaches that do exactly that. Tom Newton-Lewis is part of the community of researchers and practitioners who have observed that “health systems are complex and adaptive” and, they say, that explains why top-down control rarely succeeds. However, top-down control and directive management appear to have been key to how immunization programmes achieved impressive results in previous decades. Hence, it may be challenging for the current generation of global immunization leaders to consider that enabling approaches that leverage intrinsic motivation, foster collective responsibility, and empower teams – especially for local staff – are the ones needed now. One …

WHO Director-General says Immunization Agenda 2030 off-track

Widening inequities: Immunization Agenda 2030 remains “off-track”

Global health

The WHO Director General’s report to the 154th session of the Executive Board on progress towards the Immunization Agenda 2030 (IA2030) goals paints a “sobering picture” of uneven global recovery since COVID-19. As of 2022, 3 out of 7 main impact indicators remain “off-track”, including numbers of zero-dose children, future deaths averted through vaccination, and outbreak control targets. Current evidence indicates substantial acceleration is essential in order to shift indicators out of the “off-track” categories over the next 7 years. While some indicators showed recovery from pandemic backsliding, the report makes clear these improvements are generally insufficient to achieve targets set for 2030. While some indicators have improved from 2021, overall performance still “lags 2019 levels” (para 5). Specifically, global coverage of three childhood DTP vaccine doses rose from 81% in 2021 to 84% in 2022, but remains below the 86% rate achieved in 2019 before the pandemic (para 5). …

IA2030 Movement HPV vaccination national EPI consultation

Movement for Immunization Agenda 2030 (IA2030): National EPI leaders from 31 countries share experience of HPV vaccination

Global health

What difference can peer-led learning and action make for national EPI planners seeking new strategies to support HPV vaccine introduction or reintroduction? The stakes are high: HPV vaccination efforts, if successful, will avert 3.4 million deaths by 2030. On Friday, EPI focal points for HPV and other national-level MOH colleagues from 31 countries convened under the banner of the Movement for Immunization Agenda 2030 (IA2030), which connects over 60,000 primarily sub-national health staff worldwide. What is the Movement for Immunization Agenda 2030 (IA2030)? This time, it was national HPV vaccination focal points and other national EPI planners who joined to share experience between countries of ‘what works’ (and how). They also discussed how the Geneva Learning Foundation’s unique peer learning-to-action pathway could help them overcome barriers they are facing to ensure that local communities understand and support the benefits of this vaccine. Such a pathway can complement existing, top-down forms …

20231211.COP28 Health Pavilion event

Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

Events, Global health, The Geneva Learning Foundation

The Geneva Learning Foundation’s Charlotte Mbuh spoke today at the COP28 Health Pavilion in Dubai, United Arab Emirates (UAE). Watch the speech at COP28… Good afternoon. I am Charlotte Mbuh. I have worked for the health of children and families in Cameroon for over 15 years. I am one of more than 5,500 health workers from 68 countries who have connected to share our observations of how climate is affecting the health of those we serve.  “Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.” These are the words of Samuel Chukwuemeka Obasi, a health worker from …