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 …
The COVID-19 Peer Hub as an example of Collective Intelligence (CI) in practice
A new article by colleagues at the Cambridge Digital Education Futures Initiative (DEFI) illustrates academic understanding of Collective Intelligence (CI) through the COVID-19 Peer Hub, a peer learning initiative organized by over 6,000 frontline health workers in Africa, Asia, and Latin America, with support from The Geneva Learning Foundation (TGLF), in response to the initial shock of the pandemic on immunization services that placed 80 million children at risk of missing lifesaving vaccines. Learn more about the COVID-19 Peer Hub… From the abstract: Collective Intelligence (CI) is important for groups that seek to address shared problems. CI in human groups can be mediated by educational technologies. The current paper presents a framework to support design thinking in relation to CI educational technologies. Our framework is grounded in an organismic-contextualist developmental perspective that orients enquiry to the design of increasingly complex and integrated CI systems that support coordinated group problem solving …
Honoring health professionals as leaders of change
We honor everyone who is joining the Special Event “From community to planet: Health professionals on the frontlines of climate change”: health staff from immunization and other areas of health – environmental health and One Health, but also those who fight neglected tropical diseases (NTDs), HIV, and other ailments. We also honor allies, including human rights advocates, those working to decolonize global health, fighting for gender and racial equity as well as economic justice. Since 2016, the Geneva Learning Foundation (TGLF) has supported a global peer learning network and platform, built by and for immunization staff from all over the world. This is because we believe that practitioner-led peer education is a powerful philosophy for change in the Digital Age. In 2020, when the COVID-19 pandemic, at least 80 million children under one were placed at risk of vaccine-preventable diseases such as diphtheria, measles and polio as COVID-19 disrupted immunization service as worldwide. …
Learning from Frontline Health Workers in the Climate Change Era
By Julie Jacobson, Alan Brooks, Charlotte Mbuh, and Reda Sadki The escalating threats of climate change cast long shadows over global health, including increases in disease epidemics, profound impacts on mental health, disruptions to health infrastructure, and alterations in the severity and geographical distribution of diseases. Mitigating the impact of such shadows on communities will test the resilience of health infrastructure in low- and middle-income countries (LMICs) and especially challenge frontline health workers. The need for effective and cost-efficient public health interventions, such as immunization, will evolve and grow. Health workers, approximately 70% of which are women, that provide immunization and other health services will be trusted local resources to the communities they serve, further amplifying their centrality in resilient health systems. Listening to and building upon the experiences and insights of frontline health workers as they live with and increasingly work to address the manifestations of climate change on …
What does immunization have to do with climate change?
With climate-driven shifts in disease patterns and emerging health threats, the need for a robust immunization infrastructure is more obvious than ever. As the demand for both existing and novel vaccines rises in response to an expanding disease burden and new health threats, immunization staff will inevitably play a key role. Immunization staff, trusted health advisors to communities, already stand as sometimes-overburdened but always critical actors in resilient health systems. These professionals, entrusted with administering vaccines, contribute to preventing disease outbreaks and maintaining population health. Furthermore, their direct engagement with local communities, their intimate understanding of community health concerns, and their role as trusted advisors position them to recognize and respond to emerging health needs. The role of immunization and other primary health care (PHC) staff as health educators becomes increasingly pertinent in a changing climate. By leveraging their experience in working with communities to understand and accept health interventions, …
Digital bridges cannot cross analog gates
I’ve been doing a lot of thinking recently about an interesting question, as I’ve observed myself and colleagues starting to travel again: “Why are we again funding high-cost, low-volume face-to-face conferences that yield, at best, uncertain outcomes?” I am surprised to have to ask this question. I was hoping for a different outcome, in which the experience of the COVID-19 pandemic led to a lasting change in how we bridge physical and digital spaces for a better future. We were brutally forced to work differently due to the COVID-19 pandemic’s restrictions on freedom of movement. Nevertheless, we discovered that it is possible to connect, meet, collaborate, and learn without sinking budgets into air travel and accommodation. At least some of work-related travel was due to habit and convention, not necessity. Yes, there were limitations, especially due to the emergency nature of the pivot to online. But the debate is open …
Why an open-source manifesto for global health?
Lire la version française: Pourquoi un manifeste open-source pour la santé globale? The global immunization community is now focused on “the big catch-up”, dealing with recovery of immunization services from the consequences of the COVID-19 pandemic, as countries – and immunization staff on the frontlines – work toward the goals of Immunization Agenda 2030 (IA2030). At the Seventy-Fourth World Health Assembly, the Director General of the World Health Organization had called for “a broad social movement for immunization that will ensure that immunization remains high on global and regional health agendas and help to generate a groundswell of support or social movement for immunization”. A Movement is larger than any one individual or organization. The Geneva Learning Foundation is one of many working to support this Movement. In March 2022, we launched a call for immunization staff at all levels of the health system to connect across boundaries of geography …
Pourquoi un manifeste open-source pour la santé globale?
Read this in English: Why an open-source manifesto for global health? La communauté mondiale de la vaccination se concentre désormais sur le « grand rattrapage », en priorisant le rétablissement des services de vaccination suite aux conséquences de la pandémie de COVID-19, alors que les pays—et le personnel de la vaccination en première ligne—s’efforcent d’atteindre les objectifs du Programme pour la vaccination à l’horizon 2030 (IA2030). Lors de la soixante-quatorzième Assemblée mondiale de la santé, le directeur général de l’Organisation mondiale de la santé avait lancé un appel en faveur d’un « vaste mouvement social pour la vaccination qui veillera à ce que la vaccination reste une priorité dans les programmes de santé internationaux et régionaux et contribuera à susciter une vague de soutien ou un mouvement social en faveur de la vaccination ». Un mouvement est plus grand qu’un seul pays ou une seule organisation. La Fondation Apprendre Genève est l’une des nombreuses …
Metaphors of global health: jazz improvisation ensemble or classical orchestra?
In the realm of classical music, the orchestra stands as a formidable emblem of aesthetic grandeur and refinement. However, beneath the veneer of sophistication lies a deeply entrenched system that stymies the potential for creative exploration and spontaneity. As in a straitjacket, the rigidity of this system threatens to reduce the rich tapestry of human experience into a sterile hierarchy, devoid of the serendipity that breathes life into artistic expression. The classical orchestra is governed by a hierarchy that places the conductor at the apex, wielding an almost tyrannical authority over the musicians. It is a system that perpetuates a culture of conformity, where musicians are coerced into subsuming their individuality in the service of an imposed order. This stifling environment leaves little room for the musicians to contribute their own interpretations or creative impulses, and instead demands that they adhere strictly to the conductor’s vision, which is often based …
What works in practice to build vaccine confidence?
This is the content of a poster presented today by The Geneva Learning Foundation (LinkedIn | YouTube | Podcast | Twitter) at the International Social and Behavior Change Communication Summit 2022 (#SBCCSummit) held 5-9 December 2022 in Marrakech, Morocco. What is the Geneva Learning Foundation? Get the full report… Read the preface by Heidi Larson… From responding to the initial shock of the pandemic to preparing COVID-19 vaccine introduction Over 6,000 health professionals joined the COVID-19 Peer Hub in July 2022, part of the Geneva Learning Foundation’s (TGLF) global immunization learning-to-action platform. We asked a simple question: Can you think of a time when you helped an individual or group overcome their initial reluctance, hesitancy, or fear about vaccination? Who participated? Local practitioners from 86 countries: Health system levels: So what? What was the significance of the experience for participants? Transformation: “I can tell you this experience changed my life. It has changed my practice and made …