Sinistar Wallpaper – Beware — I Live! (Retroist.com)

Why gamification is a disaster for humanitarian learning

Reda SadkiThinking aloud

Is gamification an advantageous strategy that can help increase knowledge and application when it comes to humanitarian responses? What are these advantages? Can gamification contribute to better humanitarian preparedness?

Certainly, if you have been forced to maniacally click through 500 screens of a boring “e-learning” from the past – dressed up with multicolored bells and whistles or cute little Flash animation – to finally get to the stupid quiz that is insulting your intelligence by asking you to recall what you will have forgotten tomorrow but that you need to pass to earn your stupid gold certificate before your field deployment, “gamification” sounds enticing. After all, you figured out how to game that e-learning module… so maybe games are the key to the future of humanitarian learning? Not.

Is gamification one of the “current innovations in the field of learning”? Well, arguably, this may have been the case… over a decade ago. And it has long since been debunked. Can gamification help tackle some of the challenges we face in humanitarian learning? These challenges include scale (we need a lot more people ready to face disasters and volunteering to strengthen their communities’ resilience), reach (all the way to the last mile to people on the receiving end of aid), strategic relevance, and using new learning methodologies that model how humanitarians work together with and within communities, solve problems, and grow as leaders.

Is there potential in using game elements for increased engagement and effective training of humanitarian staff? Often, “gamification devolves to just creating competitive experiences based on some sort of point-scoring model that is at-best glorified industrial psychology and not necessarily a great, giant outcome of innovation or game design,” explains Ben Sawyer, the founder of Games for Health. (Ben convinced me five years ago that serious games not gamification are a viable approach for some needs – just an incredibly complex, costly one.)

My twelve-year-old son is a gamer. I observe and ocasionally participate. The immersive qualities of recent games are amazing, and the way they work your psychology is mind-blowing. Game studios understand the intricacies of human behavior and motivation at least as well as casinos do. So, yeah, imagine if we could put that power to use for the good of humanity…

There are three obvious problems.

The first problem is that building quality learning experienced as a game is very expensive. Creating a fully-cognitive experience with a more encompassing model of engagement and interaction starts at 50 million U.S. dollars (Final Fantasy XII) and there is no upper limit (200 million for Star Wars: The Old Republic).

What could you do with the shoestring budgets available for learning and capacity building in the humanitarian sector? At best, try to short circuit the experience and use just a few elements in hopes that creating a ‘game’ or an experience that instills some of the core ideas of what a game is by definition will generate a bump in engagement. And that, my friends, is a recipe for failure in so many ways, but above all because it is disconnected from humanitarian learning needs.

That, in fact, is the second problem. “For all staff, the abilities to learn, to reflect, to negotiate, to critically examine and analyse what they are seeing and hearing, are crucial,” wrote Connell Foley in 2008. Creating a game that is about more than stimulus-response is difficult (requiring talent that does not exist in our sector), costly, and therefore unlikely. As a learning approach, it is not the one you choose if you want to support the development of analytical capabilities or critical thinking.

Increasingly, humanitarians, like other knowledge workers (cf. Robert Kelly’s longitudinal study), can only get things done through collaboration, because the knowledge they need is no longer stored in their brains. This is not the “Social Age” (another dead end I have previously debunked) but part and parcel of the Second Machine Age. Many video games are self-contained worlds, closed systems that fail to model the very complexities that matter the most in the messy real world that we live in – and that can make the difference between life and death when you are working on the edge of chaos.
Robert Kelly: % knowledge stored in your brain needed to do your job from 1986 to 2006

Robert Kelly: % knowledge stored in your brain needed to do your job from 1986 to 2006

The third problem is that the diverse culture of video games contains a dominant strand that is just awful – full of racism, sexism, and violence that is deeply ingrained. The hottest video game right now is called Battlegrounds. It is a Battle Royale where the ultimate purpose is to kill the other 99 players and be the sole survivor whose reward as a “Winner Winner” is to earn a “Chicken Dinner”. Is this really a culture that can be reshaped to serve humanitarian needs, where a lone individual may be trying to save 99 others?

We undoubtedly need new ways of learning and thinking for humanitarians. This has to include both core abilities and value skills. Gamification cannot deliver either of these, and forces us to work from a culture in which the dominant values are difficult to stomach.

 

New ways of learning and thinking

New ways of learning and thinking

Gamification is about behaviorist rewards for selfishness, where you earn points for killing others. It is often innately, to the core, about competition – and contortions to make friendly, peaceful, collaborative forms of gamification are lipstick on the ugly pig of behaviorism that hides beneath the supposedly “innovative” character of gamification.

Behaviorism is a widely-discredited learning theory. It might be relevant for humanitarian workers only if the nature of the work was “do this-do that.” It is not. Problem-solving, navigating the unknown, strengthening the connections between us, developing contextual knowledge that we can use… gamification cannot do any of that. And that happens to be precisely what we need the most.

This brings us right back to the boring e-learning of the past. Clicking through screens and taking a quiz also contains behaviorist assumptions. And, in fact, some of gamification’s strongest advocates in the humanitarian space spent years building boring, one-dimensional, and ultimately ineffective media-heavy content before becoming enthralled with gamification.

The fascination with the video games industry is easy to understand. This industry is already bigger than Hollywood and growing much faster. The potential of virtual (VR) and augmented (AR) reality, artificial intelligence, and other emerging technologies show that this it just the beginning. But “gamification” is precisely not what will help us harness this potential to support humanitarian work.

The fetichization of gamification in learning is akin to that for “story-telling” in communication. Yes, humans play games and tell stories. That both are part of our experience and cultures poses a challenge for learning leaders, certainly. But gamification zealots seem to see every problem through their single, reductive lens – and what was originally an innovative idea full of potential becomes one more rote, knee-jerk response set of blinders.

We need to say “game over” to gamification and commit resources to approaches that foster new learning and leadership to support humanitarian work – not sink precious resources into what was once a fad in the corporate learning space, more than a decade ago.

Featured image: Sinistar Wallpaper – Beware — I Live! (Retroist.com)

Submarine control panel. Bowfin Submarine Museum, Pearl Harbor. Personal collection.

How do we measure the impact of informal and incidental learning on organizational performance?

Reda SadkiLearning strategy

Evidence from learning science clearly identifies how to strengthen learning culture in ways that will drive performance. However, in a recent study conducted by Learning Strategies International (LSi), we quickly found limitations and gaps in the data available from the organization examined, despite the best effort by the organization’s staff to answer our questions and requests.

We found two gaps that needed to be addressed before the most effective approaches to develop capabilities could  be applied usefully – and their impact measured:

  1. The gap between a commitment in principle to learning and skepticism about its actual value. (This gap surprised us.)
  2. Gaps in data and reporting needed to measure internal learning (and how to improve it).

We believe that the first gap (skepticism about the value of learning) is the direct result of the second (lack of measurement).

Without a measure of its impact on performance, internal (staff) learning is likely to be seen as a “nice-to-have” rather than a strategic priority.

Measurement is needed to demonstrate the correlation between internal learning and performance.

Measurement in learning is notoriously difficult. We recognise that although internal learning is critically important, many other variables determine organizational performance.

It would be wonderful if it were possible to draw a straight line from internal learning to specific business outcomes, but it is not.

Recognizing the value of informal learning further complicates measurement: self-directed learning, coaching, mentoring, and other informal learning strategies have this embedded capacity to allow us to learn much more than we intended or expected at the outset.

This makes such learning more difficult to measure, but far more valuable to the participant, team, and organization. This is why we recommended:

  • the use of knowledge, mission, and financial performance of an organization or network as key metrics to correlate with learning culture; and
  • an evidence-based approach (already deployed in over 8,000 organisations and adapted by LSi for global, complex humanitarian networks) to measure these three performance variables and correlate them to the dimensions of learning culture.

Featured image: Submarine control panel. Bowfin Submarine Museum, Pearl Harbor. Personal collection.

Painting at Trigonos (25 January 2017). Personal collection.

The future of learning that could have been

Reda SadkiLearning strategy

In June 2017, the Institute’s president, together with its Chief Learning Officer (CLO), convened an all-hands-on-deck meeting to announce the Institute’s commitment to strengthening its learning culture of innovation and change through an innovative, evidence-based internal learning strategy. Staff were invited to nominate and then elect representatives to the Learning & Development Committee (LDC), mandated with the challenge of ingraining learning “karma in the walls and halls” as key to delivering on its promise to prepare a new generation for the coming humanitarian challenges.

In July, the Institute performed its first benchmark of learning culture and performance. This demonstrated that staff learning is key to mission, financial, and knowledge performance (ie, to delivering results). This benchmark was followed by a learning practice audit in August that woke both managers and staff to their existing strengths and the amazing ways in which they were already continually learning at the point of work.

By the end of 2017, in response to this evidence, DFID and other donors agreed that 5% of budgets be used to support internal learning. In 2018, the LDC’s first elected chair, supported by senior management, staff, and managers, began investing in learning events that recognised and reward on-the-job innovative ideas, problem-solving and significant break-throughs. Staff rapidly learned to rely on these new approaches rather than costly, formal training.

Invited to participate in these learning events, partners expressed growing interest in adopting this methodology to their own contexts, significantly raising the profile of the Institute as an innovator and sector leader for learning.

Staff capabilities grew rapidly and engagement soared in 2018, as managers worked with their teams to define one development objective as part of their performance objectives. Each member of staff added to their personal learning dashboards the activities (both formal and informal) that reflected the diversity and productivity of their learning practices. People inspired each other to go further, sharing and collaborating in new ways. Staff were encouraged to take on stretch assignments, with the assurance that they would no longer be penalised for failure.

By 2019, retention remained impressively above the sector average, as managers adopted the practice of “stay interviews” to mitigate turnover, working within a strong HR system that recognised the need for clear career progression pathways that reward positive behaviours and leadership for learning.

Given the strength of HR and learning systems, this rapid growth in capabilities and leadership was visible to all, shared internally and externally, and directly benefitted the Institute’s partners. High-performing teams were recognised and rewarded during memorable all-staff learning events. External partners asked to join these events, as many of the innovative practices and outcomes were directly relevant to them.

Starting in 2018, new staff reported feeling positively transformed by their induction into the Institute. Formal onboarding was limited to essential information found in the new shelf of crowd-sourced, curated resources for staff learning. Instead, new people were quickly assigned a guide – both a peer and a mentor – from another team or centre. They were invited not just to consume content about the Institute, but to feed back on what they need to function effectively.

By the end of 2019, the LDC repeated its learning culture and performance measurement. The results highlighted a dramatic improvement in performance correlated with the growing strengths of its learning culture.

By 2020, the Institute was recognised by its donors and partners as a model for how to organise and strengthen staff learning to drive performance. Institute branches worldwide reported a growing number of requests from partners – humanitarian organisations but also firms from technology and other industries – who, in the past, may have been reluctant consumers of its learning products. They began to request that the Institute advise them on how to adapt this new internal learning strategy to their own context. Conversely, demand for high-cost, low volume formal training (both digital and face-to-face) diminished as partners begin to recognise that the most significant methods to improve preparedness and response for humanitarian crises are to be found in the day-to-day activities of their staff, volunteers, and the communities they serve.

Image: Painting at Trigonos (25 January 2017). Personal collection.

It's a dead end baby (Andrew Mason/flickr)

Debunking the “Social Age”, a dead end for humanitarian leadership practitioners

Reda SadkiThinking aloud

“And I can see no reason why anyone should suppose that in the future the same motifs already heard will not be sounding still … put to use by reasonable men to reasonable ends, or by madmen to nonsense and disaster.” – Joseph Campbell, Foreword to The Masks of God: Primitive Mythology, 1969

Humans are social beings. If there is one constant in our experience, this is it. Of course, the tidal waves of digital transformation are reshaping the cultures of how we learn, share, communicate, and grow. But this constant remains.

Claiming that our entry into a “Social Age” is the key to grappling with change is akin to clamoring that we are entering a new “Age of Transportation”. There are obviously new means such as electric cars. But to try to understand what is changing – and how we can learn, grow, and lead to harness change – through such a narrow lens is likely to lead to reductive, myopic approaches. It confuses both symptom with cause and effect with intent.

Anyone who values peer-reviewed evidence will find nothing to discern whether the “Social Age” is a valid concept. Zero articles in Google Scholar and just one book written a decade ago by IBM’s vice president of cloud computing enablement. There is no science to describe or theorize the “Social Age”. Stripped of its marketing collateral, the pretty pictures painted by the “Social Age” reveal themselves to be hollow of meaning.

There is no denying the constance of change. It is a truism by definition. The need to adapt is true by necessity. One should be suspicious when a concept appears to be premised by not one but two tautologies. Stating the obvious is a wonderfully effective way of reassuring those who maintain the status quo that only need to adopt a new vocabulary, distinguishing themselves from the “usual suspects”… when in fact they should be front and center in the line-up.

There is no spoon

There is no Social Age.

So why is the “Social Age” concept a dead end for humanitarian practitioners, and especially the learning leaders amongst them who work on the outer cusp of chaos in emergencies, disasters, and toward greater community resilience?

First of all, the humanitarian space is already littered by amorphous, vague, or empty concepts that, combined with opaque jargon, lead to analysis paralysis or just produce more litter. We need tools and approaches that help us clear the rubble, not add to it.

Second, there are evidence-based approaches to understand and harness the sweeping changes we face, how they impact our work, and how we can build on them to strengthen how we learn and how we lead. Yet, given the dearth of impact measurement in humanitarian capacity-building, this not the first time that we have observed senior managers seduced by an imported concept with no sector-specific evidence to back it up, for reasons that have more to do with their own identity and moral quandary than with the actual relevance and usefulness of such imports. There is a need to resist our own insularity, but this should not lead to embracing obscure concepts as an end unto itself. The vocabulary of the “Social Age” proponents may be different, but how is it different from failed attempts of the past to build capacity through training?

Third, nothing in the amorphous relativism of the “Social Age” explicitly recognizes the unequal power relations that are the heart of the contradictions in a humanitarian system that preaches localization from the center to the periphery, but lacks effective mechanisms (and, in some countries, domestic political will) to shift the balance of power. There is a growing number of promising projects that are already helping us find new, authentic and meaningful ways of growing collaborative leadership from margin to center. These are increasingly often being driven and led by those on the periphery. They are about inspiration, innovation, and collective responsibility to progress through self-directed growth and development. By contrast, the “Social Age” seems to be about renting and delivering the policies of others, rather than shared ownership and development around a compelling purpose. (Yes, I am paraphrasing Hargreaves and Shirley’s distinction between Third and Fourth Ways in their book about inspiring future for educational change.)

Barbara W. Tuchman, in her analysis of why governments pursue policy contrary to their own aims and the needs of the people they serve, asks why we should “expect anything else of government”, answering that “governments have a greater duty to act according to reason” because “folly in government has more impact on more people than individual follies.” This echoes the peculiar responsibility of those who are in the business of transforming the aid business. Imported gimmicks are not where we should be expending time and effort. Staying silent is not an option.

Yet, inertia remains a powerful force in our peculiar, mission-driven corner of the universe. Once an idea somehow gains currency, it breathes a life of its own. Lip service to failure tolerance has not changed the reality that once you have promoted a clunky concept, chances are that you will feel offended or threatened or both when challenged, especially if you lack the evidence for a rebuttal. There is little or no reward for critical reflection or questioning, for taking a necessary step back to reconsider, especially when scarce sector resources are being expended at for-profit corporate rates in the name of doing something different. This is unfortunate because stonewalling equates to lack of accountability – no matter how stringent the logframes and other formal mechanisms that may be in place. Is dissent ignored, tolerated, or does it open up to potentially nasty reprisals?

La critique est facile, l’art est difficile. It is really easier to tear down than it is to evolve and/or reconstruct?  In fact, my perspective is shaped by substantive collaborative leadership work that I admire or the digital learning that I see transforming people and strengthening their individual and collective capabilities. Few blog posts about this work ever get written. I consider this failure to self-promote to be consistent with the modesty and authenticity of practitioners who are truly pushing the boundaries. We need a space where such stories can be told, not for competitive advantage in the marketplace of ideas for rent, but to strengthen and deepen the bonds of our yearning for a better future.

Image: It’s a dead end baby (Andrew Mason/flickr)

What is the difference between a wicked problem and a grand challenge

What is the difference between a wicked problem and a grand challenge?

Reda SadkiGlobal health

The management concepts of wicked problems and grand challenges are closely related but have some key distinctions:

Similarities

Both wicked problems and grand challenges refer to complex, systemic issues that are difficult to solve and have far-reaching societal impacts. They share several characteristics:

  • Complexity and interconnectedness with other problems
  • No clear or definitive solutions
  • Require collaborative efforts from diverse stakeholders
  • Often global or multi-regional in scope
  • Involve uncertainty and changing requirements

Distinctions

While closely related, there are some nuanced differences:

Scope and framing

  • Wicked problems tend to be framed more negatively as intractable issues
  • Grand challenges are often framed more positively as ambitious goals to be tackled

Solution approach

  • Wicked problems are seen as having no definitive solution, only better or worse approaches
  • Grand challenges imply the possibility of significant progress or breakthroughs, even if not fully “solved”

Origin and usage

  • Wicked problems originated in social planning literature in the 1960s-70s
  • Grand challenges gained prominence more recently, especially in management literature since the 2010s

Relationship

Many scholars view grand challenges as a subset or reframing of wicked problems. Grand challenges can be seen as large-scale wicked problems that have been formulated into more actionable goals. The grand challenges framing aims to mobilize collaborative efforts to make progress on wicked problems, even if they cannot be fully solved.

Both concepts highlight the need for:

  • Interdisciplinary and collaborative approaches
  • Adaptive and flexible strategies
  • Consideration of diverse stakeholder perspectives
  • Acceptance of uncertainty and continuous learning

Understanding both wicked problems and grand challenges can help managers and policymakers develop more effective approaches to complex societal issues. The grand challenges framing, in particular, may help motivate action and innovation in addressing wicked problems that might otherwise seem insurmountable.

References

Daar, A.S. et al. (2018) ‘Grand challenges in humanitarian aid’, Nature, 559(7713), pp. 169–173. Available at: https://doi.org/10.1038/d41586-018-05642-8.

Gariel, C. and Bartel-Radic, A. (2024) ‘Tidying Up the Concept of Grand Challenges: A Bibliometric Analysis’, M@n@gement, 27(S1), pp. 58–79. Available at: https://doi.org/10.37725/mgmt.2024.8884.

Rittel, H.W. and Webber, M.M. (1973) ‘Dilemmas in a general theory of planning’, Policy sciences, 4(2), pp. 155–169. Available at: https://escholarship.org/uc/item/01v4t1c9.

Image: The Geneva Learning Foundation Collection © 2025

Zapnito advisor insight: Reda Sadki’s story

Reda SadkiWriting

I spoke to Zapnito about why I became an advisor, my background and more…

Please tell us a little bit about yourself

My name is Reda Sadki, born and based in Geneva, Switzerland. I came to education from publishing, confronted with the challenge of how to harness the digital transformation to help meet the learning needs of 17.1 million Red Cross volunteers in 190 countries. 

I could see and feel the changing landscape of education, with the hype of MOOCs as a tangible harbinger of the next wave: the fusion of machine learning, neuroscience, and life sciences (think CRISPR) to augment how we learn and help expand what it means to be human. I saw that existing organisations, mired with the legacy of training, needed a catalyst to embrace such changes. 

Today, I lead The Geneva Learning Foundation, a non-profit with the mission to foster learning innovation to help us meet the humanitarian, global health, and development challenges that threaten our future. The Foundation’s focus is on R&D, trying new ways of doing new things. The other half of my time is spent building Learning Strategies International (LSi.io), a startup based at EPFL’s Swiss EdTech Collider. LSi is betting on ‘wetware’ – human beings with incredible talent and experience – to help organisations find their way through the Digital Transformation.

How did you end up becoming a Zapnito advisor?

Charles [Thiede, Zapnito CEO] just had to ask. I believe in the value of sharing experience and networks: that is how we grow. I first came across Zapnito while working with the OECD and was impressed with the simplicity and efficacy of its product. 

Organisations that work with the imperative of profit are interesting to me, because of how different and similar their logic is compared to that of non-profits. There is something to be gained from any profit-driven business, no matter the size, whether it’s Zapnito or Google (worked with them too, a while back). 

My know-how is in how to take a strategy problem that is complex, distributed, and global and build an incredibly effective experience that will involve not just staff but customers, helping each of them make sense of their own context while strengthening their connection to others, delivering not just performance but mindfulness, building key analytical and reflective capabilities to navigate the knowledge landscape.

Having a good knowledge system like Zapnito is a cornerstone to building such experiences.

Why is Zapnito necessary and important today?

I have written about the autopsy of knowledge management and my belief that ‘KM’ is a dead-end when trying to grapple with knowledge. [Read Reda’s insights on the the death of the knowledge bank here and here.] 

Companies selling KM have over complicated the issue. There is so much rubble left over from past failures of KM driven by IT teams obsessed with putting pieces of information into pigeonholes. That failed because knowledge is a process not a product, and its half-life constantly diminishes. 

To me, what Zapnito has done is to clear the rubble leaving only what an organisation actually needs in order to have its capabilities in the production of expert knowledge recognised, in the right place and at the right time. Any organisation needs this capability so that expertise can be harnessed into routines that confer decision options.

How do you see Zapnito’s business developing in the next 5 years?

Zapnito makes me think of Auttomatic, the company behind WordPress. Zapnito has a unique, syncretic synthesis of talent and technology to scale craftsmanship. How you do that is a 21st century business challenge. Think mass production of highly-complex hardware like smart phones and how even the Big Five can stumble and fall (Amazon’s Fire phone or Google’s Pixel…). 

Every Zapnito instance can be a carefully-crafted labor of love that is uniquely carved (not just tailored) to its environment no matter how many instances there are in the world. And, unlike WordPress, none of them will be ugly. 

What in your opinion/experience is the single-most important skill in running a successful start-up?

A good question. The most important skill is your ability to diagnose and fill the gaps in your own capabilities as a leader, at any point in time, by connecting to the right talent and technology.

What has been the biggest lesson you have learnt in your career to date?

You can have all the right ingredients but making the perfect dish at the right time is not certain. It is a constant struggle of learning and labour. Sure, you need a compelling vision and great talent to execute on that vision but that is no longer sufficient to guarantee success. In large Fortune 500 companies, there is a restructuring every seven months, on the average. It is not just the fast pace of change, it is the acceleration of it. How do you navigate the unknown? How do you build the capabilities that will let you prepare for what you are not expecting? That is now what it is about.

And what is your main career goal for the next 5 years?

Sorry, I think in terms of mission, not career. I have had the enormous privilege of working only on solving problems that matter for humanity. 

In a society where the nature of knowledge is changing, where we accumulate information but know less and less, I have two convictions that drive me. The first conviction is that learning is the key process to help us navigate and shape our future. I discovered this working on what Ben Ramalingam calls the ‘edge of chaos’, where humanitarians face disasters, war, epidemics, and more, when failure usually means that people will die. My second conviction is that what works on the edge can also be useful to other organisations – including companies whose mission is to make money –  trying to survive and thrive in these changing times. I would like to share our R&D and expertise with others working to help organisations solve knowledge and learning problems, such as Zapnito. 

If you could advocate one company to the world (aside from Zapnito & your own), what would it be and why?

I would look for the most improbable startup in the most unlikely place. The next big things are going to come from the periphery, not the centre. If Facebook hadn’t bought it, WhatsApp would be an example of that: it solved a bandwidth problem for people in developing countries and moved to everywhere. It is our responsibility to seek out and nurture new leaders who may not resemble us but who are part of our shared future. 

Everyone has a brilliant app idea. What’s yours?

The app that frees us from all other apps. An AI app that can do more than find knowledge, but empower each of us to become a knowledge producer, in a global network of knowledge producers.

If you had £1 billion and had to invest it in only one of the following three, which would it be and why? 1. Virtual Reality, 2. Artificial Intelligence, 3. Renewable Energy

AI. I don’t see an end to the possibilities of AI. It is key to the 2nd Machine Age, what some have called the ‘Fourth Industrial Revolution’. At the AI for Good Summit organised by the United Nations, there was a session about AI for education. No one had a clue. That is in itself a signal that the implications and impact are likely to be profound. 

Aboard the USS Bowfin (Pearl Harbor, Hawaii, United States of America). Personal collection.

Implementation of guidelines, officially

Reda SadkiGlobal health

This is everything that the World Health Organization’s Handbook for Guideline Development says about implementation. 

Implementation of a guideline should be taken into account right from the beginning of the guideline development. Implementation is generally the responsibility of national or subnational groups, which explains why their participation in guideline development is critical. WHO headquarters and regional and country offices can support implementation activities by promoting new guidelines at international conferences and providing guideline dissemination workshops, tools, resources and overall coordination [emphasis mine].

Implementation strategies are context-specific. The basic steps for implementing a guideline are:

  • convene a multidisciplinary working group to analyse local needs and priorities (looking for additional data on actual practice);
  • identify potential barriers and facilitating factors;
  • determine available resources and the political support required to implement recommendations;
  • inform relevant implementing partners at all levels; and
  • design an implementation strategy (considering how to encourage theadoption of the recommendations and how to make the overall context favourable to the proposed changes). Implementation or operational research can help inform field testing and rollout strategies to promote the uptake of recommendations.

There is a range of derivative documents or tools that can be developed to facilitate implementation. These can be distributed with the guideline, or local guideline implementers can develop them. Such documents or tools may include a slide set re ecting the guideline content; a “how to” manual or handbook; a flowchart, decision aide or algorithm; fact sheets; quality indicators; checklists; computerized applications; templates, etc.

Source: World Health Organization. WHO Handbook for Guideline Development, 2014.

Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.

Keys abord the USS Bowfin

I want them to read it

Reda SadkiThinking aloud

“So… can you tell me how you would like people to use the guidelines?”

“Well… it is difficult to say… I am not sure.”

“What is the change that you are hoping to produce?”

“Well… I don’t know. It was so much work putting these together already! Now they are available and people in countries just need to start using them.”

“So… what do you mean by ‘using them’? Can you tell me what that looks like…?”

“I want them to read it.”

That is our point of departure.

Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.

 

USS Bowfin diving plane control levers

From guidelines to impact

Reda SadkiGlobal health, Thinking aloud

Most global public health organizations issue guidelines that are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. However, they often lack an effective, scalable mechanism to support governments and health workers at country and sub-country level in turning these into action that leads to impact.

Existing activities intended to help countries build public health capacity carry potential risk for these organizations, as they rely on high-cost, low-volume workshops and trainings that may be characterized by startling disparities in quality, scalability, replicability, and sustainability, often making it difficult or impossible to determine their impact.

In some thematic areas, stakeholders have recognized the problem and are developing their own frameworks to improve quality of training and improve capacity-building. A few stakeholders are experimenting with new capacity-building approaches to empower local actors and strengthen the resilience of communities.

The global community allocates considerable human and financial resources to training. The delivery of this training, however, has not kept pace with the increasing cost and complexity of global challenges.[1] Furthermore, a reductive focus on formal training is unlikely to lead to improvements in service delivery.[2]

Digital learning offers new ways to scale and open learning. However, existing digital learning platforms appear to be premised on the one-way transmission of knowledge – when it is the co-creation, adaptation, and application of knowledge that are needed to achieve double-loop learning – and  from the center (HQ, capital city) to the periphery (countries, villages, volunteers). The transmitted knowledge is often abstract and decontextualized, while the value of existing local knowledge, practices and understanding is not recognized or incorporated into the learning experience.

Progress toward the global health goals will remain elusive if the prevailing paradigm for capacity-building remains unchanged.

[1] The Bill and Melinda Gates Foundation. “Framework for Immunization Training and Learning.” Seattle, USA: The Bill and Melinda Gates Foundation, August 2017.

[2] Sadki, Reda. “Quality in Humanitarian Education at the Crossroads of History and Technology.” In World Disasters Report 2013: Technology and the Effectiveness of Humanitarian Action. Geneva: International Federation of Red Cross and Red Crescent Societies, 2013.

Image: Personal collection. These levers control the diving planes which allow the vessel to pitch its bow and stern up or down to assist in the process of submerging or surfacing the boat, as well as controlling depth when submerged. USS Bowfin, a Balao-class submarine, was a boat of the United States Navy named for the bowfin fish. It is now stationed in Pearl Harbor, Honolulu, Hawaii, USA.

Seventh Epidemiological Training Workshop for Biologists Draws 48 Participants from Outside Organizations

New learning for radiation emergency medical preparedness and assistance

Reda SadkiEvents, Presentations

My presentation for the Geneva Learning Foundation at the 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), World Health Organization, Geneva – 3-5 July 2017.

The 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) Geneva 3–5 July 2017

The 15th meeting of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) Geneva 3–5 July 2017

Featured image: Participants of the Radiation Effects Research Foundation’s (RERF) Seventh Epidemiological Training Workshop for Biologists. The objective of the RERF is to conduct research and studies for peaceful purposes on medical effects of radiation and associated diseases in humans, with a view to contributing to maintenance of the health and welfare of the atomic bomb (A-bomb) survivors and to enhancement of the health of all humankind.