Strengthening primary health care in a changing climate

Strengthening primary health care in a changing climate

and Global health

A new article by Andy Haines, Elizabeth Wambui Kimani-Murage, and Anya Gopfert, “Strengthening primary health care in a changing climate,” outlines how climate change is already impacting health systems worldwide, with primary health care (PHC) workers bearing the immediate burden of response.

Haines and colleagues make a compelling case for strengthening primary health care (PHC) as a cornerstone of climate-resilient health systems.

First, they note that approximately 90% of essential universal health coverage interventions are delivered through PHC settings, making these facilities and workers the backbone of healthcare delivery.

This is particularly significant because PHC systems address many of the health outcomes most affected by climate change, including non-communicable diseases, childhood undernutrition, and common infectious diseases like malaria, diarrheal diseases, and respiratory infections.

Furthermore, PHC workers are often the first responders to extreme weather events such as floods, droughts, and heatwaves.

They must manage both the immediate health impacts and the longer-term consequences of these events.

This comprehensive view of PHC’s role in climate resilience represents a significant shift from viewing primary care merely as a service delivery mechanism to recognizing it as a crucial component of climate adaptation and health system strengthening.

The authors argue that investing in PHC is not only essential for addressing immediate health needs but also for building long-term resilience to climate-related health threats.

In examining workforce issues, Haines et al. specifically emphasize that “building the capacity of the PHC and public health workforce in emergency preparedness and response to climate-induced risks is crucial for enhancing the resilience of health systems.”

They argue that “the health-care workforce, including multidisciplinary PHC teams, should be provided with training and education on the impacts of climate change on health and the implications for health-care delivery.”

The article specifies that this training should focus on three key areas: “strengthening integrated disease surveillance and response systems,” “diagnosis and management of changing disease patterns (eg, outbreaks of vector-borne diseases in new locations),” and “interpretation and use of available climate, weather, and health data to support planning and management of adaptation and mitigation interventions.”

They mention resources like those proposed by the “WONCA Global Family Doctor Planetary Health Working Party” as instructive for such training.

Although the article emphasizes the role of PHC workers as being “often on the front line of responses to extreme events such as floods, droughts, and heatwaves,” it does not discuss mechanisms for capturing or leveraging their experiential knowledge.

This is what they know because they are there every day.

Recommendations follow a traditional institutional approach: strengthen health information systems, build workforce capacity, develop integrated service delivery models, increase funding, and enhance governance.

While these recommendations are well-founded, they primarily envision a top-down flow of knowledge and resources, with health workers positioned as recipients of training and implementers of policies.

The epistemological framework underlying their recommendations reflects what educational theorists would recognize as a transmission model of learning, where knowledge is conceived as flowing primarily from experts to practitioners in a hierarchical manner.

This approach, while valuable for disseminating standardized protocols and evidence-based practices, implicitly positions health workers as passive recipients rather than active knowledge creators and agents of climate-health resilience.

Such a framework potentially undervalues the situated knowledge and practical wisdom (what Aristotle called phronesis) that practitioners develop through direct experience with climate-health challenges in their communities.

It also overlooks the potential for what complexity theorists describe as emergent learning – where new knowledge and practices arise from the dynamic interactions between practitioners facing similar challenges in different contexts.

Our research has documented how health workers are already responding to climate-related health challenges.

For example, observations from more than 1,200 health workers in 68 countries reveal a rich tapestry of local knowledge and insights that often go unrecognized in formal academic and policy discussions

Health workers are already intimate witnesses to the impacts of climate change on the health of the communities they serve, possessing valuable knowledge that should inform both science and policy.

Where Haines sees health workers primarily as implementers of climate-resilient healthcare strategies, we view them as leaders and innovators in climate adaptation.

However, these perspectives need not be mutually exclusive.

TGLF’s model offers a bridge between formal institutional approaches and ground-level experiential knowledge.

New peer learning platforms like Teach to Reach enable rapid sharing of solutions across geographical and institutional boundaries.

This platform enables health workers to be both learners and teachers, sharing successful adaptations while learning from colleagues facing similar challenges in different contexts.

Such participatory approaches also help local knowledge inform global understanding – if global research institutions and funders are willing to listen and learn.

When TGLF gathered observations about climate change impacts on health, we received detailed accounts of everything from disease transmission to healthcare access.

A health worker from Cameroon described how flooding from Mount Cameroon led to deaths in their community.

Another from Kenya shared how changing agricultural patterns forced them to develop new strategies for ensuring safe food access.

Jones, I., Mbuh, C., Sadki, R., Eller, K., Rhoda, D., 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.10204660

These granular insights complement the broader statistical evidence presented in academic literature, providing crucial context for how climate changes manifest in specific communities.

TGLF’s model demonstrates how digital technologies can democratize knowledge sharing to strengthen scientific evidence and drive locally-led action.

This creates a dynamic knowledge ecosystem that can respond more quickly to emerging challenges than traditional top-down approaches.

Importantly, this model addresses a key gap in Haines’ recommendations: the need for rapid, scalable knowledge sharing among frontline workers.

While formal research and policy development necessarily take time, climate impacts are already affecting communities.

TGLF’s approach enables immediate peer learning while building an evidence base for longer-term policy development.

The model also addresses the issue of trust.

Health workers, as trusted community members, play a crucial role in helping communities make sense of and navigate the changes they are facing.

Their understanding of local contexts and constraints are critical to develop strategies that can actually be implemented.

By combining institutional support with health worker-led local action, we can strengthen health systems to be both technically robust and locally responsive.

Our experience at the Geneva Learning Foundation suggests that new learning and leadership are needed to bridge these approaches, enabling the rapid sharing of both formal and experiential knowledge while building the collective capacity needed to survive the impacts of climate change on our health.

References

Haines, A., Kimani-Murage, E.W., Gopfert, A., 2024. Strengthening primary health care in a changing climate. The Lancet 404, 1620–1622. https://doi.org/10.1016/S0140-6736(24)02193-7

Image: The Geneva Learning Foundation Collection © 2024

Anecdote or lived experience reimagining knowledge for climate-resilient health systems

Anecdote or lived experience: reimagining knowledge for climate-resilient health systems

Global health

A health worker in rural Kenya notices that malaria cases are appearing earlier in the season than usual.

A nurse in Bangladesh observes that certain neighborhoods are experiencing more heat-related illnesses despite similar temperatures.

These observations often remain trapped in the realm of “anecdotal evidence.” 

The dominant epistemological framework in public health traditionally dismisses such knowledge as unreliable, subjective, and of limited scientific value.

This dismissal stems from a deeply-rooted global health paradigm that privileges quantitative data, randomized controlled trials, and statistical significance over the nuanced, contextual understanding that emerges from direct experience.

The phrase “it’s just anecdotal” has become a subtle but powerful way of delegitimizing knowledge that does not conform to established scientific methodologies.

Yet this epistemological stance creates a significant blind spot in our understanding of how climate change affects health at the community level.

Climate change manifests in complex, locally specific ways that often elude traditional epidemiological surveillance systems.

The health worker who notices shifting disease patterns or the community nurse who identifies vulnerable populations possesses what philosopher Donald Schön termed “knowing-in-action” – a form of knowledge that emerges from sustained engagement with complex, dynamic situations.

Experiential knowledge often precedes formal scientific understanding, particularly in the context of climate change where impacts are emerging and evolving rapidly.

Health workers’ observations are not mere anecdotes but rather early warning signals of climate-health relationships that would take years to document through traditional research methods.

Why would we build early warning systems that ignore the significance or value of health worker observations and insights?

Is the risk of error greater than the risk of inaction?

In late 2023, more than 1 million people were displaced by flooding from intense rainfall in parts of Somalia, Kenya, and Ethiopia, attributed to a combination of climate change and the Indian Ocean Dipole, a natural climate phenomenon.

Are there signals that health workers might be attuned to, alongside weather systems to measure them?

The challenge, then, is not to replace scientific methodologies but to develop new epistemological frameworks that can integrate different forms of knowing.

This requires recognizing that knowledge exists on a spectrum rather than in hierarchical tiers.

Experiential knowledge, systematic observation, statistical analysis, and randomized controlled trials each offer different and complementary insights into complex climate-health relationships.

A new epistemological framework would recognize that the health worker who notices changing disease patterns is engaging in what anthropologist James Scott calls “mētis” – a form of practical knowledge that comes from intimate familiarity with local conditions.

Is this knowledge necessarily less valuable than statistical data or no data?

It is different and often provides crucial context that helps interpret quantitative findings.

Let us imagine how this integration might work in practice.

In the Philippines, a climate-health surveillance system could combine traditional epidemiological data with structured documentation of health workers’ observations.

Health workers would use a mobile app to share unusual patterns or emerging concerns with each other.

This could then be analyzed alongside conventional surveillance data.

Such an approach could identify climate-health relationships that are not visible through standard surveillance alone.

Health workers can also form “knowledge circles” in which they regularly meet to share observations and insights about climate-related health impacts.

These observations can then be systematically documented and analyzed, creating a bridge between experiential knowledge and formal evidence bases.

When patterns emerge across multiple knowledge circles, they trigger more formal investigation.

This shift requires rethinking how we validate knowledge.

Instead of asking whether an observation is “merely anecdotal,” we might ask: What does this observation tell us about local conditions? How does it complement our quantitative data? What patterns emerge when we more systematically collect and analyze experiential knowledge?

The implications of this epistemological shift extend beyond climate change.

By recognizing the value of experiential knowledge, health systems will become more adaptive and responsive to emerging challenges.

Health workers, feeling their knowledge is valued, become more engaged in systematic observation and documentation.

Communities, seeing their experiences reflected in health system responses, develop greater trust in health institutions.

However, this shift faces significant challenges.

Academic institutions, funding bodies, and policy makers often remain wedded to traditional hierarchies of evidence.

Publishing systems privilege certain types of knowledge over others.

Career advancement often depends on producing conventional scientific evidence rather than integrating different forms of knowing.

Overcoming these challenges requires institutional change.

Medical and public health education needs to incorporate training in recognizing and documenting experiential knowledge.

Research methodologies need to expand to include systematic ways of collecting and analyzing practical knowledge.

Funding mechanisms need to support projects that bridge different epistemological approaches.

The climate crisis demands this evolution in how we think about knowledge.

As health systems face unprecedented challenges, we cannot afford to ignore any source of understanding about how climate change affects human health.

The health worker’s observation, the community’s experience, and the statistician’s analysis all have crucial roles to play in building climate-resilient health systems.

This is not about replacing scientific rigor but about expanding our understanding of what constitutes valid knowledge.

By creating frameworks that can integrate different forms of knowing, we strengthen our ability to respond effectively to the complex challenges posed by climate change.

The future of climate-resilient health systems depends not just on what we know, but on how we think about knowing itself.

References

Haines, A., Kimani-Murage, E.W., Gopfert, A., 2024. Strengthening primary health care in a changing climate. The Lancet 404, 1620–1622. https://doi.org/10.1016/S0140-6736(24)02193-7

Jones, I., Mbuh, C., Sadki, R., Eller, K., Rhoda, D., 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/ZENODO.10204660

Jones, I., Mbuh, C., Sadki, R., Steed, I., 2024. Climate change and health: Health workers on climate, community, and the urgent need for action. The Geneva Learning Foundation. https://doi.org/10.5281/ZENODO.11194918

Romanello, M., et al. The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action. The Lancet 404, 1847–1896. https://doi.org/10.1016/S0140-6736(24)01822-1

Schön, D.A., 1995. Knowing-in-action: The new scholarship requires a new epistemology. Change: The Magazine of Higher Learning 27, 27–34.

Scott, J.C., 2020. Seeing like a state: how certain schemes to improve the human condition have failed. ed, Yale agrarian studies. Yale University Press, New Haven, CT London.

Teach to Reach network of organizational leaders

Teach to Reach’s new leadership network connects health organizations tackling common challenges

Global health

The Geneva Learning Foundation is launching REACH (Relate, Engage, Act, Connect, Help), a new initiative to connect leaders of health organizations who are solving similar problems in different countries.

Launching November 6, 2024 REACH responds to an unexpected outcome of Teach to Reach, a peer learning platform that–in less than four years–has already documented over 10,000 local solutions and experiences to health challenges by connecting more than 60,000 participants across 77 countries.

When organizations began formally participating in Teach to Reach in June 2024, many leaders discovered they were tackling similar challenges.

A digital immunization tracking system in Rwanda sparked interest from several African countries.

A community engagement approach to vaccine hesitancy in Nigeria resonated with teams in Kenya and Zimbabwe.

These spontaneous connections led to the creation of REACH.

What is Teach to Reach?

“Teach to Reach is a place where you learn in the most formidable way. You’re learning from people’s experiences and it makes the learning very easy to adapt, very easy to replicate wherever you are,” says Ful Marine Fuen, Humanitarian Program Coordinator at Cameroon Baptist Convention Health Services.

Teach to Reach is a bilingual (French/English) peer learning platform where government health workers, local organizations, and frontline staff document, analyze, and share implementation solutions across borders.

Half of all participants work in government health services, with around 80% based at district and facility levels where policy meets practice.

The platform’s structured learning process includes pre-event experience sharing, live sessions for discussion and networking, and post-event analysis to capture insights.

“It’s a meeting of giving and receiving. Because with Teach to Reach, we always learn from peers and we develop ourselves and develop others,” notes Arthur Fidelis Metsampito Bamlatol, Coordinator at AAPSEB Cameroon.

From individual learning to organizational impact

The impact of these connections is already visible.

Nduka Ozor, Project Director at the Centre for HIV/AIDS and STD RESEARCH in Nigeria, describes how a single connection expanded his organization’s reach: “I was able to meet with a potential partner who stays in Australia. Something I thought is just an online stuff is moving into a greater partnership. We have had several meetings with other networks from that initial meeting, including with representatives of New York University.”

These kinds of partnerships form naturally as organizations share their work.

Imagine what else might happen as health leaders like these meet, connect, and learn:

  • In Rwanda, Albert Ndagijimana shared how his country achieved 95% childhood vaccination coverage through initiatives like digital tracking of immunization outreach
  • In Kenya, Samuel Mutambuki‘s organization works with other civil society groups to rehabilitate areas affected by illegal dumping and create community gardens
  • In Zimbabwe, Rebecca Chirenga’s team addresses how climate change and food insecurity are driving early marriage and teenage pregnancy, with half of girls dropping out before completing secondary school

“It is essentially a framework that allows us to share experiences… to strengthen our capacities,” says Patrice Kazadi, Project Director at Save the Children International DR Congo. “The challenges in DRC can be the same as in Ivory Coast and what is done in Ivory Coast can also help address challenges in DRC.”

REACH: A new network exclusively for Teach to Reach Partners

REACH builds on this foundation but with an important distinction – it’s exclusively for leaders of organizations that have committed to partnership with Teach to Reach.

Over 700 organizational leaders have already confirmed their participation, representing both government agencies and civil society organizations.

The first REACH sessions will:

  1. Connect organizations working on similar challenges
  2. Share practical approaches that have worked in different contexts
  3. Facilitate direct conversations between organizational leaders
  4. Identify potential areas for collaboration

How can organizations join REACH?

To participate in REACH, organizations must complete all partnership steps for Teach to Reach:

  1. Attend a Partner briefing
  2. Complete the Partnership application
  3. Share the Teach to Reach announcement
  4. Have organizational leadership endorse participation
Meeting of The Geneva Learning Foundation's Scholars and Alumni of Ghana

Making connections: Ghana’s Alumni of The Geneva Learning Foundation meet in Accra

Global health

The Geneva Learning Foundation (TGLF) will host its first physical-world meeting of Ghana Scholars and Alumni on Wednesday, October 30, 2024 in Accra. Seventy-two health professionals from across Ghana’s health system will participate in the evening event.

The participants include staff from the Ghana Health Service, teaching hospitals, district health directorates, and non-governmental organizations. They represent all levels of the health system, with 8 working at the national level, 8 at regional facilities, 39 in district health services, and 13 in community-based programs.

“This is a great opportunity for all health workers for impact,” says one participant, reflecting the anticipation among attendees.

These professionals are alumni of TGLF’s programs, including the Movement for Immunization Agenda 2030 (IA2030) and Teach to Reach initiatives, which focus on transforming global health strategies into practical, locally-adapted solutions.

“TGLF’s learning platforms give us great information and knowledge that are feasible and can be applied in the field,” notes Gordon Yibey from the Asutifi South District.

The meeting will feature a message from the Programme Manager of Ghana’s Expanded Programme on Immunisation (EPI), followed by discussions on strengthening partnerships with Ghana Health Service and advancing immunization and responding to health of impacts of climate change, malaria, and NTDs. Participants will share experiences from their work and discuss challenges in implementing health programs across different contexts.

To enable broad participation, the organizers have arranged a hybrid format. 31 participants will attend in person, while 39 will join remotely. This approach allows health workers from northern regions and remote districts to contribute their perspectives without traveling to Accra.

As one participant from a civil society organization explains, “I will join remotely to avoid travelling and accommodation inconveniences since I am not a resident in Accra.”

Another participant from Kintampo in the Bono East Region captures the spirit of anticipation: “Even though I’m not based in Accra, I can’t wait. I must be there as a member of TGLF Alumni.”

The non-governmental health sector will be represented by staff of organizations that include the Community and Family Aid Foundation-Ghana, Seek to Save Foundation, and Restorative Seed Society, which work to complement government health services in various communities.

Healthcare facilities with participating staff include teaching hospitals in Tamale, Sunyani, and Korle Bu, district hospitals, polyclinics, and community health centers. Several nursing training colleges will also participate, bringing perspectives from health education.

The evening’s agenda includes discussions on:

  • Current challenges in Ghana’s health system
  • Implementation of Immunization Agenda 2030
  • Impact of climate change on health services and disease patterns
  • Malaria control and elimination strategies
  • Neglected Tropical Diseases, with specific focus on female genital schistosomiasis (FGS)
  • Service integration opportunities for primary health care (PHC)
  • Professional development opportunities
  • Collaboration between different levels and domains of the health system

The meeting aims to facilitate knowledge sharing among health professionals and explore ways to strengthen Ghana’s health services through collaborative approaches grounded in The Geneva Learning Foundation’s innovative model to catalyze change led by health professionals working with communities.

Another participant from looks ahead: “What next, after this historic encounter in Ghana for sustainable improvement and continued knowledge brokering exchange?”

Painting: The Geneva Learning Foundation Collection © 2024

The pedagogy of Teach to Reach

What is the pedagogy of Teach to Reach?

Global health, Learning strategy, Theory

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 work?

The challenge in global health is not just about what people need to learn – it is about reimagining how learning happens and gets applied in complex, rapidly-changing environments to improve performance, improve health outcomes, and prepare the next generation of leaders.

Traditional approaches to professional development, built around expert-led training and top-down knowledge transfer, often fail to create lasting change.

They tend to ignore the rich knowledge that exists in practice – what we know when we are there every day, side-by-side with the community we serve – and the complex ways that learning actually occurs in professional networks and communities.

Teach to Reach is one component in The Geneva Learning Foundation’s emergent model for learning and change.

This article describes the pedagogical patterns that Teach to Reach brings to life.

A new vision for digital-first, networked professional learning

Teach to Reach represents a shift in how we think about professional learning in global health.

Its pedagogical pattern draws from three complementary theoretical frameworks that together create a more complete understanding of how professionals learn and how that learning translates into improved practice.

At its foundation lies Bill Cope’s and Mary Kalantzis’s New Learning framework, which recognizes that knowledge creation in the digital age requires new approaches to learning and assessment.

Teach to Reach then integrates insights from Watkins and Marsick’s research on the strong relationship between learning culture (a measure of the capacity for change) and performance and George Siemens’s learning theory of connectivism to create something syncretic: a learning approach that simultaneously builds individual capability, organizational capacity, and network strength.

Active knowledge making

The prevailing model of professional development often treats learners as empty vessels to be filled with expert knowledge.

Drawing from constructivist learning theory, it positions health workers as knowledge creators rather than passive recipients.

When a community health worker in Kenya shares how they’ve adapted vaccination strategies for remote communities, they are not just describing their work – they’re creating valuable knowledge that others can learn from and adapt.

The role of experts is even more significant in this model: experts become “Guides on the side”, listening to challenges and their contexts to identify what expert knowledge is most likely to be useful to a specific challenge and context.

(This is the oft-neglected “downstream” to the “upstream” work that goes into the creation of global guidelines.)

This principle manifests in how questions are framed.

Instead of asking “What should you do when faced with vaccine hesitancy?” Teach to Reach asks “Tell us about a time when you successfully addressed vaccine hesitancy in your community.” This subtle shift transforms the learning dynamic from theoretical to practical, from passive to active.

Collaborative intelligence

The concept of collaborative intelligence, inspired by social learning theory, recognizes that knowledge in complex fields like global health is distributed across many individuals and contexts.

No single expert or institution holds all the answers.

By creating structures for health workers to share and learn from each other’s experiences, Teach to Reach taps into what cognitive scientists call “distributed cognition” – the idea that knowledge and understanding emerge from networks of people rather than individual minds.

This plays out practically in how experiences are shared and synthesized.

When a nurse in Brazil shares their approach to integrating COVID-19 vaccination with routine immunization, their experience becomes part of a larger tapestry of knowledge that includes perspectives from diverse contexts and roles.

Metacognitive reflection

Metacognition – thinking about thinking – is crucial for professional development, yet it is often overlooked in traditional training.

Teach to Reach deliberately builds in opportunities for metacognitive reflection through its question design and response framework.

When participants share experiences, they are prompted not just to describe what happened, but to analyze why they made certain decisions and what they learned from the experience.
This reflective practice helps health workers develop deeper understanding of their own practice and decision-making processes.

It transforms individual experiences into learning opportunities that benefit both the sharer and the wider community.

Recursive feedback

Learning is not linear – it is a cyclical process of sharing, reflecting, applying, and refining.

Teach to Reach’s model of recursive feedback, inspired by systems thinking, creates multiple opportunities for participants to engage with and build upon each other’s experiences.

This goes beyond communities of practice, because the community component is part of a broader, dynamic and ongoing process.

Executing a complex pedagogical pattern

The pedagogical pattern of Teach to Reach come to life through a carefully designed implementation framework over a six-month period, before, during, and after the live event.

This extended timeframe is not arbitrary – it is based on research showing that sustained engagement over time leads to deeper learning and more lasting change than one-off learning events.
The core of the learning process is the Teach to Reach Questions – weekly prompts that guide participants through progressively more complex reflection and sharing.

These questions are crafted to elicit not just information, but insight and understanding.

They follow a deliberate sequence that moves from description to analysis to reflection to application, mirroring the natural cycle of experiential learning.

Communication as pedagogy

In Teach to Reach, communication is not just about delivering information – it is an integral part of the learning process.

The model uses what scholars call “pedagogical communication” – communication designed specifically to facilitate learning.

This manifests in several ways:

  • Personal and warm tone that creates psychological safety for sharing
  • Clear calls to action that guide participants through the learning process
  • Multiple touchpoints that reinforce learning and maintain engagement
  • Progressive engagement that builds complexity gradually

Learning culture and performance

Watkins and Marsick’s work helps us understand why Teach to Reach’s approach is so effective.

Learning culture – the set of organizational values, practices, and systems that support continuous learning – is crucial for translating individual insights into improved organizational performance.

Teach to Reach deliberately builds elements of strong learning cultures into its design.

Furthermore, the Geneva Learning Foundation’s research found that continuous learning is the weakest dimension of learning culture in immunization – and probably global health.

Hence, Teach to Reach itself provides a mechanism to strengthen specifically this dimension.

Take the simple act of asking questions about real work experiences.

This is not just about gathering information – it’s about creating what Watkins and Marsick call “inquiry and dialogue,” a fundamental dimension of learning organizations.

When health workers share their experiences, they are not just describing what happened.

They are engaging in a form of collaborative inquiry that helps everyone involved develop deeper understanding.

Networks of knowledge

George Siemens’s connectivism theory provides another crucial lens for understanding Teach to Reach’s effectiveness.

In today’s world, knowledge is not just what is in our heads – it is distributed across networks of people and resources.

Teach to Reach creates and strengthens these networks through its unique approach to asynchronous peer learning.

The process begins with carefully designed questions that prompt health workers to share specific experiences.

But it does not stop there.

These experiences become nodes in a growing network of knowledge, connected through themes, challenges, and solutions.

When a health worker in India reads about how a colleague in Nigeria addressed a particular challenge, they are not just learning about one solution – they are becoming part of a network that makes everyone’s practice stronger.

From theory to practice

What makes Teach to Reach particularly powerful is how it fuses multiple theories of learning into a practical model that works in real-world conditions.

The model recognizes that learning must be accessible to health workers dealing with limited connectivity, heavy workloads, and diverse linguistic and cultural contexts.

New Learning’s emphasis on multimodal meaning-making supports the use of multiple communication channels ensuring accessibility.

Learning culture principles guide the creation of supportive structures that make continuous learning possible even in challenging conditions.

Connectivist insights inform how knowledge is shared and distributed across the network.

Creating sustainable change

The real test of any learning approach is whether it creates sustainable change in practice.

By simultaneously building individual capability, organizational capacity, and network strength, it creates the conditions for continuous improvement and adaptation.

Health workers do not just learn new approaches – they develop the capacity to learn continuously from their own experience and the experiences of others.

Organizations do not just gain new knowledge – they develop stronger learning cultures that support ongoing innovation.

And the broader health system gains not just a collection of good practices, but a living network of practitioners who continue to learn and adapt together.

Looking forward

As global health challenges have become more complex, the need for more effective approaches to professional learning becomes more urgent.

Teach to Reach’s pedagogical model, grounded in complementary theoretical frameworks and proven in practice, offers valuable insights for anyone interested in creating impactful professional learning experiences.

The model suggests that effective professional learning in complex fields like global health requires more than just good content or engaging delivery.

It requires careful attention to how learning cultures are built, how networks are strengthened, and how individual learning connects to organizational and system performance.

Most importantly, it reminds us that the most powerful learning often happens not through traditional training but through thoughtfully structured opportunities for professionals to learn from and with each other.

In this way, Teach to Reach is a demonstration of what becomes possible when we reimagine how professional learning happens in service of better health outcomes worldwide.

Image: The Geneva Learning Foundation Collection © 2024

Teach to Reach 10 Experiences shared

Experiences shared at Teach to Reach 10

Global health

Before, during, and after Teach to Reach on 20-21 June 2024, 21,398 health workers across the Global South—from veteran national managers to newly-trained community health workers—shared their unfiltered, frontline experiences of delivering care in an increasingly complex world.

Ahead of Teach to Reach 11, The Geneva Learning Foundation has just released the English-language collection of “Experiences shared“.

A second collection of experiences shared by French-speaking participants is also available.

This remarkable collection captures over 600 experiences that health workers shared, in their own words, offering rare, ground-level perspectives on how global health challenges manifest in communities.

Themes and topics explored in this collection:

  • How we use what we learn from Teach to Reach
  • Learning culture and performance
  • On the frontlines of climate change and health
  • Health workers insights to end malaria
  • Health workers insights to fight neglected tropical diseases
  • Integration of health services
  • Health workers insights on e-health
  • 50 years of the Expanded Programme for Immunization

Through questions that probe specific moments rather than seeking generalizations, these accounts detail personal encounters with everything from climate change’s effects on malaria transmission to the challenges of integrating immunization with other health services.

Health workers share candid stories of their successes, failures, and innovations: using WhatsApp for vaccine advocacy, adapting disease control strategies as weather patterns shift, building community trust during mass drug administration campaigns, and more.

While these experiences are inherently context-specific and should not be mistaken for systematic evidence, their value lies in illuminating the lived reality of health service delivery—the kind of rich, qualitative insight that often eludes formal research.

The collection represents a mosaic of perspectives from different levels of the health system, each contributor speaking in a personal capacity about their direct observations and experiences.

This comprehensive volume is part of Teach to Reach, an ongoing cycle of learning and exchange facilitated by The Geneva Learning Foundation.

Contributors receive back the complete collection of shared experiences, enabling them to learn from peers facing similar challenges across contexts.

The experiences are also available as focused thematic publications on specific topics such as malaria control, climate change adaptation, and immunization integration.

Finally, an accompanying insights report provides concise thematic summaries and analysis of key learnings about each of the topics that were explored.

Whether your focus is immunization, digital health, climate change adaptation, or disease control, these raw accounts provide crucial context for anyone seeking to bridge the gap between global health policy and local implementation.

Rather than providing definitive answers, this volume offers a unique window into how health workers learn, adapt, and drive change in their communities—making it an invaluable complement to traditional evidence for understanding and improving global health delivery.

These Shared Experiences should be required reading for global health practitioners, policymakers, and researchers interested in understanding how macro-level health challenges and interventions play out on the ground.

The Geneva Learning Foundation (TGLF). (2024). Teach to Reach 10. Experiences shared (1.0). Teach to Reach 10, Online. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.13366491

La Fondation Apprendre Genève. (2024). Teach to Reach 10. Expériences partagées (1.0). Teach to Reach 10, En ligne. La Fondation Apprendre Genève (TGLF). https://doi.org/10.5281/zenodo.13769081

Teach to Reach 11 briefing for partners

Ahead of Teach to Reach 11, organizational leaders share experience of ‘what works’ for health

Global health

Over 730 organizations have already confirmed their participation in Teach to Reach 11, a peer learning platform, network, and community for health workers facilitated by the Geneva Learning Foundation (TGLF).

This announcement came during TGLF’s first partnership briefing held on 16 October 2024. Voir la présentation aux partenaires en français…

Teach to Reach, which connects health professionals across borders, is expanding its focus on local partnerships for its upcoming 11th edition, scheduled for 5-6 December 2024.

Why does this matter?

The initiative’s reach is substantial. Teach to Reach 10, held in June 2024, attracted 21,398 participants from over 70 countries. Notably, 80% of participants were from district and facility levels.

Each participant is now being encouraged to involve their organization – and to invite staff, volunteers, and community members to join.

“I plan to involve women from every province. We made a small committee. So our network is represented“ at Teach to Reach, said Isabelle Monga, national president of RENAFER, an NGO based in the Democratic Republic of Congo.

What do organizational leaders say about Teach to Reach?

Here is what Amadou Gueye, president of the Malaria Youth Corps, said about his first time participating in Teach to Reach 10: “I was very impressed by the sharing and the results I saw at Teach to Reach, especially the real data, and the fact that every time people take part afterwards, we tally it all up and give a report that’s really precise and clear.”

Watch the first experience-sharing session on malaria at Teach to Reach 10. Voir la séance en français…

Dr. Ornela Malembe, President of ONG SADF (Santé et Développement de la Femme et de l’Enfant) in the Democratic Republic of Congo, shared how previous Teach to Reach events influenced her work: “Before Teach to Reach, we did not know about Female Genital Schistosomiasis (FGS). With what we learned, we put in place activities to raise awareness among women.”

FGS is a neglected tropical disease that afflicts an estimated 56 million women and girls in sub-Saharan Africa. Learn more about FGS…

Vincent Kamuasha, Country Representative of United Front Against River Blindness (UFAR) in DRC, highlighted the practical impact: “At Teach to Reach, we exchanged with the national NTD programme. We approached the national program for the fight against HIV. And recently, we approached the national program for reproductive health and adolescents.”

Watch the Teach to Reach 10 session about NTDs. Voir la séance en français…

Teach to Reach aims to deepen engagement and impact by supporting organizational change. As Reda Sadki, co-founder of TGLF, explained, “It’s really about developing your organization: share your experience, increase visibility, and access opportunities.”

Organizations interested in becoming Teach to Reach partners are guided through the partnership application process.

There is no cost for participants or locally-led organizations, as global partners subsidize the programme.

What issues are these organizations about?

The organizations at Teach to Reach 11’s briefings mirror the complexity of global health.

They span from local community initiatives to national disease control programs, covering infectious diseases, health system strengthening, maternal and child health, youth empowerment, and community healthcare.

Environmental health and climate change impacts were represented, as were mental health, nutrition, and digital health solutions.

Organizations focusing on health equity, emergency response, and One Health approaches were also present.

This diverse representation highlights the interconnected nature of global health challenges and the need for collaborative, multidisciplinary solutions.

Teach to Reach emphasizes collaborative intelligence and active knowledge production. Participants are positioned as knowledge creators rather than passive recipients, reflecting a shift towards more inclusive global health practices.

As global health faces complex, interconnected challenges, Teach to Reach’s focus on peer learning to drive locally-led change offers a new approach to collaboration and knowledge sharing in the field.

Who actually attended the briefing?

Attendees spanned a wide spectrum of the health system, from community-based workers to national-level policymakers.

Government agencies were well-represented, including ministries of health, national immunization programs, and regional health departments from countries across Africa, Asia, and Latin America.

Civil society organizations (CSOs) and non-governmental organizations (NGOs) formed a significant portion of attendees, ranging from local community groups to international non-profits.

A strong presence of district and facility-level health workers included nurses, community health workers, and local health facility managers.

International organizations such as WHO, UNICEF, and various UN agencies were also present, alongside research institutions and academic bodies.

The linguistic diversity was notable, with a balanced representation from both anglophone and francophone countries.

Strong participation was seen from nations such as Nigeria, Democratic Republic of Congo, Ghana, Côte d’Ivoire, Burkina Faso, Senegal, and Cameroon, among others.

Building on Teach to Reach 10

The partnership process was offered for the first time ahead of Teach to Reach 10 in June 2024. 240 organizations from 41 countries joined as local partners.

Watch the Leaders & Partners Forum at Teach to Reach 10. Voir le Forum des Leaders & Partenaires en français…

What came out of Teach to Reach 10?

Outputs from Teach to Reach 10 included almost 2,000 real-world stories and insights shared by participants.

These experiences are shared back with the community, creating a rich repository of practical knowledge. 

99.7% of participants reported increased motivation and commitment to their work, and 97.8% stated they learned something new that changed their perspective.

Learn more

Find out why you should participate in Teach to Reach, if Teach to Reach can help your organization, and why become a Teach to Reach Partner.

Listen to the Teach to Reach podcast:

Are you a health professional? Join the Geneva Learning Foundation’s peer learning programme on climate change and health:

Is your organisation interested in learning from health workers? Learn more about becoming a Teach to Reach partner.

World Health Summit World Health Organization Investment Round Climate change and health

World Health Summit: to rebuild trust in global health, invest in health workers as community leaders

Global health

Discussions at the World Health Summit in Berlin this week have rightly emphasized the role of health workers, especially those directly serving local communities.

Health workers stand at the intersection of climate change and community health.

They are first-hand eyewitnesses and the first line of defense against the impacts of climate on health.

There is real horror in the climate impacts on health they describe.

Read the Health Worker Eyewitness reports “Climate change and health: Health workers on climate, community, and the urgent need for action“ and “On the frontline of climate change and health: A health worker eyewitness report”.

There is also real hope in the local solutions and strategies they are already implementing to help communities survive such impacts, most often without support from their government or from the global community.

There is no alternative to the health workforce as the ones most likely to drive effective adaptation strategies and build trust when it comes to climate change and health.

Their unique value stems from several key factors:

  1. Firsthand experience: Health workers witness the direct and indirect health impacts of climate change daily, providing valuable insights.
  2. Community trust: As respected figures in their communities, health workers can effectively communicate climate-health risks and promote adaptive behaviors.
  3. Local knowledge: Their deep understanding of local contexts allows for the development of tailored, culturally appropriate solutions.
  4. Existing infrastructure: Health workers represent an established network that is already having to respond to climate change.

As Dr. Maria Neira from the World Health Organization emphasized at Teach to Reach 10 in June 2024: “We need to use our voice, the power of the voice of health, to convince governments to do three things. First, accelerate the transition to clean sources of energy to stop this disaster. Second, to accelerate the transition to sustainable food systems. And third, to accelerate the transition to better planning of urban areas…” Learn more about Teach to Reach.

However, current global health investments often overlook the potential of health workers.

Furthermore, there is a tendency to see them as instruments to implement national plans and policies and recipients for knowledge about climate change that they are assumed to be lacking.

This fails to recognize the potential of health workers to lead, not just execute plans, in the face of climate change impacts on health.

It also fails to recognize the significance and value of local knowledge and experience that health workers hold because they are there every day.

A shift in focus could make health workers the most obvious “best buy” for governments and international funders.

By investing in health workers as agents of change, we can leverage an existing, trusted workforce to rapidly scale up adaptation efforts and rebuild trust in global health initiatives.

One innovative model developed by The Geneva Learning Foundation has shown promise in this area, connecting over 60,000 health practitioners across 137 countries and reaching frontline government staff working for health in conflict zones and other challenging contexts.

This approach not only maximizes the impact of climate-health investments but also strengthens health systems overall, creating a win-win scenario for global health and climate resilience.

Image: The Geneva Learning Foundation Collection © 2024

Psychological First Aid in Support of Children Affected by the Humanitarian Crisis in Ukraine: the Experiences of Children, Caregivers and Helpers

Support of children affected by the humanitarian crisis in Ukraine: Bridging practice and learning through the sharing of experience

Global health

Psychological First Aid in Support of Children Affected by the Humanitarian Crisis in Ukraine: the Experiences of Children, Caregivers and Helpers

“Do you have an experience supporting children affected by the humanitarian crisis in Ukraine that you would like to share with colleagues? Tell us what happened and how it turned out. Be specific and detailed so that we can understand your story.”

This was one of the questions that applicants to the Certificate peer learning programme on Psychological First Aid (PFA) in support of children affected by the humanitarian crisis in Ukraine could choose to answer.

If you are reading this, you may be one of the education, health, or social work professionals who answered questions like these. You may also be a policy maker or organizational leader asking yourself how children from Ukraine and the people who work with them can be better supported.

The Geneva Learning Foundation (TGLF), in collaboration with the International Federation of Red Cross and Red Crescent Societies (IFRC) and with support from the European Union’s EU4Health programme, is pleased to announce the publication of the first “Listening and Learning” report focused on the experiences of education, social work, and health professionals who support children affected by the humanitarian crisis in Ukraine.

This new report, published in both Ukrainian and English editions, gives back the collected experiences of 873 volunteers and professionals who applied to this new programme in spring 2024.

Readers will find short, thematic analyses. A comprehensive annex is also included to present the full compendium of experiences shared.

To transform these rich experiences into actionable insights, the Foundation’s Insights Unit applied a rigorous analytical process. This included systematic consolidation of data, thematic analysis to identify recurring patterns, synthesis of key trends and effective practices, and careful curation of representative experiences. This methodology allows for the rapid sharing of on-the-ground knowledge and innovative practices tailored to the specific context of MHPSS in humanitarian crises. As with any qualitative analysis, these insights should be considered alongside other forms of evidence and expertise in the field.

Experiences shared reflect the intrinsic motivation of helpers, their subtle attention to children, the magic of doing the right thing at the right moment. They also describe the personal and practical challenges helpers face when working with distressed individuals and communities, often with limited resources. 

This programme, offered by The Geneva Learning Foundation (TGLF) in partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC), employs an innovative peer learning-to-action model grounded in the most recent advances in the learning sciences.

To complement existing top-down skills-based training in Psychological First Aid (PFA), we are working with IFRC to create structured opportunities for practitioners to learn directly from each other’s experiences while applying what they learn to their own work, aligning to the best guidance and norms for mental health and psychosocial support. For professionals working in crisis settings, this offers several key advantages:

It leverages the collective expertise and tacit knowledge of practitioners on the ground.

It creates a supportive community of action, connecting professionals across boundaries of geography, hierarchy, and job roles.

It helps bridge gaps between theory and practice by positioning learning at the point of work.

It fosters critical thinking and problem-solving skills through peer analysis and feedback.

It is highly adaptable and can be implemented quickly in response to emerging crises.

This process not only enhanced participants’ understanding of Psychological First Aid principles but also built their capacity to critically reflect on and improve their practice. By engaging professionals from across Europe and Ukraine in both English and Ukrainian cohorts, the exercise fostered cross-cultural exchange and mutual learning.

As the humanitarian sector continues to grapple with how to effectively build capacity at scale, particularly in rapidly evolving crisis situations, we believe this peer learning-to-action model offers a promising pathway. It empowers practitioners as both learners and teachers, creating a dynamic and sustainable approach to professional development that can adapt to meet emerging needs.

The Foundation would like to thank IFRC, the Psychosocial Support Centre (PSC), National Societies, as well as the network of governmental and non-governmental organizations across Europe that has engaged in this new approach, as a complement to their efforts on the ground. As the programme continues through to June 2025, this report will be followed by others to share what we learned from successive peer learning exercises, folllowed by the development and implementation of local projects guided by the collective intelligence of practitioners.

We invite you to explore these insights, reflect on their implications for your own work, and consider how this approach might be applied to strengthen mental health and psychosocial support capacity in your own context.

The Geneva Learning Foundation

Image: The Geneva Learning Foundation Collection © 2024

Why become a Teach to Reach Partner?

Why become a Teach to Reach Partner?

Global health

We need new ways to tackle global health challenges that impact local communities.

It is obvious that technology alone is not enough.

We need human ingenuity, collaboration, and the ability to share across borders and boundaries.

That is why I am excited about Teach to Reach.

Imagine if we could tap into the collective intelligence of over 20,000 health professionals working on the front lines in low- and middle-income countries.

What insights could we gain?

What innovations might we uncover?

This is exactly what Teach to Reach is doing.

In June 2024, Teach to Reach 10 brought together 21,398 participants from across the health system – from community health workers to national policymakers.

This diverse group represents an incredible wealth of knowledge and experience that has often been overlooked in global health decision-making.

Bridge the gap between policy and practice

One of the most exciting aspects of Teach to Reach is how it bridges the gap between policy and practice.

Too often, there is a disconnect between those making decisions at the global level and those implementing programs on the ground.

Teach to Reach creates a direct line of communication, allowing frontline workers to influence policy and program design in real-time.

This approach not only leads to more effective interventions but also empowers health workers, increasing their engagement and motivation.

Scale knowledge transfer and translation efficiently

In global health, we are always looking for ways to scale solutions efficiently.

This scaling effect is particularly crucial in low-resource settings, where formal learning opportunities may be limited.

Teach to Reach applies this principle to peer learning.

Then there is speed.

The platform can disseminate best practices and local solutions much more rapidly than traditional top-down approaches.

There is also the “know-do” gap or the “applicability problem”.

Teach to Reach supports continuous learning by sharing experience, focused on how to get results, especially at the local community level.

Measuring impact and driving innovation

The Teach to Reach platform uses a comprehensive framework to track the value of participation for individuals and the benefits for partners.

But we do not stop there.

Teach to Reach is just one component in the Geneva Learning Foundation’s model to support new learning and leadership to drive change.

We then track and measure what participants do with the knowledge gained and the experiences shared.

We do this all the way to the time where improved health outcomes can be attributed to a discovery or significant learning made at Teach to Reach.

Moreover, Teach to Reach serves as an innovation hub, surfacing diverse ideas and solutions from the field.

For organizations looking to drive innovation in their global health programs, this platform offers a new path to creative problem-solving with those closest to the challenges.

A call to action for global health leaders

If you are a leader in the global health space, I urge you to consider partnering with Teach to Reach.

Here are 5 ways in which partners have found utility in Teach to Reach:

  1. Inform a strategy with ground-level insights.
  2. Expand reach across multiple countries and health system levels.
  3. Tap into a diverse pool of local solutions – and help augment and scale them.
  4. Demonstrate commitment to supporting locally-led, community-based positive change.
  5. Accelerate progress towards global health goals through collaborative learning.

In today’s interconnected world, our ability to solve global health challenges depends on our capacity to learn from one another and scale effective solutions quickly.

Teach to Reach is pioneering a new approach that harnesses the power of peer learning to do just that.

Investing in Teach to Reach can help unlock the full potential of our global health workforce and make significant strides towards a healthier, more equitable world.

The future of global health is collaborative.

Teach to Reach provides a way to turn the rhetoric of collaboration into practical action.