On International Nurses Day 2024, The Geneva Learning Foundation stands in solidarity with the over 28 million nurses worldwide who form the backbone of health systems globally.
As an organization dedicated to researching, developing, and implementing new approaches to learning and leadership for health, we recognize the vital role of nurses in driving progress towards global health goals, including the health-related Sustainable Development Goals and Universal Health Coverage.
Nurses represent a significant proportion of participants in our Teach to Reach peer learning programme, which exemplifies commitment to lifelong learning and desire to connect with and learn from colleagues around the world to improve practice.
Teach to Reach is the world’s largest health peer learning event, bringing together tens of thousands of health professionals, primarily from low- and middle-income countries, in dynamic digital convenings. Request your invitation
It exemplifies our vision of empowering health workers as agents of change through digitally-enabled collaborative learning and knowledge sharing.
For its tenth edition on 20-21 June 2024, Teach to Reach will focus on the critical issue of climate change and health.
Nurses are already finding themselves on the frontlines in supporting communities to navigate the increasing health risks posed by a changing climate.
As trusted members of the communities they serve, nurses are uniquely positioned to strengthen resilience and lead adaptations to protect health.
Through platforms like Teach to Reach, The Geneva Learning Foundation aims to elevate nurses’ voices and insights, facilitating the rapid exchange of locally-tailored solutions to shared challenges.
We call on global health leaders to recognize the expertise that nurses hold as a result of their proximity to communities, and to systematically include nurses in policy dialogues and decision-making on the health impacts of climate change.
On this International Nurses Day, we reaffirm our commitment to leveraging the power of digital networks and innovative learning approaches to support nurses in their vital work to protect and promote health.
Through strong partnerships and by empowering nurses as leaders, we believe it is possible to build resilient, equitable and sustainable health systems in a changing climate.
À l’occasion de la Journée internationale des infirmières 2024, La Fondation Apprendre Genève est solidaire des plus de 28 millions d’infirmières et d’infirmiers dans le monde qui constituent l’épine dorsale des systèmes de santé à l’échelle internationale.
En tant qu’organisation dédiée à la recherche, au développement et à la mise en œuvre de nouvelles approches de l’apprentissage et du leadership pour la santé, nous reconnaissons le rôle vital des infirmières et infirmiers dans la réalisation de progrès vers les objectifs de santé globale, y compris les Objectifs de développement durable liés à la santé et la Couverture santé universelle.
Les infirmiers représentent une proportion importante des participants à notre programme d’apprentissage par les pairs Teach to Reach, qui illustre l’engagement en faveur de l’apprentissage tout au long de la vie et le désir de tisser des liens avec des collègues du monde entier et de partager l’expérience afin d’améliorer les pratiques.
Teach to Reach est le plus grand événement que nous connaissons de partage d’expérience dans le domaine de la santé au monde, réunissant des dizaines de milliers de professionnels de la santé, principalement issus de pays à revenu faible ou intermédiaire, dans le cadre de rassemblements digitaux dynamiques. Demandez votre invitation
Il illustre notre vision de l’autonomisation des travailleurs de la santé en tant qu’agents de changement grâce à l’apprentissage collaboratif et au partage des connaissances par voie numérique.
Pour sa dixième édition, les 20 et 21 juin 2024, Teach to Reach se concentrera sur la question cruciale du changement climatique et de la santé.
Les infirmières se retrouvent déjà en première ligne pour aider les communautés à faire face aux risques sanitaires croissants posés par le changement climatique.
En tant que membres de confiance des communautés qu’elles servent, les infirmières sont particulièrement bien placées pour renforcer la résilience et mener les adaptations nécessaires à la protection de la santé.
Grâce à des plateformes telles que Teach to Reach, La Fondation Apprendre Genève vise à élever les voix et les points de vue des infirmières et infirmiers, facilitant l’échange rapide de solutions adaptées localement à des défis partagés.
Nous appelons les leaders de la santé globale à reconnaître l’expertise que les infirmières détiennent du fait de leur proximité avec les communautés, et à inclure systématiquement les infirmières dans les dialogues politiques et les prises de décision sur les impacts sanitaires du changement climatique.
En cette Journée internationale des infirmières, nous réaffirmons notre engagement à tirer parti de la puissance des réseaux digitaux et des approches d’apprentissage innovantes pour soutenir les infirmières dans leur travail vital de protection et de promotion de la santé.
Grâce à des partenariats solides et à l’autonomisation des infirmières en tant que leaders, nous pensons qu’il est possible de mettre en place des systèmes de santé résilients, équitables et pérennisés dans un contexte de changement climatique.
Chaque jour, des milliers d’agents de santé, de l’Afghanistan au Zimbabwe, se lèvent et se rendent au travail avec un seul objectif en tête : faire en sorte que les vaccins parviennent à ceux qui en ont besoin.
Plus de 1 000 témoignages visuels ont été partagés.
Il ne s’agit pas de clichés soigneusement composés et techniquement élaborés par des photographes professionnels, mais plutôt d’une vue authentique sur ce que signifie la vaccination dans la pratique. Les difficultés de transport. Les mères concernées et aimantes. Les curieux. Le dialogue entre les praticiens et les membres de la communauté. Les écoliers brandissant leur carte de vaccination. Les cahiers contenant les données.
Voici donc notre deuxième galerie annuelle de photographies partagées par les membres du Mouvement. Une fois encore, elle célèbre la diversité de leurs rôles et des défis auxquels ils sont confrontés dans leur vie quotidienne, ainsi que leur engagement en faveur du Programme pour la vaccination à l’horizon 2030 (IA2030), qui vise à ce que chaque enfant, chaque famille, soit protégés contre les maladies évitables par la vaccination.
Si nous avons réitéré cette opération, c’est parce que nous avons observé que la narration visuelle avait un effet profond sur l’ensemble du Mouvement. Cet effet peut être difficile à quantifier. En soi, il n’améliore certainement pas la couverture vaccinale. Il a tout à voir avec la façon dont les agents de santé se perçoivent eux-mêmes, perçoivent la valeur de leur propre travail. En effet, le fait non seulement de savoir, mais aussi de voir qu’il y a des collègues dans le monde entier qui font le même travail, quel que soit le contexte, est réconfortant et inspirant. Cela peut contribuer à renforcer ou à renouveler la détermination et l’engagement. Cela peut aider à faire la différence – et à la maintenir dans le temps.
Certains professionnels de la santé travaillent dans des centres de santé offrant des services de vaccination et d’autres formes de soins de santé primaires. D’autres prennent part à des stratégies avancées, allant à la rencontre de la population. Ils peuvent également être basés dans des bureaux de district ou régionaux, où ils assurent la supervision et des conseils pour permettre aux praticiens de mieux faire leur travail.
Pour ceux qui contribuent aux activités de sensibilisation, ils peuvent être confrontés à de multiples défis. Ils peuvent avoir à surmonter des obstacles géographiques : rivières, inondations, routes en mauvais état, ou simplement de longues distances. Ils peuvent être amenés à s’aventurer dans des zones d’instabilité politique ou de conflit. Ils peuvent être amenés à entrer en contact avec des populations mobiles dont la localisation précise peut être incertaine. Enfin, ils peuvent être amenés à pénétrer dans des zones urbaines informelles en perpétuel changement.
Une fois arrivés à destination, ils constatent parfois que les personnes qu’ils contactent ne sont pas forcément réceptives à la vaccination. Ils devront alors passer du temps avec les gens pour les aider à comprendre les bénéfices et la sécurité de la vaccination.
Bien entendu, la vaccination proprement dite n’est pas la seule tâche à accomplir. Les programmes de vaccination s’appuient sur un réseaux de personnes ayant des rôles divers, tels que l’entretien des équipements essentiels de la chaîne du froid, la gestion des données et la collaboration avec les communautés pour obtenir leur soutien en faveur de la vaccination. Les volontaires issus de la communauté constituent un lien vital entre les programmes de vaccination et les communautés locales. Un travail d’équipe efficace est essentiel.
À la fin d’une longue journée, chaque praticien de la vaccination peut rentrer chez lui en sachant qu’il a contribué à rendre le monde plus sain et qu’il a peut-être sauvé une vie. Ce sont les véritables héros de la vaccination, et nous les saluons.
Charlotte Mbuh et Reda Sadki La Fondation Apprendre Genève (TGLF)
Aujourd’hui, à l’occasion de la Journée mondiale contre le paludisme, la Fondation Apprendre Genève est fière de se tenir aux côtés des travailleurs de la santé en première ligne dans la lutte contre cette maladie.
Le paludisme reste un problème de santé majeure, affectant de manière disproportionnée les communautés d’Afrique et d’Asie.
C’est pourquoi la lutte contre le paludisme sera au cœur de Teach to Reach 10, un événement phare qui permet à des milliers de professionnels de santé du monde entier de partager leurs expériences, leurs réussites et leurs défis.
Teach to Reach est une plateforme qui facilite l’apprentissage par les pairs afin de mener des actions locales sur des questions de santé urgentes.
Lors de Teach to Reach 10 le 21 juin 2024, nous nous concentrerons sur la menace urgente que représente le changement climatique pour la santé, en mettant particulièrement l’accent sur la façon dont l’évolution des conditions environnementales modifie le paysage du risque de paludisme et de la riposte à ce fléau.
Le leadership des professionnels de la santé est essentiel pour une vision intégrée de la lutte contre le paludisme par et pour les communautés locales
La hausse des températures, les phénomènes météorologiques extrêmes et l’évolution des précipitations créent des conditions idéales pour la prolifération des moustiques vecteurs du paludisme, exposant ainsi les communautés à des risques accrus.
Des acteurs comme Yapoulouce Bamba, de Guinée, ont observé cette tendance inquiétante : «La dégradation de l’environnement a créé davantage de lieux de reproduction pour les moustiques. Pendant la saison des pluies, on observe une augmentation exponentielle des populations de moustiques, ce qui accroît le nombre de cas de paludisme.»
De la gouvernance internationale à l’action locale : comment Teach to Reach peut contribuer à transformer la déclaration de Yaoundé en action locale
Lors de la conférence Teach to Reach 10, nous discuterons de la manière de transformer l’engagement des dirigeants africains dans la déclaration de Yaoundé en actions concrètes, menées localement pour accélérer la lutte contre le paludisme.
En rassemblant les acteurs de la santé pour partager des solutions locales et renforcer la résilience, nous soutenons l’appel de la déclaration en faveur de l’investissement dans la recherche et l’innovation, de la collaboration transfrontalière et de l’engagement des communautés en tant que partenaires dans la lutte contre le paludisme.
Teach to Reach incarne ainsi la vision de cette Déclaration, qui consiste à soutenir ceux qui sont en première ligne de la lutte contre le paludisme en leur apportant les connaissances, les outils et la solidarité dont ils ont besoin pour avoir un impact transformateur dans leurs communautés.
Nous avons besoin d’inventer de nouvelles façons de mener le changement
En cette Journée mondiale contre le paludisme, nous invitons tous ceux qui se sont engagés à mettre fin à cette maladie à se joindre à nous pour apprendre et écouter auprès des agents de santé de première ligne.
Leurs voix, leurs expériences et leur leadership sont essentiels pour stimuler l’action locale et la collaboration internationale nécessaires pour vaincre cette menace persistante dans un climat changeant.
Ensemble, nous pouvons trouver de nouvelles façons de mener le changement pour construire un avenir sans paludisme, pour tous.
Today, on World Malaria Day, the Geneva Learning Foundation is proud to stand with health workers on the frontlines of the fight against this deadly disease.
Malaria remains a critical global health challenge, disproportionately affecting communities in Africa and Asia.
That’s why we’re putting malaria at the heart of the agenda for Teach to Reach 10, our landmark event connecting tens of thousands of health workers worldwide to share their experiences, successes, and challenges.
Teach to Reach is a unique platform that enables health workers to learn from each other, contribute to global knowledge, and drive local action on pressing health issues.
At Teach to Reach 10 this June, we will be focusing on the urgent threat of climate change to health, with a special emphasis on how changing environmental conditions are altering the landscape of malaria risk and response.
Rising temperatures, extreme weather events, and changing rainfall patterns are creating ideal conditions for malaria-carrying mosquitoes to thrive, putting communities at greater risk.
Health workers like Yapoulouce Bamba from Guinea have observed this worrying trend: “The degradation of the environment has created more breeding grounds for mosquitoes. During the rainy season, there is a noticeable exponential increase in mosquito populations, which in turn raises the number of malaria cases.”
From global governance to local action: how Teach to Reach can contribute to turning the Yaoundé Declaration into local action
At Teach to Reach 10, we’ll be discussing how to turn the commitment of African leaders in the Yaoundé Declaration into locally-led action to accelerate action against malaria.
By bringing together health workers to share local solutions and build resilience, we are supporting the Declaration’s call for investment in research and innovation, cross-border collaboration, and engagement of communities as partners in the malaria fight.
Teach to Reach embodies the Declaration’s vision of supporting those at the forefront of the malaria fight with the knowledge, tools, and solidarity they need to drive transformative impact in their communities.
We need new ways to learn and lead
On this World Malaria Day, we invite all those committed to ending malaria to join us in listening to and learning from frontline health workers.
Their voices, experiences, and leadership are key to driving the local action and global collaboration needed to overcome this persistent threat in a changing climate.
New ways to learn and lead are vital so that we can build a healthier, malaria-free future for all.
Every day, thousands of health workers, from Afghanistan to Zimbabwe, get up and go to work with a single goal in mind to ensure that vaccines reach those who need them.
To mark World Immunization Week 2023 (24–30 April 2023) and the launch of the “Big Catch Up” campaign, the Geneva Learning Foundation (TGLF) invited members of the Movement for Immunization Agenda 2030 (IA2030) to share photographs of themselves and their daily work.
More than 1,000 visual stories were shared.
These are not the carefully composed and technically accomplished shots of the professional photographer: rather, they capture a raw and authentic view of what immunization means in practice.
The transport challenges.
The concerned and loving mothers.
The curious onlookers.
The dialogue between practitioners and community members.
The schoolchildren waving their vaccination cards.
The reams of paper-based data.
This is our second annual gallery of photographs shared by members of the Movement. Get the 2022 World Immunization Week photo book It takes people to make #vaccineswork…
Once again, it celebrates their diversity of roles and challenges faced in their daily lives, and their commitment to the IA2030 goal of ensuring that every child, every family, is protected from vaccine-preventable diseases.
If we did it again, it is because we observed that visual storytelling had a profound effect across the Movement.
This effect may be hard to quantify.
On its own, it certainly does not improve vaccination coverage.
And yet, it has everything to do with how health workers perceive themselves, perceive the value of their own work.
Not just knowing but seeing that there are colleagues across the world who are doing the same work, whatever the contexts, is heartening and inspiring.
It can help strengthen or renew resolve and commitment.
It can help make a difference – and sustain it over time.
To achieve their goals, they may be working in health facilities offering immunization services and other forms of primary health care.
Or they may be taking part in outreach or stratégies avancées, delivering vaccines out in the communities where people live.
Alternatively, they may be based in district or regional offices, providing oversight and offering “supportive supervision” constructive feedback and advice to ensure practitioners can do their jobs better.
If they are among the many practitioners engaged in outreach activities, they may face multiple challenges.
They may have to overcome geographical obstacles rivers, flooding, poor roads, or just long distances.
They may have to venture into areas of political instability or conflict.
They may have to make contact with mobile populations whose precise location may be uncertain.
And they may have to enter informal urban settings in a state of permanent flux.
Then, when they reach their destination, they may find that those they engage are not receptive to vaccination.
They may have to spend time with people to help them understand the benefits and safety of vaccines.
Of course, actually vaccinating people is not the only task that needs to be undertaken.
Vaccination programmes rely on a collective of people with a diverse range of roles, such as maintaining essential cold chain equipment, managing data, and working with communities to build support for vaccination.
Community-based volunteers provide a vital link between immunization programmes and local communities.
Effective teamwork is essential.
At the end of a long day, every vaccination practitioner can return home knowing that they have done their bit to make the world a healthier place, and just might have saved a life.
Charlotte Mbuh and Reda Sadki The Geneva Learning Foundation (TGLF)
Jones, I., Sadki, R., & Mbuh, C. (2024). The many faces of immunization (IA2030 Listening and Learning Report 5) (1.0). Special Event: World Immunization Week. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.8166653
Today, the Geneva Learning Foundation’s Charlotte Mbuh delivered a scientific presentation titled “On the frontline of climate change and health: A health worker eyewitness report” at the University of Hamburg’s Online Expert Seminar on Climate Change and Health: Perspectives from Developing Countries.
Mbuh shared insights from a report based on observations from frontline health workers on the impact of climate change on health in their communities.
“93% of respondents believed that there was a link between climate change and health, and they reported a direct local experience of a wide range of climatic and environmental impacts,” Mbuh stated.
The most commonly reported impacts were on farming and farmland, the distribution of disease-carrying insects, and urban areas becoming hotter.
Health impacts linked to these climatic and environmental changes included increased malnutrition and/or undernutrition, increased waterborne diseases, and changes to the incidence and distribution of vector-borne diseases.
Mbuh emphasized that these impacts were particularly prevalent in smaller communities or mid-sized towns.
Mbuh highlighted the unique role of frontline health workers as trusted advisors to their communities: “Frontline health workers are trusted advisors of the communities that they serve, and they have unique insights to local realities and are strategically positioned to bring about change,” she said.
The Geneva Learning Foundation aims to leverage its digitally-enabled peer learning network of health workers to drive change across different levels of the health system and geographical boundaries.
Mbuh concluded : “These experiences demonstrate the importance of community engagement, sustainable practices, and support from relevant stakeholders in addressing the climate health nexus and building resilience in the face of a changing climate.”
The presentation underscored the urgent need to invest in frontline health workers at the local level to build resilience against the impacts of climate change on health, particularly in vulnerable communities in developing countries.
The event was organized by the International Expert Centre of Climate Change and Health (IECCCH) at the Research and Transfer Centre Sustainable Development and Climate Change Management, Hamburg University of Applied Sciences, in collaboration with the European School of Sustainability Science and Research (ESSSR), the UK Consortium on Sustainability Research (UK-CSR), and the Inter-University Sustainable Development Research Programme (IUSDRP).
On March 18, 2024, the Geneva Learning Foundation (TGLF) hosted a workshop bringing together 553 health workers from 55 countries with TGLF’s First Fellow of Photography and award-winning photographer Chris de Bode. Watch the workshop in English and in French. Poor connectivity? Get the audio-only podcast.
The dialogue focused on exploring the power of health workers who are there every day to communicate the impacts of climate change on the health of those they serve. Learn more…
The Geneva Learning Foundation’s exploration of visual storytelling began, two years ago, with a simple yet powerful call to action for World Immunization Week: “Would you like to share a photo of your daily work, the work that you do every day?” Over 1,000 photos were shared within two weeks. “We repeated this in 2023, to show that it is people who make #VaccinesWork”, explains Charlotte Mbuh, the Foundation’s deputy director. Watch the 2022 and 2023 events, as well as the inauguration of the First International Photography Exhibition of the Movement for Immunization Agenda 2030 (IA2030).
In July 2023, over 4,700 health professionals – primarily government workers from 68 low and middle-income countries – responded to the call to share their firsthand observations of the impacts of climate change on health. Watch the special event “From community to planet: Health professionals on the frontlines of climate change“… Get the insights report…
That is when Chris de Bode, who has spent decades documenting global health stories, expressed his excitement to flip the script:
“Over the last two years, we received so many pictures about your daily work. By asking you a new question, a different angle on what you work on, we can go a little bit deeper in what you actually do. Since you are on the front line everywhere in the world, it’s super interesting to create a collection of images to show the world and also show each other within the community.”
What would Taphurother Mutange, a community health worker from Kenya, want to show in the photos she will take?
“What I want to show to people is the floods. In my community where I work, the floods were too much. Water went into a house where there was a 12-year-old girl sleeping. The water carried the girl out, and up to date, as I’m talking, she has never been seen.”
She linked this devastation directly to health, adding, “So climate change goes together with health, because after the rains, the children, pregnant mothers, and even older people get sick, and you might see there’s not enough drugs in the facility. So we might even go on losing some lives.”
Brigitte Meugang, a health professional from Yaoundé, Cameroon, captured the essence of why visual storytelling matters:
“I’m attending this event because I believe that with a picture, you can say a thousand words.
And with a beautiful picture, you can learn a lot.
You can understand a lot.
And you can understand really the story just by looking at a picture, usually.”
Chris guided participants on the psychology and ethics of photography, the power of light, and how to create compelling visual narratives.
He challenged the idea that photos must be candid to be authentic.
“A picture is always subjective.
It’s your position as a photographer who decides which picture you take and what you want to tell with the image.
When I take portraits of people, I stage, and I always stage.”
Participants grappled with this in the context of their health work.
Emmanuel Musa, from Nigeria, highlighted the tension:
“Professionally, we’ve been asked to take pictures, action pictures, but not to have a kind of arranged, organized setting…
Because normally we look at pictures that are actionable, that probably funders can see, probably supervisors can see what’s happening in the field, instead of organizing a group picture, you set as if we’re in a studio.”
Aimée N’genda, a health worker from the Democratic Republic of Congo (DRC), also emphasized the importance of consent and the risk of exploitation, especially in urban settings.
“Based on our experience, you need to ask for a written consent that you should keep, because you’ve got some people that will take advantage of it and think that when you take pictures of their children, they think you make money out of this, without paying them any fees.”
Despite the challenges, Chris affirmed the unique power health workers have as visual storytellers.
“You guys and ladies, you are there on the spot.
You’re there every day.
You have a large, large advantage on us, professional photographers who have to go there.”
Participants left energized to apply what they learned.
François Desiré, for example, declared, “I’m going to share pictures of mobile clinics that integrate immunization and nutrition.”
The dialogue equipped health workers to harness visual storytelling to communicate vital stories of how climate change impacts health in their communities, sparking change through the power of a single image.
The Geneva Learning Foundation (TGLF) is actively seeking a donor or sponsor to support visual storytelling by health professionals.
Version française: Raconter la santé en image: un atelier photo avec Chris de Bode pour Teach to Reach 10
This story was written by generative AI, based on a word-for-word transcript of the workshop.
Image: Screen shot of the chat during the workshop “Visual storytelling for health” on 18 March 2024.
Example 1: Addressing low uptake of a vaccine program
Single–Loop Learning: Improve logistics and supply chain management to ensure consistent vaccine availability at clinics.
Double–Loop Learning: Engage with community leaders to understand cultural beliefs and concerns around vaccination, and co-design a more localized and trustworthy immunization strategy.
What is the difference? Double-loop learning questions the assumption that the primary goal should be to increase uptake at all costs. It considers whether the program design respects community autonomy and addresses their real concerns. It may surface competing values of public health impact vs. community self-determination.
Example 2: Responding to an infectious disease outbreak
Single–Loop Learning: Rapidly mobilize health workers and supplies to affected areas to contain the outbreak following established emergency protocols.
Double–Loop Learning: Critically examine why the health system was vulnerable to this outbreak, and work with communities to redesign surveillance, preparedness and response systems to be more resilient.
What is the difference? Double-loop learning interrogates whether the existing outbreak response system is built on the value of health equity. It asks if the system privileges the needs of some populations over others and perpetuates historical power imbalances. It strives to create a more inclusive, participatory approach to defining outbreak preparedness and response priorities.
Example 3: Implementing a maternal health intervention that shows low adherence
Single–Loop Learning: Retrain health providers to improve their counseling skills and provide better patient education on the intervention.
Double–Loop Learning: Conduct participatory research with women and families to understand their needs, preferences and barriers to care-seeking, and collaborate with them to iteratively adapt the intervention design.
What is the difference? Double-loop learning challenges the implicit assumption that the intervention design is inherently correct and that non-adherence is a ‘user error’. It examines whether the intervention embodies values of respect, humility and co-creation with communities. It seeks to align the intervention with women’s self-articulated reproductive health values and preferences.
Example 4: Evaluating an underperforming community health worker (CHW) program
Single–Loop Learning: Strengthen CHW supervision, increase performance incentives, and optimize the ratio of CHWs to households.
Double–Loop Learning: Facilitate a joint reflection process with CHWs and community representatives to examine program strengths, challenges and equity gaps, and co-create a revised strategy that better aligns with community priorities and integrates CHWs’ insights.
What is the difference? Double-loop learning questions whether the CHW program is driven by the value of empowering communities as agents of their own health vs. treating CHWs as an instrument of technocratic public health aims. It re-centers the program on the value of CHW leadership and community-driven problem definition.
Example 5: Reforming a health financing policy to improve population coverage
Single–Loop Learning: Adjust the premium amounts, enrollment processes and benefit package based on initial uptake data.
Double–Loop Learning: Convene citizen panels and key stakeholders to deliberate on the fundamental goals and values underlying the financing reforms, and recommend redesigning the policy to better advance equity and financial protection.
What is the difference? Double-loop learning interrogates whether the true intent of the policy is to advance equity and financial protection for marginalized groups or simply to expand coverage as an end unto itself. It opens up debate on the core values and theory of change underlying the reforms. It aims to re-anchor the policy in a wholistic vision of equitable universal health coverage.
Learning culture is a critical concept missing from health systems research.
It provides a practical and actionable framework to operationalize the notion of ‘learning health systems’ and drive transformative change.
Watkins and Marsick describe learning culture as the capacity for change. They identify seven key action imperatives or “essential building blocks” that strengthen it: continuous learning opportunities, inquiry and dialogue, collaboration and team learning, systems to capture and share learning, people empowerment, connection to the environment, and strategic leadership for learning (Watkins & O’Neil, 2013).
Crucially, the instrument developed by Watkins and Marsick assesses learning culture by examining perceptions of norms and practices, not just individual behaviors (Watkins & O’Neil, 2013).
This aligns with Seye Abimbola’s assertion that learning in health systems should be “people-centred” and occurs at multiple interconnected levels.
Furthermore, this research demonstrates that certain dimensions of learning culture, like strategic leadership and systems to capture and share knowledge, are key mediators and drivers of performance outcomes (Yang et al., 2004).
This provides compelling evidence that investments in learning can yield tangible improvements in health delivery and population health.
Learn more: Jones, I., Watkins, K. E., Sadki, R., Brooks, A., Gasse, F., Yagnik, A., Mbuh, C., Zha, M., Steed, I., Sequeira, J., Churchill, S., & Kovanovic, V. (2022). IA2030 Case Study 7. Motivation, learning culture and programme performance (1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7004304
As Watkins and Marsick (1996) argue, to develop a strong learning culture, we need to “embed a learning infrastructure”, “cultivate a learning habit in people and the culture”, and “regularly audit the knowledge capital” in our organization or across a network of partners.
While investments in learning can be a challenging sell in resource-constrained global health settings, this evidence establishes that learning culture is in fact an indispensable driver of health system effectiveness, not just a “nice to have” attribute.
Subsequent studies have also linked learning culture to key performance indicators like care quality, patient satisfaction, and innovation.
To advance learning health systems, it is important to translate this research in terms that resonate with the worldview of global health practitioners like epidemiologists and to produce further empirical studies that speak to their evidentiary standards.
The learning culture framework offers an evidence-based approach to guide this transformation.
References
Abimbola, S. The uses of knowledge in global health. BMJ Glob Health 6, e005802 (2021).
Watkins, K. E. & O’Neil, J. The Dimensions of the Learning Organization Questionnaire (the DLOQ): A Nontechnical Manual. Advances in Developing Human Resources 15, 133–147 (2013).
Watkins, K., & Marsick, V. (1996). (Eds.). In action: Creating the learning organization (Vol. 1). Alexandria, VA: ASTD Press.
Yang, B., Watkins, K. E. & Marsick, V. J. The construct of the learning organization: Dimensions, measurement, and validation. Human Resource Development Quarterly 15, 31–55 (2004).
