How Teach to Reach can help your organization

Can Teach to Reach help your organization?

Global health

Teach to Reach stands as a unique nexus in the global health landscape, offering unprecedented opportunities for diverse stakeholders to engage, learn, and drive meaningful change.

With over 60,000 participants from more than 90 countries, this platform, network, and community bring together a mix of frontline health workers, policymakers, and key decision-makers.

At Teach to Reach, research institutions and academic researchers engage health workers to translate their findings into policy and practice

For research institutions and academic partners, Teach to Reach provides a site for knowledge translation.

It provides direct access to practitioners and policymakers at all levels, enabling researchers to share findings with those best positioned to apply them in real-world settings.

The platform’s interactive features, such as “Teach to Reach Questions,” allow for rapid data collection and feedback, helping bridge the gap between research and practice.

At Teach to Reach, global agencies can listen and learn with local communities

Global health organizations can leverage Teach to Reach to gain invaluable insights into unmet needs of local communities.

With half of the participants working in districts and local facilities, and many in challenging contexts such as armed conflict zones (1 in 5) or remote rural areas (>60%), partners can engage with ground-level perspectives that inform development, strategies, and programme design.

This direct engagement with frontline workers offers a unique window into the realities of diverse health systems.

At Teach to Global, global actors help elevate the voices and leadership of local actors

For those looking to make a tangible impact on global health equity, Teach to Reach’s scholarship programme offers a compelling opportunity.

Scholarship sponsors support health workers from low and middle-income countries to participate in Teach to Reach.

This investment not only builds individual capacity but strengthens health systems by recognizing and amplifying health worker voices and expertise.

Facilitate meaningful dialogue on critical issues

Global health stakeholders find in Teach to Reach a platform that facilitates meaningful dialogue on critical issues.

The diverse participant base, including national policymakers and heads of national programmes, creates an environment ripe for new kinds of inclusive dialogue that can shape national and global strategies and frameworks.

Become a Teach to Reach sponsor

This mix of participants offers partners a unique opportunity to engage with key decision-makers in an interactive, collaborative setting.

Some partners also become sponsors by contributing to the costs.

For example, partners can sponsor scholarships for health workers to support their participation in Teach to Reach.

This is just one of the ways in which partners can help sustain Teach to Reach as a platform, network, and community.

For private sector organizations, sponsoring Teach to Reach aligns seamlessly with corporate social responsibility goals in global health.

By this platform, organizations can articulate their concrete commitment to strengthening health systems, showing their support to health workers, and promoting health equity.

This engagement goes beyond traditional philanthropy, offering sponsors a way to showcase their dedication to improving global health outcomes while enhancing their reputation in the field.

In essence, Teach to Reach offers a multifaceted value proposition for partners.

It is a place to listen and learn, to share and collaborate, to influence and be influenced.

Whether an organization’s goals revolve around research impact, market insights, policy influence, or social responsibility, Teach to Reach provides a unique, efficient, and impactful site to engage.

By joining this community, partners do not just support a platform – they become part of a movement that is reshaping how we approach global health challenges, one connection at a time.

Teach to Reach 11 Call for Partners

Why participate in Teach to Reach?

Global health

In global health, where challenges are as diverse as they are complex, we need new ways for health professionals to connect, learn, and drive change.

Imagine a digital space where a nurse from rural Nigeria, a policymaker from India, and a WHO expert can share experiences, learn from each other, and collectively tackle global health challenges.

That’s the essence of Teach to Reach.

Welcome to Teach to Reach, a peer learning initiative launched in January 2021 by a collection of over 300 health professionals from Africa, Asia, and Latin America as they were getting ready to introduce COVID-19 vaccination.

Four years later, the tenth edition of Teach to Reach on 20-21 June 2024 brought together an astounding 21,389 health professionals from over 70 countries.

Discussion has expanded beyond immunization to include a range of challenges that matter for the survival and resilience of local communities.

What makes this gathering extraordinary is not just its size, but its composition.

Unlike traditional conferences dominated by high-level experts, 80% of Teach to Reach participants work at district and facility levels, bringing ground-level insights to global discussions.

Half are government workers.

One in five work for health in the context of armed conflict.

Why do so many health workers join and contribute to Teach to Reach?

The event’s success lies in its unique process.

Weeks before the main event, participants start sharing their experiences through targeted questions.

In June, these “Teach to Reach Questions” resulted in over 2,000 real-world stories and insights being collected and shared back with the community.

This pre-event engagement ensures that when participants finally meet virtually, conversations are rich, relevant, and rooted in real-world challenges.

During the two-day event, participants engage in a mix of plenary sessions, interactive workshops, and one-on-one networking.

“It’s like speed dating for global health professionals,” jokes The Geneva Learning Foundation’s Charlotte Mbuh. “But instead of romantic connections, we’re forming professional bonds that can transform health outcomes in our communities.”

This structure facilitates direct dialogue between global health leaders and frontline workers.

How does this relate to the work done by global partners?

Ahead of Teach to Reach 10, Dr. Kate O’Brien, Director of Immunization at WHO, noted, “Our job is to take everything that you all know at the grassroots level and bring it together into sort of that collated guidance.”

Jaded global health staff may ask “So what?”.

The impact of Teach to Reach extends far beyond the event itself.

Health workers leading Teach to Reach helped create the Movement for Immunization Agenda 2030 (IA2030).

This year, over 2,400 civil society and community-based organizations and at least as many local leaders engaged as as partners, creating a diverse network that spans from grassroots NGOs and local government agencies to global institutions like Gavi and UNICEF.

Connections made through the network outlast the event itself, strengthening local action and creating new ways to inform global strategies.

For global partners, Teach to Reach offers an unparalleled opportunity.

Dr. Ephraim T. Lemango, Chief of Immunization at UNICEF, said: “We’ve said we want to listen and that co-creation is very important… This is exactly the type of innovative approach that we need to overcome the complex challenges we are faced with in global health.”

Teach to Reach 10 demonstrated the event’s growing impact and reach:

  • Diverse participation: 80% of attendees were district and facility-level health workers, providing ground-level perspectives often missing from global health dialogues.
  • Organizational engagement: 2,400 organizations participated in the partnership process, with 240 selected as official partners, spanning local NGOs to global institutions.
  • Thematic relevance: The event addressed critical issues like climate change’s impact on health, with insights from 4,700 health workers informing discussions.
  • Global-local collaboration: Sessions featured partnerships between international organizations and local implementers, such as UNICEF’s work on reaching zero-dose children in urban settings.
  • Tangible outcomes: Post-event surveys revealed that 99.7% of respondents reported increased motivation, and 97.4% learned something new and applicable to their work.

We are pleased to announce Teach to Reach 11 that will be held on 5-6 December 2024.

As Teach to Reach 11 approaches, the excitement is palpable.

This year’s event promises to continue to explore critical issues like climate change’s impact on health, malaria, and immunization, bringing new partners seeking to listen and learn with communities.

The running thread across all these issues is expressed in a groundbreaking Manifesto for investment in health workers, developed collaboratively by over 1,300 Teach to Reach participants.

For those new to Teach to Reach, participating is straightforward.

The event is free for health professionals from low and middle-income countries, with options for low-bandwidth participation to ensure inclusivity.

Global organizations can join as partners, gaining access to a wealth of insights and opportunities through their respectful, meaningful engagement with health workers.

By harnessing the collective wisdom of health professionals worldwide, Teach to Reach is creating a new paradigm for learning, collaboration, and action in global health.

So, whether you’re a community health worker in rural Asia or a decision-maker at a global health institution, Teach to Reach invites you to be part of this transformative journey.

Together, we can bridge the gap between global strategies and local realities, turning shared knowledge into powerful action for better health worldwide.

Brevity’s burden The executive summary trap in global health

Brevity’s burden: The executive summary trap in global health

Global health, Learning strategy

It was James Gleick who noted in his book “Faster: The Acceleration of Just About Everything” the societal shift towards valuing speed over depth:

“We have become a quick-reflexed, multitasking, channel-flipping, fast-forwarding species. We don’t completely understand it, and we’re not altogether happy about it.”

In global health, there’s a growing tendency to demand ever-shorter summaries of complex information.
 
“Can you condense this into four pages?”

“Is there an executive summary?”

These requests, while stemming from real time constraints, reveal fundamental misunderstandings about the nature of knowledge and learning.

Worse, they contribute to perpetuating existing global health inequities.

Here is why – and a few ideas of what we can do about it.

We lose more than time in the race to brevity

The push for shortened summaries is understandable on the surface.

Some clinical researchers, for example, undeniably face increasing time pressures.

Many are swamped due to underlying structural issues, such as healthcare professional shortages.

This is the result of a significant shift over time, leaving less time for deep engagement with new information.

If we accept these changes, we lose far more than time.

Why does learning require time, depth, and context?

True understanding and the ability to apply knowledge in diverse contexts demands deep engagement, reflection, and often, struggle with our own assumptions and mental models.

Consider the process of learning a new language.

No one expects to become fluent by reading a few pages of grammar rules.

Mastery requires immersion, practice, making mistakes, and gradually building competence over time.

The same principle applies to making sense of multifaceted global health issues.

5 risks of executive summaries

Here are five risks of demanding summaries of everything:

  1. Oversimplification: Complex health challenges often cannot be adequately captured in a few pages. Crucial nuances and context-specific details get lost. Those ‘details’ may actually be the ‘how’ of what makes the difference for those leading change to achieve results.
  2. Losing context: Information that can be easily summarized (quantitative data, broad generalizations) gets prioritized over more nuanced, qualitative, or context-specific knowledge. 
  3. Stunting critical thinking: The habit of relying on summaries can atrophy our capacity for deep, critical engagement with complex ideas.
  4. Overconfidence: It assumes that learning is primarily about information transfer, rather than a process of engagement, reflection, and application. Reading a summary can give the false impression that one has grasped a topic, leading to overconfidence in decision-making.
  5. Devaluing local knowledge: Rich, contextual experiences from health workers and communities often do not lend themselves to easy summarization.

The expectation that complex local realities can always be distilled into brief summaries for consumption by decision-makers (often in the Global North) perpetuates existing power structures in global health.

The ability to demand summaries often comes from positions of power.

This can lead to privileging certain voices (those who can produce polished summaries) over others (those with deep, context-specific knowledge that resists easy summarization).

This knowledge then gets sidelined in favor of more easily digestible but potentially less relevant information.

10 ways to value and engage with knowledge in global health

Addressing the “summary culture” requires more than better time management.

It calls for a fundamental rethinking of how we value and engage with knowledge in global health.

Instead of defaulting to demands for ever-shorter summaries, we need to rethink how we engage with knowledge.

Here are 10 practical ways to do so.

  1. Prioritize productive diversity over reductive simplicity: Sometimes, it is better to engage deeply many different ideas than to seek one reductive generalization.
  2. Value local expertise: Prioritize knowledge from those closest to the issues, even when it does not fit neatly into summary format.
  3. Value diverse knowledge forms: Recognize that not all valuable knowledge can be easily summarized. Create space for stories, case studies, and rich qualitative data.
  4. Improve information design: Instead of just shortening, focus on presenting information in more accessible and engaging ways that do not sacrifice complexity.
  5. Create new formats: Develop ways of sharing information that balance accessibility with depth and nuance.
  6. Pause and reflect: What might be lost in the condensing? Are you truly seeking efficiency, or avoiding the discomfort of engaging with complex, potentially challenging ideas? Are you willing to advocate for systemic changes that truly value deep learning and diverse knowledge sources?
  7. Challenge the demand: When asked for summaries, push back (respectfully) and explain why certain information resists easy summarization.
  8. Foster critical engagement: Encourage professionals to develop skills in quickly assessing and engaging with complex information, rather than providing pre-digested summaries.
  9. Educate funders and decision-makers: Help those in power understand the value of engaging with complexity and diverse knowledge forms.
  10. Rethink the economy of time allocation: Advocate for systemic changes that value time spent on deep learning and reflection as core to effective practice and leadership.

Image: The Geneva Learning Foundation Collection © 2024

Gavi Zero-Dose Learning Hub Recommendations to support knowledge translation of evidence to identify and reach zero-dose children

Recommendations to support knowledge translation of evidence to identify and reach zero-dose children

Global health

This article is excerpted from the Gavi Zero-Dose Learning Hub publication “Knowledge Translation for Zero-Dose Immunization Research”.

In its role as the Learning Innovation Unit (LIU) lead, The Geneva Learning Foundation (TGLF) conceptualized a baseline strategy for knowledge translation (KT).

TGLF developed the following recommendations to support the Country Learning Hubs’ (CLH) KT work. 

The recommendations are intended to improve the use of evidence generated by research, ensuring it effectively informs practices, policies, and interventions targeting vaccine equity.

Each recommendation is accompanied by a rationale and example.

Together, these recommendations aim to build a robust and efficient approach to KT that maximizes the impact of research findings on identifying and reaching ZD and UI children, ultimately contributing to improved immunization equity. This toolkit provides researchers with a list of steps for planning for KT with guiding

Table 1. KT Recommendations from TGLF

RecommendationExample
Perform a rapid capacity audit for KT to inform strategies. Diagnose organizational capacity for KT and builds on available infrastructure and expertise, while tailoring strategies to address limitations.Rapid capacity audit questions include: (1) what percent of resources are committed to KT?, (2) what competencies are needed for KT?, and (3) what networks are needed for KT?
Integrate KT planning from the research inception. Get buy-in from stakeholders, and capitalize on emerging insights. This will also allow sufficient time for capacity strengthening, prevent lags between results and translation, and create efficiencies.Establish KT goals at the beginning of the project, and consider the KT goals while designing evaluation frameworks and stakeholder engagement plans.
Engage intended stakeholders/audiences throughout the evidence generation process. Drive relevance, applicability, and shared ownership of emerging findings.Include sub-national practitioners on advisory committees, and engage stakeholders and communities in developing research questions.
Implement co-creation and participatory processes. Foster a culture that values active listening; encourages engagement with diverse viewpoints; and supports questioning, feedback, and experimentation. This approach underpins the development of a shared vision for collective progress and innovation.Involve a diverse group of stakeholders. Explore rapid feedback mechanisms. Establish platforms or forums for peer-to-peer exchange, where individuals can share their success stories and challenges.
Tailor methods and communications materials to the audience(s). Contribute to the effectiveness and impact of KT efforts.Identify audience(s) and their preferred mode(s) of communication and needs (i.e., busy policymakers may prefer short, non-technical policy briefs).
Leverage informal networks and create continuous learning opportunities to translate evidence. Tap into peer learning and try new ideas; facilitate cost-effective diffusion that enables adaptation.Identify influencers. Support sharing through professional networks and learning collaboratives.
Capture user feedback systematically on value and use. Demonstrate the value and use of the translated knowledge.Distribute short usage surveys when research outputs are accessed (post-webinar/event surveys, follow-up email/surveys after sharing resources).
Monitor changes in policies and practices beyond dissemination metrics.Facilitate evidence uptake and measurable improvements from application.Establish key indicators on changes adopted across networks based on research findings.
Share experiences. Encourage learning from real-world examples of how evidence-based practices have been adapted and implemented. This can inform efforts to tailor interventions to unique settings, fostering innovation and problem-solving.Develop and disseminate case studies that highlight the pathway from learning to action, facilitating peer-to-peer learning and accelerating the adoption of effective practices.

See also: Gavi Zero-Dose Learning Hub’s innovative model for inter-country peer learning and knowledge translation

Image: The Geneva Learning Foundation Collection © 2024

Gavi Zero-Dose Learning Hub peer exchange for knowledge translation

Gavi Zero-Dose Learning Hub’s innovative model for inter-country peer learning and knowledge translation

Global health

This article is excerpted from the Gavi Zero-Dose Learning Hub publication “Knowledge Translation for Zero-Dose Immunization Research”.

The Geneva Learning Foundation (TGLF) hosted the first ZDLH Inter-Country Peer Learning Exchange session (ZDLH-X), in May 2023 with a focus on Bangladesh and Mali.

The second online peer learning exchange, ZDLH-X2, in September 2023 focused on Nigeria and Uganda.

The ZDLH-X events were the centerpiece of a mini learning program that includes three general steps.

  • First, providers completed a questionnaire, provided by TGLF, on local ZD challenges, practices, and priorities.
  • Second, there was a series of online events to share and curate ZD practices. Finally, there were follow-up events online for reflection on learning, and participants completed post-event questionnaires.

Through this process, TGLF identified stories to be featured in a January 2024 ZDLH webinar event. The stories reveal how practitioners in Bangladesh, Mali, Nigeria, and Uganda are developing local solutions to increase equity in immunization.

The peer learning events provide a framework for addressing the complex problem-solving required to address the ZD challenge.

The ZDLH-X approach uses multidisciplinary participation, narrative-based mental model building, peer inspiration, reflective sessions, and collaborative activities to address multidimensional challenges like reaching ZD children.

Watch the complete Gavi Zero-Dose Learning Hub Webinar: Equity in Action: Local Strategies for Reaching Zero-Dose Children and Communities. Here is an excerpt, focused on the ZDLH-X learning model and its relevance for knowledge translation.

Table 5. ZDLH-X Peer Exchange as a KT Model

Driver for complex problem-solvingHow ZDLH-X provides a model
Learning from each otherThe events connected over 3,000 practitioners working on ZD issues globally, enabling peer exchange of insights from across contexts. This diversity of knowledge and perspectives mirrors the need identified by research to assimilate inputs from different domains when solving complex problems.
Utilizing mental models (reflective thinking)Through presentations, participants shared local strategies for reaching communities with ZD children. These stories and visuals helped others envision new ways to make a difference, showcasing the power of learning from peers to expand the problem-solving toolkit.
Enabling metacognition (thinking about thinking)Q&A sessions encouraged participants to think critically about their current methods and attitudes. These reflective conversations are crucial for understanding and improving thought processes, a key element in tackling complex issues.
Managing affective factors (motivation)Peer testimonials provided motivation through relatable stories of overcoming barriers, such as vaccine hesitancy or gender-related barriers. Psychology research links such motivation and emotional regulation to complex problem-solving success.
Supporting collaborationThe event facilitated group discussions, allowing for a collective examination of challenges specific to different communities. Research shows that collaborative efforts lead to better outcomes in solving complex problems, thanks to a shared understanding among team members.

Prior TGLF research on immunization learning culture revealed continuous learning as the weakest dimension, characterized by few opportunities, low risk tolerance, limited incentives, and a focus on tasks over capacity strengthening.

By incorporating evidence-based strategies to strengthen continuous learning, the ZDLH-X events were designed to provide the missing elements through blended peer, social, remote, and networked learning.

Value Creation Framework

A value creation framework measured the ZDLH-X events’ impact across five areas: professional change, social connections, practice improvement, influence, and mindset shifts.

Value creation questions provide a method to assess value through both quantitative and qualitative responses.

These evidence-based inquiries, made optional to encourage participation, can provide deeper understanding of how resources or events facilitate knowledge application, ensuring more accurate evaluation of the effectiveness of KT activities.

Respondents rated agreement with statements in each area.

Results were benchmarked against a 10,000-participant cohort.

Across all five areas assessed, ZDLH-X participants reported substantially higher value creation versus the 10,000-respondent benchmark, demonstrating the effectiveness of the peer learning approach.

Sample value creation questions
Participation changed me as a professional (change in skills, attitudes, identity, self-confidence, feelings, etc.).
Participation helped my professional practice (get new ideas, insights, materials, procedures, etc.)
Participation made me see my world differently (change in perspective, new understandings of the situation, redefine success, etc.)

Relating Learning to Performance

Previous large-scale TGLF research (n=6,185) demonstrated significant predictive relationships between strengthening immunization learning culture and enhancing knowledge and mission performance.

These causal links contextualize ZDLH-X outcomes within a broader performance framework.

When asked about applying learnings, 99 percent of ZDLH-X respondents expressed intent to use new ZD strategies.

Post-event feedback included examples of adaptations based on ideas gained, illustrating tangible practice changes.

This evidence indicates that structured, blended peer learning can reliably extract practical insights on local ZD solutions from frontline staff and spur knowledge translation.

Quantitatively and qualitatively, the methodology generated value for participants while enabling continuous learning.

Coupled with prior research linking learning culture to performance, it is reasonable to hypothesize that such methods may positively influence coverage outcomes.

Additional research should replicate these findings across contexts and connect observed practice changes to immunization results.

The ZDLH-X model leverages peer exchange to sustainably strengthen continuous learning and identify how to better reach ZD children.

Initial findings suggest this approach could complement traditional learning agendas to build immunization system resilience.

Wider application and validation is warranted based on the events’ promising outcomes.

Practitioners gained the knowledge of relevant solutions while advancing the learning culture needed to continuously adapt and perform in our complex world.

ZDLH-X Recommendations to Support Engagement Conducive to Effective KT

Table 6. ZDLH-X Recommendations to Support Engagement Conducive to Effective KT

Virtual Peer Exchange Model RecommendationsImplementation Guidance and Questions
Help ZD practitioners relate their own experiences to what is shared.Ask: “When you listen to your colleague, how different is this from the ZD challenge you face? Tell us about this challenge.”
Explain the role of global and national-level experts as a guide on the side rather than sage on the stage.Remind them to listen attentively to each person sharing their experience: “Examine this experience in light of your global expertise. Identify questions for follow-up to clarify the story. Share short, specific feedback first, and then generalize to bring in the big picture. Be concise and get to the point. The longer you speak, the less we will learn from ZD practitioners.”
Emphasize that participant experience is valued and recognized as legitimate.Share that there will be no slide presentations. Instead, participants are invited to share stories and respond to stories shared. National/ global staff are invited to listen, learn, and contribute as a guide on the side.
Provide explicit guidance to help participants structure their thinking to act as scaffolding for knowledge translation.Tell participants, “Prepare to listen and share your feedback. As you listen to fellow ZD practitioners, reflect on your own experience. What experience do you want to share and why? How do you think this experience will be helpful to colleagues working on ZD? Be concise.”
Share rules of engagement to ensure all participants are included and feel recognized.Reminder: if a person from one country or region has spoken, the next person should be from a different country or region. When possible, if a man has spoken, the next person should be a woman. Tell participants, “We will be very strict about timing. Remember that you can also share your thoughts by writing in the comments. Respect diversity and differences, and one another as peers.”
Acknowledge connectivity challenge in a frontline event to encourage participation.Remember that practitioners from remote areas may have connectivity issues, despite interest and motivation. Consider organizing “viewing parties” where staff gather to watch and listen from a location with reliable internet.
Share supportive messaging to help build engagement that increases motivation to translate knowledge into practice.Tell participants, “We are here to listen and learn from you. Trust your experience. Focus on what you know because you are there every day. Do not forget to introduce yourself: who you are and where you work. Be concise. You will be asked questions by the facilitation team, by guides on the side, and by attendees. It is okay if you do not have all the answers. Listen to the experiences of your peers, as you will be asked questions about them.”
Emphasize the value proposition of the opportunity to translate knowledge into practice.Tell participants, “Learn from the experiences of other immunization professionals on how they have successfully identified and reached ZD and UI communities; gain understanding about the specific tools and interventions that were effective in other contexts and be able to adapt them to your context. Share your own experience, including success stories, lessons learned and challenges; reflect on your own ZD practices and identify areas for improvement.”
Share criteria to help  participants share  relevant experience.Advise participants, “Be as precise and concrete as possible. Describe what you did and why, step by step. How do you know it worked? What did you do that is new or different? What facilitated and complicated this intervention? How does what you did connect to broader health system components (e.g., HRH, data/monitoring, planning, financing, supply chain/logistics)? For challenges that are relevant to others: In what specific ways does your intervention impact a ZD problem? What other challenges relate to this one (e.g., gender, conflict, urban/rural, demand, finance)? What about your intervention do you think is common or relevant to others— in your country or in another country?”
Provide guiding questions to help practitioners share their ZD experience.Ask: “What is the ZD situation where you work? How do you know? What are you doing about it, why, and how? How is it different from what you did before? How has it turned out so far? How do you know what you are doing is successful?”
Consider the determinants of KT for individuals.When trying to translate knowledge into practice: Give me enough time to work on knowledge translation. Ensure progress is monitored by my supervisor. Make available someone to coach or mentor me. Facilitate access to fellow practitioners for guidance and support. Encourage co-workers to support. Make job aids available for guidance. Periodically remind of need for change in practice.
Share relevant content with platforms, with an invitation to disseminate and report back on KT.Follow up with each platform to analyze KT effectiveness and lessons learned.

Learn more: Access the ZDLH-X recordings, synthesis reports, a list of frequently asked questions,  and conceptual framework.

Image: The Geneva Learning Foundation Collection © 2024

The Nigeria Immunization Collaborative what happened after just two weeks

The Nigeria Immunization Collaborative: Early learning from a novel sector-wide approach model for zero-dose challenges

Global health

Less than three weeks after its launch, the Nigeria Immunization Collaborative – a partnership between the Geneva Learning Foundation, the National Primary Health Care Development Agency (NPHCDA), and UNICEF – has already connected over 4,000 participants from all 36 states and more than 300 Local Government Areas (LGAs).

The Collaborative is part of the Movement for Immunization Agenda 2030 (IA2030).

In the Collaborative’s first peer learning exercise that concluded on 6 August 2024, over 600 participants conducted root cause analyses of immunization barriers in their communities.

Participants engaged in a two-week intensive process of analyzing immunization challenges, conducting root cause analyses, and developing actionable plans to address these issues.

They did this without having to stop their daily work or travel, a key characteristic of The Geneva Learning Foundation’s model to support work-based learning.

Watch the General Assembly of the Nigeria Immunization Collaborative on 6 August 2024

What are health workers saying about the Collaborative?

For Mariam Mustapha, a participant from Kano State, the Collaborative is “multiple individuals that perform a task”, united around a shared purpose.

She highlighted the importance of engaging with community members, noting, “These people from the community, most of them, they don’t have enough knowledge or they are receiving misinformation about immunization and vaccines.”

The peer learning exercise employed a structured approach, asking participants to explain their immunization challenge, conduct a “5 Whys” analysis to identify root causes, and develop actionable plans within their scope of work.

How does the Collaborative help health workers?

This method proved enlightening for many participants.

John Emmanuel, a community health worker from Bauchi State, shared his experience: “I just discovered that over the years, I have been superficial in my approach. I’ve been one sided. I’ve been actually peripheral in my approach. So during the root cause analysis, I was able to identify the broader perspective of identifying the challenge and then fixing it as it affects my job here in the community.”

The Collaborative also fostered connections between health workers across different regions of Nigeria.

Mohammed Nasir Umar, a JSI HPV program associate in Zamfara State, noted the value of this cross-pollination of ideas: “The root cause analysis really widened my horizon on how I think around the challenges. The ‘5 Whys’ techniques approach was really, really helpful.”

Participants identified a range of immunization challenges, including vaccine hesitancy, lack of information and awareness, sociocultural and religious factors, reaching zero-dose children, incomplete immunization, healthcare worker issues, logistical challenges, political interference, poor documentation, and community trust issues.

But then each one started asking ‘why’, stopping only once they found a root cause that they are in a position to do something about.

Esther Sharma, working with NPHCDA in a local government area, identified a critical issue in her facility: “The reason why people turn out low for immunization is because there are no health workers in the facilities to attend to them when they get here.”

Her solution involves ensuring consistent staffing during immunization days, which should encourage more community members to seek vaccination services.

How are new stakeholders participating in the Collaborative?

The Collaborative also welcomed participation from organizations not traditionally involved in immunization services.

Angela Emmanuel, a nurse and founder of the Emmanuel Cancer Foundation in Lagos, found value in the exercise for her work on HPV vaccination and cancer prevention.

She emphasized the need for a more educational approach: “Our motive should be education. Our motive should be the awareness, not just asking them to take this vaccine.”

Chijioke Kaduru, a public health physician who served as a Guide for the Collaborative, reflected: “While some of these challenges are similar in many settings, the local context and the nuances that shape these challenges clearly make them a good opportunity to engage, to interact, to understand them better, and to start to also see the ideas that colleagues have about how to solve those problems.”

By connecting frontline health workers, fostering critical thinking, and encouraging the development of locally-tailored solutions, the Nigeria Immunization Collaborative represents a potentially scalable model for strengthening health systems and improving immunization coverage.

As the exercise concludes, participants are poised to implement their action plans in their respective communities.

How are government workers participating in the Collaborative?

A key focus of the final session was the presentation of root cause analyses by government workers from the Federal and State Primary Health Care Development Agencies.

These presentations provided valuable insights into the challenges faced at various levels of the health system and the innovative solutions being developed.

Maimuna Tata, a deputy in-charge at a health facility in Bunkura local government area of Kano State, presented her analysis of why routine immunization sessions were not being conducted at her facility.

Through her “5 Whys” analysis, she uncovered a systemic issue: “The health facility is newly built and was commissioned after the 2024 micro plan exercise and needs to undergo several processes for provision of routine immunization.”

Tata’s proposed solution demonstrated the kind of innovative thinking the Collaborative aimed to foster: “Instead of them coming for outreach session in the settlement, I think the vaccine should be channeled to the health facility so that the health facility can conduct the sessions. And at the end of the day, we will now be submitting our reports to the health facility, that is the model health facility, pending the time the health facility will be recorded or will be updated in the server.”

Esther Sharma, working with NPHCDA in a local government area, identified a critical staffing issue: “The reason why people turn out low for immunization is because there are no health workers in the facilities to attend to them when they get here. I am the routine immuunization focal person where I currently work and when I went there newly, I asked a lot of people, why don’t they come to the hospital for immunization? And they said when they come, they don’t find anybody to attend to them.”

Her solution involves ensuring consistent staffing during immunization days, which she reported has already encouraged more community members to seek vaccination services.

Image: The Geneva Learning Foundation Collection © 2024

7 take-aways from Nigeria’s first Immunization Collaborative peer learning exercise

7 take-aways from Nigeria’s first Immunization Collaborative peer learning exercise

Writing

On August 6, 2024, the Nigeria Immunization Agenda 2030 Collaborative concluded its first peer learning exercise with a final Assembly.

This groundbreaking initiative, a partnership between The Geneva Learning Foundation, Nigeria’s National Primary Health Care Development Agency (NPHCDA), and UNICEF, has already engaged over 4,400 health workers from all 36 States and more than 300 Local Government Areas (LGAs) across Nigeria.

The Collaborative’s innovative approach focuses on empowering health workers to identify root causes of local immunization challenges and develop practical, context-specific solutions.

As the initiative continues to grow, with new members joining daily, it could help shift how Nigeria approaches immunization capacity building and problem-solving.

Right after the final Assembly on 6 August 2024, Nigeria immunization specialist Jenny Sequeira and The Geneva Learning Foundation’s deputy director Charlotte Mbuh shared their initial thoughts about the exercise.

Here are 7 key takeaways from their discussion.

1. Critical Thinking Evolution: Participants made significant progress in their analytical skills, moving from vague problem statements to nuanced understanding of local immunization challenges. The “5 Whys” technique proved particularly effective.

2. Power of Peer Review: The structured, time-bound peer review process emerged as a practical learning tool, fostering self-reflection and exposing participants to diverse perspectives.

3. Leveling the Playing Field: The Collaborative created an environment where hierarchies dissolved, enabling workers from the local levels to engage laterally with state and national-level participants.

4. Focus on Actionable Solutions: Participants were encouraged to identify root causes within their control, promoting practical, context-specific solutions.

5. Importance of Community Engagement: The process highlighted the crucial role of engaging communities and addressing barriers to improve vaccine uptake.

6. Emphasis on Implementation: While the RCA exercise was valuable, leaders stressed the critical need for follow-through and implementation of proposed solutions.

7. Cross-Sector Collaboration: The collaborative saw participation from diverse stakeholders, including government agencies, civil society organizations, and private sector entities.

Image: The Geneva Learning Foundation Collection © 2024

Experience-sharing sessions in the Movement for Immunization Agenda 2030- A novel approach to localize global health collaboration

Experience-sharing sessions in the Movement for Immunization Agenda 2030: A novel approach to localize global health collaboration

Global health

As immunization programs worldwide struggle to recover from pandemic disruptions, the Movement for Immunization Agenda 2030 (IA2030) offers a novel, practitioner-led approach to accelerate progress towards global vaccination goals.

From March to June 2022, the Geneva Learning Foundation (TGLF) conducted the first Full Learning Cycle (FLC) of the Movement for IA2030, engaging 6,185 health professionals from low- and middle-income countries.

A cornerstone of this programme was a series of 44 experience-sharing sessions held between 7 March and 13 June 2022. These sessions brought together between 20 and 400 practitioners per session to discuss and solve real-world immunization challenges.

IA2030 case study 16, by Charlotte Mbuh and François Gasse, offers valuable insights from these experience-sharing session:

  1. what we learned from the experiences themselves and how it can help practitioners; and
  2. what we learned about the significance and potential of the peer learning process itself.

Download the full case study: IA2030 Case study 16. Continuum from knowledge to performance. The Geneva Learning Foundation.

For every challenge shared during the experience sharing sessions, there was always at least one member who had encountered or was encountering the same challenge and had carried out measures to resolve it.

These sessions provided a space to share practical stories that are making a difference – and supported participants in considering their relevance to their own situations.

Experience sharing also helped build confidence and motivation.

Members were able to identify with experiences shared, realizing they were not alone in facing similar challenges.

The sessions covered a wide range of critical immunization topics.

For instance, a participant from Nigeria discussed strategies for reaching zero-dose children in Borno state.

Facing the challenge of reaching approximately 600,000 unvaccinated children, the presenter received practical suggestions from peers, including developing a zero-dose reduction operational plan, leveraging new vaccine introductions, and partnering with the private sector for evening vaccination services.

In another session, a subnational Ministry of Health staff member from Côte d’Ivoire presented challenges related to cross-border immunization campaigns.

Peers shared experiences of organizing cross-border meetings to identify unvaccinated children, synchronize efforts, and involve community representatives in the process.

Such context-specific, experience-based advice exemplifies the unique value of peer learning in addressing complex health system challenges.

The case study of 44 sessions highlights how these sessions fostered multiple types of learning simultaneously.

Participants reported learning from each other’s experiences, experiencing the power of solving problems together across distances, feeling a growing sense of belonging to a community, and connecting across country borders and health system levels.

A district-level Ministry of Health staff member from Ghana encapsulated the impact: “I have linked up with expert vaccinators worldwide through experience sharing and twinning. I have become more competent and knowledgeable in the area of immunization, and work confidently.”

This sentiment was echoed by many participants who found value not only in acquiring new knowledge but also in expanding their professional networks and gaining confidence in their problem-solving abilities.

The case study also reveals the adaptability of the approach in responding to unique contexts.

This resilience underscores the potential of digital platforms to democratize access to expertise and foster global collaboration.

However, the study also identifies areas for improvement.

  • Participants expressed a desire for more follow-up support and opportunities to continue their peer learning groups beyond the initial sessions.
  • Additionally, the need for better integration of community engagement strategies was identified as a key area for future development.

To contextualize these findings, we can turn to a 2022 study by Watkins et al., which evaluated a prototype of these experience-sharing sessions known as Immunization Training Challenge Hackathons (ITCH), conducted in 2020.

The ITCH methodology, developed by The Geneva Learning Foundation (TGLF), informed the design of the 2022 IA2030 Movement sessions.

Watkins et al. found that the ITCH approach fostered four simultaneous types of learning: peer, remote, social, and networked.

  1. Peer Learning: This involves participants learning directly from each other’s experiences and knowledge. In the context of immunization, imagine a scenario where a vaccination program manager from rural India shares their successful strategy for improving vaccine cold chain management with a colleague facing similar challenges in sub-Saharan Africa. This direct exchange of practical, context-specific knowledge can complement more theoretical training, as it is based on real-world application.
  2. Remote Learning: This refers to the ability to learn and solve problems collaboratively across geographical distances. For an immunization specialist, this might seem counterintuitive, as many believe that hands-on, in-person training is essential. However, the ITCH sessions demonstrated that meaningful learning can occur remotely. For example, a team in Bangladesh could describe their approach to overcoming vaccine hesitancy, and a team in Nigeria could immediately adapt and apply those strategies to their local context, all without the need for costly and time-consuming travel.
  3. Social Learning: This concept emphasizes the importance of learning within a network. In the immunization field, professionals often work in isolation, especially at sub-national levels. The ITCH sessions created a sense of belonging to a global network, community, and platform of immunization practitioners. This social aspect can boost motivation, reduce feelings of isolation, and foster a collective approach to problem-solving that transcends individual or even national boundaries.
  4. Networked Learning: This type of learning emerges from connections made across different levels of health systems and across country borders. For an epidemiologist, this might be analogous to how disease surveillance networks function across borders. In the ITCH context, it means that a district-level immunization officer could learn from and share ideas with national-level policymakers from other countries, fostering a more holistic understanding of immunization challenges and solutions.

These four types of learning operate simultaneously during ITCH sessions, creating a synergistic effect. 

For instance, a participant might learn a new cold chain management technique (peer learning) from a colleague in another country (remote learning), feel supported by the global community in implementing this new technique (social learning), and then share their adaptation of this technique with others across various levels of the health system (networked learning).

From an epidemiological perspective, this approach to learning could be compared to how we understand disease transmission and intervention effectiveness.

Just as multiple factors contribute to disease spread and control, these multiple learning types contribute to knowledge dissemination and capacity building in the immunization field.

The value of this approach lies in its potential to rapidly disseminate practical, context-specific knowledge and solutions across a global network of immunization professionals.

This can lead to faster adoption of best practices, more innovative problem-solving, and ultimately, improvements in immunization program performance that could contribute to better disease control outcomes.

While this approach may seem unconventional compared to traditional training methods in the immunization field, the evidence presented by Watkins et al. suggests that it can be a powerful complement to existing capacity-building efforts, particularly in resource-constrained settings where access to formal training opportunities may be limited.

This multifaceted approach allowed participants to not only acquire new knowledge but also to expand their professional networks and gain confidence in their problem-solving abilities—findings that align closely with the outcomes observed in the 2022 IA2030 Movement sessions.

The Watkins study emphasized the importance of building confidence and motivation through peer learning experiences, a theme strongly echoed in the Mbuh case study.

Furthermore, Watkins et al. highlighted the potential of this approach to create a “space of possibility” for innovation and problem-solving, which is evident in the diverse and creative solutions shared during the 2022 sessions.

Both studies underscore the significance of peer-led, digital learning experiences in accelerating progress towards global health goals.

By fostering peer learning and digital collaboration, these approaches empower health workers to turn global strategies into effective local action.

References

Mbuh, C., Gasse, F., Jones, I., Sadki, R., Brooks, A., Zha, M., Steed, I., Sequeira, J., Churchill, S., Kovanovic, V., 2022. IA2030 Case study 16. Continuum from knowledge to performance. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7014392

Watkins, K.E., Sandmann, L.R., Dailey, C.A., Li, B., Yang, S.-E., Galen, R.S., Sadki, R., 2022. Accelerating problem-solving capacities of sub-national public health professionals: an evaluation of a digital immunization training intervention. BMC Health Serv Res 22, 736. https://doi.org/10.1186/s12913-022-08138-4

Image: The Geneva Learning Foundation Collection © 2024

What is norms shifting in immunization and global health

What is norms-shifting in immunization and global health?

Global health

The concept of “norms shifting perspective”, in the field of immunization and global health focuses on strategies that aim to alter norms and attitudes towards vaccination to promote uptake and acceptance.

This perspective acknowledges the influence that social norms have on individuals decisions regarding vaccination. Aims to utilize this insight to enhance acceptance through well crafted policies, messaging and interventions. The goal is to make vaccination the expected and socially endorsed choice across communities

Here are a few aspects of this perspective.

Recognizing the influence of social norms on vaccination behavior:

  • People’s vaccination decisions are significantly influenced by their perceptions of what others in their community think and do regarding vaccines.
  • Misperceptions about how many others accept vaccines can lead to lower uptake.

Using accurate information about norms to increase acceptance:

  • Providing factual information about high levels of vaccine acceptance in a community can increase individuals’ intentions to vaccinate.
  • This works by correcting underestimations of vaccine acceptance and leveraging social conformity.

Shaping norms through public policy:

  • Government policies and messaging around vaccines can shape social norms and expectations.
  • Mandates, passports, and other policies signal what is considered normal or expected behavior.

Designing targeted interventions:

  • Campaigns that feature relatable community members getting vaccinated can help establish vaccination as a social norm.
  • Messaging that emphasizes the social benefits and widespread acceptance of vaccines can be effective.

Considering unintended consequences:

  • Heavy-handed approaches like strict mandates may backfire by creating resistance and polarization.
  • Care must be taken to avoid stigmatizing unvaccinated individuals.

Adapting to local contexts:

  • Effective norm-shifting interventions need to be tailored to specific communities and cultures.
  • What works to shift norms in one setting may not work in another.

Taking a long-term view:

  • Changing deeply held social norms around health behaviors takes time and sustained effort.
  • The goal is to create lasting shifts in how vaccination is perceived and valued in communities.

Where to learn more about norms-shifting in immunization?

Bardosh, K., De Figueiredo, A., Gur-Arie, R., Jamrozik, E., Doidge, J., Lemmens, T., Keshavjee, S., Graham, J.E., Baral, S., 2022. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 7, e008684. https://doi.org/10.1136/bmjgh-2022-008684

Fayaz-Farkhad, B., Jung, H., Calabrese, C., Albarracin, D., 2023. State policies increase vaccination by shaping social norms. Sci Rep 13, 21227. https://doi.org/10.1038/s41598-023-48604-5

Moehring, A., Collis, A., Garimella, K., Rahimian, M.A., Aral, S., Eckles, D., 2023. Providing normative information increases intentions to accept a COVID-19 vaccine. Nat Commun 14, 126. https://doi.org/10.1038/s41467-022-35052-4

Reñosa, M.D.C., Landicho, J., Wachinger, J., Dalglish, S.L., Bärnighausen, K., Bärnighausen, T., McMahon, S.A., 2021. Nudging toward vaccination: a systematic review. BMJ Glob Health 6, e006237. https://doi.org/10.1136/bmjgh-2021-006237

Vriens, E., Tummolini, L., Andrighetto, G., 2023. Vaccine-hesitant people misperceive the social norm of vaccination. PNAS Nexus 2, pgad132. https://doi.org/10.1093/pnasnexus/pgad132

Image: The Geneva Learning Foundation Collection © 2024

Taking the pulse why and how we change everything in response to learner signals

Taking the pulse: why and how we change everything in response to learner signals

Learning design, Theory

The ability to analyze and respond to learner behavior as it happens is crucial for educators.

In complex learning that takes place in digital spaces, task separation between the design of instruction and its delivery does not make sense.

Here is the practical approach we use in The Geneva Learning Foundation’s learning-to-action model to implement responsive learning environments by listening to learner signals and adapting design, activities, and feedback accordingly.

Listening for and interpreting learner signals

Educators must pay close attention to various signals that learners emit throughout their learning journey. These signals appear in several key ways:

  1. Engagement levels: This includes participation rates, the quality of contributions in discussions, how learners interact with each other, and knowledge artefacts they produce.
  2. Emotional responses: The tone and content of learner feedback can indicate enthusiasm, frustration, or confusion.
  3. Performance patterns: Trends in speed and volume of responses tend to strongly correlate with more significant learning outcome indicators.
  4. Interaction dynamics: Learners can feel a facilitator’s conviction (or lack thereof) in the learning process. Observing the interaction should focus first on the facilitator’s own behavior: what are they modeling for learners?
  5. Technical interactions: The way learners navigate the learning platform, which resources they access most, and any technical challenges they face are important indicators.

Making sense of learner signals

Once these signals are identified, a nuanced approach to analysis is necessary:

  1. Contextual consideration: Understanding the broader context of learners’ experiences is vital. For example, differences between language cohorts might reflect varying levels of real-world experience and cultural contexts.
  2. Holistic view: Look beyond immediate learning objectives to understand all aspects of learners’ experiences, including factors outside the course that may affect their engagement.
  3. Temporal analysis: Track changes in learner behavior over time to reveal important trends and patterns as the course progresses.
  4. Comparative assessment: Compare behavior across different cohorts, language groups, or demographic segments to identify unique needs and preferences.
  5. Feedback loop analysis: Examine how learners respond to different types of feedback and instructional interventions to provide valuable insights.

Adapting learning design in situ

What can we change in response to learner behavior, signals, and patterns?

  1. Customized content: Tailor case studies, examples, and scenarios to match the real-world experiences and cultural contexts of different learner groups.
  2. Flexible pacing: Adjust the rhythm of content delivery and activities based on observed engagement patterns and feedback.
  3. Varied support mechanisms: Implement a range of support options, from technical assistance to emotional support, based on identified learner needs.
  4. Dynamic group formations: Adapt group activities and peer learning opportunities based on observed interaction dynamics and skill levels.
  5. Multimodal delivery: Offer content and activities in various formats to cater to different learning preferences and technical capabilities.

Responding to learner signals

Feedback plays a crucial role in the learning process:

  1. Comprehensive acknowledgment: Feedback mechanisms should demonstrate to learners that their input is valued and considered. This might involve creating, at least once, detailed summaries of learner feedback to show that every voice has been heard.
  2. Timely interventions: Using real-time feedback to address emerging issues or confusion quickly can prevent small challenges from becoming major obstacles.
  3. Personalized guidance: Tailor feedback to individual learners based on their unique progress, challenges, and goals.
  4. Peer feedback facilitation: Create opportunities for learners to provide feedback to each other to foster a collaborative learning environment.
  5. Metacognitive prompts: Incorporate feedback that encourages learners to reflect on their learning process to promote self-awareness and self-directed learning.

Balancing act

When combined, these analyses provide clues to inform decisions.

Nothing should be set in stone.

Decisions need to be pragmatic and rapid.

In order to respond to the pattern formed by signals, what are the trade-offs?

The digital economy of effort makes rapid changes possible.

Nevertheless, we consider the cost of each change versus its benefit.

This adaptive approach involves careful balancing of various factors:

  1. Depth versus speed: Navigate the tension between providing comprehensive feedback and maintaining a timely pace of instruction.
  2. Structure versus flexibility: Maintain a coherent course structure while allowing for adaptations based on learner needs.
  3. Individual versus group needs: Balance addressing individual learner challenges with maintaining the momentum of the entire cohort.
  4. Emotional support versus learning structure: Provide necessary emotional support, especially in challenging contexts, while maintaining focus on learning objectives.

Learning is research

Each learning experience should be treated as a research opportunity:

  1. Data collection: Systematically collect data on learner behavior, feedback, and outcomes.
  2. Team reflection: Conduct regular debriefs with the instructional team to share insights and adjust strategies.
  3. Iterative design: Use insights gained from each cohort to refine the learning design for future iterations.
  4. Cross-cohort learning: Apply lessons learned from one language or cultural group to enhance the experience of others, while respecting unique contextual differences.

Image: The Geneva Learning Foundation Collection © 2024