IA2030 Movement HPV vaccination national EPI consultation

Movement for Immunization Agenda 2030 (IA2030): National EPI leaders from 31 countries share experience of HPV vaccination

Global health

What difference can peer-led learning and action make for national EPI planners seeking new strategies to support HPV vaccine introduction or reintroduction?

The stakes are high: HPV vaccination efforts, if successful, will avert 3.4 million deaths by 2030.

On Friday, EPI focal points for HPV and other national-level MOH colleagues from 31 countries convened under the banner of the Movement for Immunization Agenda 2030 (IA2030), which connects over 60,000 primarily sub-national health staff worldwide.

What is the Movement for Immunization Agenda 2030 (IA2030)?

This time, it was national HPV vaccination focal points and other national EPI planners who joined to share experience between countries of ‘what works’ (and how).

They also discussed how the Geneva Learning Foundation’s unique peer learning-to-action pathway could help them overcome barriers they are facing to ensure that local communities understand and support the benefits of this vaccine.

Such a pathway can complement existing, top-down forms of vertical technical assistance and may provide a new ‘lever’ for national planners.

In June and October 2023, health workers – primarily from districts and facilities – in over 60 countries shared 298 lessons learned and success stories about HPV vaccination in the Foundation’s Teach to Reach peer learning events. Watch the video: Why HPV matters for women who deliver vaccines.

The active participation of national EPI managers from Burkina Faso and key stakeholders Sierra Leone led to the consultative engagement in January.

Although HPV vaccine is not new, the global community’s effort to introduce it has been stymied by a number of factors.

Doing what has been done before is unlikely to produce the change that is needed.

For example, it remains unclear how early gains achieved through campaigns can sustainably become part of routine immunization.

TGLF’s Insights Unit will now produce a short summary of key learning from this inter-country peer learning exchange, which will be shared back with participants.

If you are interested in learning more about the Movement for Immunization Agenda 2030 (IA2030) or the Geneva Learning Foundation’s HPV vaccination learning-to-action pathway, please do get in touch.

20231211.COP28 Health Pavilion event

Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

Events, Global health, The Geneva Learning Foundation

The Geneva Learning Foundation’s Charlotte Mbuh spoke today at the COP28 Health Pavilion in Dubai, United Arab Emirates (UAE). Watch the speech at COP28…

Good afternoon. I am Charlotte Mbuh. I have worked for the health of children and families in Cameroon for over 15 years.

I am one of more than 5,500 health workers from 68 countries who have connected to share our observations of how climate is affecting the health of those we serve. 

“Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.”

These are the words of Samuel Chukwuemeka Obasi, a health worker from Nigeria.

Dr Kumbha Gopi, a health worker from India said: “The use of motor vehicles has led to an increase in air pollution and we see respiratory problems and skin diseases”.

Climate change is hurting the health of those we serve. And it is getting worse.

Few here would deny that health workers are an essential voice to listen to in order to understand climate impacts on health.

Yet, a man named Jacob on social media snapped: “Since when are health workers the authority on air pollution?”

Here are the words of Bie Lilian Mbando, a health worker from my country: “Where I live in Buea, the flood from Mount Cameroon took away all belongings of people in my neighborhood and killed a secondary school student who was playing football with his friends.”

Climate change is killing communities.

Cecilia Nabwirwa, a nurse in Nairobi, Kenya: “I remember my grand-son getting sick after eating vegetables grown along areas flooded by sewage. Since then I resolved to growing my own vegetables to ensure healthy eating.”

And yet, another man on social media, Robert, found this “ridiculous. As if my friend who sells fish at his fish stall comes as an expert on water quality.”

I wondered: why such brutal responses?

Well, unlike scientists or global agencies, we cannot be dismissed as “experts from on-high”.

What we know, we know because we are here every day.

We are part of the community.

And we know that climate change is a threat to the health of the communities we serve.

We are already having to manage the impacts of climate change on health.

We are doing the best that we can.

But we need your support.

The global community is investing in building a new scientific field around climate and health.

Massive investments are also being made in policy.

Are we making a commensurate investment in people and communities?

That should mean investing in health workers.

What will happen if this investment is neglected?

What if big global donors say: “it’s important, but it’s not part of our strategy?”

Well, in 5, 10, or 15 years, we will certainly have much improved science and, hopefully, policy.

Yet, some communities might reject better science and policy.

Will the global community then wonder: “Why don’t they know what’s good for them?” 

I am an immunization worker. For over 15 years, I have worked for my country’s ministry of health.

Like my colleagues from all over the world, I know more than a little about what it takes to establish and maintain trust.

Trust in vaccination, trust in public health.

Trust that by standing together in the face of critical threats to our societies, we all stand to do better.

Local communities in the poorest countries are already bearing the brunt of climate change effects on health.

Local solutions are needed.

Health workers are trusted advisors to the communities we serve.

With every challenge, there is an opportunity.

On 28 July 2023, 4,700 health workers began learning from each other through the Geneva Learning Foundation’s platform, community, and network.

Thousands more are connecting with each other, because they choose to.

And because they want to take action.

It is our duty to support them.

In March 2024, we will hold the tenth Teach to Reach conference.

The last edition reached over 17,000 health workers from more than 80 countries.

This time, our focus will be on climate and health.

We invite global partners to join, to listen and to learn.

We invite you to consider how you, your organization, your government might support action by health workers on the frontline.

Because we will rise.

As health workers, with or without your support, we will continue to stand up with courage, compassion and commitment, working to lift up our communities.

Our perseverance calls us all to press forward towards climate justice and health equity.

I wish to challenge us, as a global community, to rise together, so that  the voices of those on the frontline of climate change will be at the next Conference of Parties.

By standing together, we all stand to do better.

Thank you.

Investing in the health workforce is vital to face climate change: A new report shares insights from over 1,200 on the frontline

Investing in the health workforce is vital to tackle climate change: A new report shares insights from over 1,200 on the frontline

Global health, The Geneva Learning Foundation

Geneva, Switzerland (1 December 2023) – The Geneva Learning Foundation has published a new report titled “On the frontline of climate change and health: A health worker eyewitness report.” The report shares first-hand experiences from over 1,200 health workers in 68 countries who are first responders already battling climate consequences on health.

As climate change intensifies health threats, local health professionals may offer one of the most high-impact solutions.

Charlotte Mbuh of The Geneva Learning Foundation, said: “Local health workers are trusted advisers to communities. They are first to observe health consequences of climate change, before the global community is able to respond. They can also be first to respond to limit damage to health.”

Listen to Charlotte Mbuh’s speech at the COP28 Healthcare Pavilion on 11 December 2023. Read the full speech…

“Health workers are already taking action with communities to mitigate and respond to the health effects of climate change, often with little or no recognition,” said Reda Sadki, President of The Geneva Learning Foundation (TGLF). “If we want to build and maintain trust in climate science, policy, and action, we need to invest in the workforce, as they are the ones that communities rely on to make sense of what is changing.” 

The report vividly illustrates the profound impacts climate change is already having on health, as shared by health workers themselves.

The wide-ranging health consequences directly observed by health workers include malnutrition due to crop failures, increasing incidence of infectious diseases, widespread mental health impacts, and reduced access to health services. Here are three examples.

  • Bie Lilian Mbando, a health worker in Cameroon: “Where I live in Buea, the flood from Mount Cameroon took away all belongings of people in my neighbourhood and killed a secondary school student who was playing football with his friends.”
  • Cecilia Nabwirwa, a nurse in Nairobi, Kenya: “I remember my grand-child getting sick after eating vegetables grown along sewage areas. Since then I resolved to growing my own vegetables to ensure healthy eating.”
  • Alhassan Kenneth Mohammed, health facility worker in Ghana: “During the rainy season, it is very difficult for people to seek care for their health needs. They wait for the condition to get worse before coming to the facility.”

Surprising insights from these experiences include:

  • Climate change worsens menstrual hygiene: Scarce water access brought by droughts can severely affect women’s ability to maintain proper menstrual hygiene. “Women and girls have challenges during menstruation as there is limited water,” noted one community health worker.
  • Respiratory disease spikes with prolonged dust storms: Multiple health workers traced a rise in chronic coughs and other respiratory illness directly back to longer dry seasons and dust storms in areas turned to desert by climate shifts.
  • Crop failure drives up alcohol abuse among men: In farming regions struggling with drought, women health practitioners connected livelihood loss to a stark rise in substance abuse, specifically alcoholism among men. “There has been job loss, low income, and depression. Also, men became alcoholics, which is now a national menace,” described one district-level worker.

Reda Sadki explains: “The experiences shared provide vivid illustrations of the human impacts of climate change. By giving a voice to health workers on the front lines, the report highlights the urgent need to support local action with communities to build resilience. This report is only a first step that needs to lead to action.”

Beyond the report, an opportunity to scale locally-led action using innovative approaches 

As John Wabwire Shikuku, a community health worker from Port Victoria Sun County Hospital in Kenya, explains: “What gives me hope and keeps me going in my work is witnessing the growing awareness and mobilization of young people to address climate change, the development of sustainable solutions, and the potential for global collaboration to safeguard their future.”

We need new approaches to supporting climate and health action. We need to go directly to those on climate change’s frontlines – connecting local health workers globally not just to share struggles but lead action.

  • Rather than siloed programs, we need radically participatory solutions that distill and share hyperlocal innovations across massive peer groups in real-time.
  • Through new approaches, we can rapidly distill hyperlocal insights and multiplier solutions no top-down program matches.

The Geneva Learning Foundation’s proven peer learning model provides one such solution to connect and amplify local action across boundaries, offering those on the frontline tailored support and capabilities to lead context-specific solutions.

How to access the report

The report “On the frontline of climate change and health: A health worker eyewitness report” is available here: https://www.learning.foundation/cop28. An abridged Summary report and an At a glance executive summary are also available, together with a compendium of 50 health worker experiences.

Watch the Special Event: From community to planet: Health professionals on the frontlines of climate change

What happens next?

  • Register here to receive email updates from The Geneva Learning Foundation about climate and health.
  • During COP28, health workers are answering this question: “If you could ask the leaders at COP28 to do one thing right now to keep your community healthy, what would it be?”. You can find their responses on LinkedIn, Twitter/X, Facebook, and Instagram.

About The Geneva Learning Foundation

Learn more about The Geneva Learning Foundation: https://doi.org/10.5281/zenodo.7316466

Created by a group of learning innovators and scientists with the mission to discover new ways to lead change, TGLF’s team combines over 70 years of experience with both country-based (field) work and country, region, and global partners.

  • Our small, fully remote agile team already supports over 60,000 health practitioners leading change in 137 countries.
  • We reach the front lines: 21% face armed conflict; 25% work with refugees or internally-displaced populations; 62% work in remote rural areas; 47% with the urban poor; 36% support the needs of nomadic/migrant populations.

TGLF’s unique package:

  1. Helps local actors take action with communities to tackle local challenges, and
  2. provides the tools to build a global network, platform, and community of health workers that can scale up local impact for global health.

In 2019, research showed that TGLF’s approach can accelerate locally-led implementation of innovative strategies by 7X, and works especially well in fragile contexts.

Aerial view of a flooded urban residential area of Dera Allah yar city in Jaffarabad District, Baluchistan Province, Pakistan. Credit: Gavi/2022/Asad Zaidi

Ten eyewitness reports from the frontline of climate change and health

Global health

The Geneva Learning Foundation (TGLF) has created a platform enabling health workers to describe the impacts of climate change on their local communities. Here are ten of the most striking reports.

Published on 30 November 2023 on the Gavi blog. Written by Ian Jones for Gavi.

In July 2023, more than 1,200 health workers from 68 countries shared their experiences of changes in climate and health at a unique Geneva Learning Foundation event designed to shed light on the realities of climate impacts on the health of the communities they serve.

A special TGLF report – On the frontline of climate change and health: A health worker eyewitness report – includes a compendium and analysis of these 1,200 health workers’ observations and insights. Here are ten of the most striking.

Samuel Chukwuemeka Obasi, who works for the Ministry of Health in Abuja, Nigeria, has noticed big changes to the environment.

“Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow, so that you can easily walk through a river you required a boat to cross in years past.”

Iruoma Chinedu Ofortube, who works at the district level in Lagos State, Nigeria, recounts two stories that illustrate the lethal impact of extreme weather.

“A family embarked on a journey without potentially expecting any danger. Sadly, on their way, heavy rainfall started. The family was oblivious to the reality that the rain started ahead of them while they were en route to their destination. Unfortunately, they ran into a massive flood near a river. The force and the current from the flood swept their vehicle down the river, and before help could come for them, they drowned helplessly alongside other victims of the same circumstances.

“There was also a pregnant woman in labour. Unfortunately, they couldn’t get a strong boat or canoe that could stand the high current and waves coming from the seaside. In the process of searching for a better means of taking her to the nearest health centre, she got exhausted and died.”

Assoumane Mahamadou Issifou, who works for an NGO in Agadez, Niger, points out how food shortages are leading to malnutrition and anaemia, particularly in women and children.

“During the five years that I served in the health service in the Agadez region, I observed significant changes, particularly in the occurrence of heavy rains, which were uncommon in the past. These heavy rains have led to flooding and the displacement of populations, often forcing them to settle wherever they can. Due to their vulnerability during these challenging times, children and women suffer greatly.

“This situation, especially prevalent among newborns and children under five, contributes to malnutrition. The challenges persist because the Agadez region is situated in a desert area with very low rainfall.

“However, even with minimal rain, the region faces immense difficulties. Nutritional foods are insufficient, and environmental degradation compounds the issue. As a result, the population struggles to access daily sustenance. Pregnant women and children lack foods rich in vitamins, leading to undernourishment and subsequent diseases such as malnutrition and anaemia.

“Historically, Agadez was known for its scarcity of rain. With the recent climate change-induced increase in rainfall, few people have come to accept and understand this phenomenon. The region’s architecture is outdated, and the city has transformed into a migratory hub where diverse behaviours converge. New diseases emerge, and the indigenous population is grappling with illnesses that were previously unknown to them.”

A woman working for the Ministry of Health in the DRC, based in Kinshasa, describes how water level changes are affecting insect proliferation and leading to changing patterns of malaria and other diseases.

“A drought, characterised by a drop in rainfall during recent rainy seasons, has affected the City Province of Kinshasa, particularly in the Makelele District (located in the Bandalungwa commune) where I live.

“This area is bordered by two rivers, Mâkelele 1 and 2. The scarcity of rain in the region during the past rainy seasons has led to a significant reduction in water flow within these two rivers. Consequently, rubbish and debris have accumulated along the riverbanks.

“This situation has resulted in the proliferation of mosquitoes and other unidentified insects. This increase in insect activity has not only led to a rise in malaria cases, but has also given rise to a newly emerging form of dermatosis, the exact nature of which is yet to be determined. It is suspected that these skin lesions develop due to scratching after insect bites. Disturbingly, over 10% of the population within the municipality has been affected by this condition.”

Dieudonne Tanasngar, who works for the Ministry of Health in Chad, explains how displacement contributes to poor sanitation practices, leading to increased spread of water-borne diseases.

“In Lake Chad, during the rainy season, the various arms of the lake expand, causing flooding that affects the villages situated along its shores. This flooding often forces the inhabitants to relocate to higher ground.

“However, a significant portion of the population around the lake lacks proper sanitation facilities, leading to open defecation near the water’s edge. As the water levels rise, this practice contributes to the spread of diseases, particularly when access to health care facilities becomes challenging.

“Access to health care centres is hindered by the need to cross one or two bodies of water before reaching the nearest facility. This geographical challenge adds to the difficulties faced by the affected population. Consequently, a range of diseases can emerge and afflict the community due to these conditions.

“The combination of poor sanitation practices, flooding, and limited access to health care facilities creates a complex situation that requires concerted efforts to improve living conditions, sanitation infrastructure, and health care access for the people living around Lake Chad.”

Coulibaly Seydou, who works for the Ministry of Health in Boussé District, Burkina Faso, has noted how changing dietary habits, alongside declining mental wellbeing, is leading to an increased risk of non-communicable diseases such as high blood pressure and diabetes.

“For several years, the pattern of rainfall has been becoming increasingly irregular. The duration of the rainy season is progressively getting shorter, interspersed with periods of drought. This unpredictability makes it challenging for farmers to adjust their crop choices according to the rainfall pattern, leading to growing concerns. Discussions about the upcoming rainy season can induce anxiety and worry among rural communities.

“When it comes to the impact of climate change on mental health, we can observe a significant disturbance in the well-being of farmers. Even just a couple of days without rainfall can trigger a sense of sadness among them. Instances of minor depression have been noted among household heads who helplessly witness their crops withering due to inadequate moisture.

“In terms of physical health, there has been an uptick in the prevalence of diseases and conditions that can be attributed to changes in dietary habits. Conditions such as hypertension, diabetes and obesity are on the rise. This can be linked to the shift towards consuming industrially processed foods that are low in nutritional value and high in chemical additives.”

A man working for the Ministry of Health in Beni in the DRC describes the tragic case of a family driven into poverty and unable to afford health care for the children.

“As a result of the disruption in the seasonal shifts, a modest family reliant solely on agriculture experienced the tragic death of their young son within their community.

“The critical factors involved were as follows: their crop yield plummeted to zero due to their inability to manage the erratic changes in the seasons, and malnutrition, likely compounded by other illnesses, afflicted the family. Faced with financial constraints stemming from the complete failure of their agricultural efforts, they resorted to providing home-based care for their family.

“Tragically, their youngest son paid the ultimate price with his life. In summary, the ever-changing climate dynamics have left us disoriented and uncertain about the future.”

Fokzia Elijah, who works for the Ministry of Health in the Province of Batha, Chad, highlights how climate change is having multiple health and social impacts, particularly on pastoralists.

“Batha is the first pastoral province, often experiencing prolonged droughts followed by irregular and sometimes excessive rainfall. These climatic variations lead to challenges in cattle herding, house collapses, and difficulties in sustaining pastoralism, which typically lasts only two to three months.

“Pastoralists often migrate southward with women and children following them. Consequently, malnutrition prevails, affecting over 14% of the population, with women and children being the most vulnerable. Women who remain in the villages demonstrate resilience by engaging in limited market gardening and gathering wild oilseeds to produce sweet syrup for porridge.

“A significant issue is the death of animals between March and June due to inadequate pasture and water. This impacts the most vulnerable, particularly women and children. Batha Province, once renowned for its diverse flora and fauna, has seen the disappearance of most animals except for birds. Hyena attacks have become frequent as they search for food in communities, often targeting domestic pets.”

Linda Raji, who works for an NGO in the Kaida and Waru communities in Nigeria, highlights the implication of enviornmental change for young women – one of a range of gender-specific impacts of climate change.

“Prolonged drought dries up the dirty community stream that serves both livestock and residents. This makes it difficult for community members to access water and much harder for menstrual hygiene management for teenage girls leading to an increase in infections in the unbearable heat.

“Due to the difficulty in managing the monthly menstrual cycle due to limited access to water sanitation hygiene and period poverty, many teenage girls prefer to get pregnant to save them the worry of menstruating monthly for nine months.”

Dr Chinedu Anthony Iwu, who works at a health facility in Orlu Local Government Area in Nigeria, describes how working with communities can build resilience to climate change impacts.

“The changing climate has brought about an increase in the prevalence of vector-borne diseases. Mosquitoes are now breeding and transmitting diseases like malaria more intensely. The community lacked proper health care facilities and resources to effectively combat these diseases, leading to a rise in illness and mortality rates. Mothers’ means of livelihood were usually disrupted due to the time and effort spent in caring for their sick children with a significant impact on household welfare.

“Recognising the urgent need to address these climate-related health challenges, we engaged in community-led initiatives that included comprehensive health awareness campaigns to provide education on sanitation and hygiene practices, and education of residents about preventive measures against vector-borne diseases. By engaging our community health extension workers, we were able to organise regular health check-ups in the communities, focusing on early detection and treatment of illnesses.

“Over time, these collective efforts began to yield positive results. The mothers in the communities witnessed improvements in income as they progressively began to spend less time pursuing children’s health care challenges due to the adoption of preventive measures, thereby becoming more resilient to the changing climate.

This experience highlights the challenges faced by rural communities in Nigeria due to climate change. It demonstrates 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.”

Photo credit: Aerial view of a flooded urban residential area of Dera Allah yar city in Jaffarabad District, Baluchistan Province, Pakistan. Credit: Gavi/2022/Asad Zaidi

Health worker voices and agenda at COP28

Before, during, and after COP28: Climate crisis and health, through the eyes of health workers from Africa, Asia, and Latin America 

Events, Global health

Samuel Chukwuemeka Obasi, a health professional from Nigeria:

“Going back home to the community where I grew up as a child, I was shocked to see that most of the rivers we used to swim and fish in have all dried up, and those that are still there have become very shallow so that you can easily walk through a river you required a boat to cross in years past.”

In July 2023, more than 1200 health workers from 68 countries shared their experiences of changes in climate and health, at a unique event designed to shed light on the realities of climate impacts on the health of the communities they serve.

Before, during and after COP28, we are sharing health workers’ observations and insights.

Follow The Geneva Learning Foundation to learn how climate change is affecting health in multiple ways:

  • How extreme weather events can lead to tragic loss of life.
  • How changing weather patterns are leading to crop failures and malnutrition, and forcing people to abandon their homes.
  • How infectious diseases are surging as mosquitoes proliferate and water sources are contaminated.
  • How climate stresses are particularly problematic for those with existing health conditions, like cardiovascular disease and diabetes.
  • How climate impacts are having a devastating effect on mental health as people’s ways of life are destroyed.
  • How climate change is changing the very fabric of society, driving displacement and social hardship that undermines health and wellbeing.
  • How a volatile climate is disrupting the delivery of essential health services and people’s ability to access them.
  • We will finish the series with  inspiring stories of how health workers are already responding to such challenges, working with communities to counter the effects of a changing climate.

On 1 December 2023, TGLF will be publishing a compendium and analysis of these 1200 contributions – On the frontline of climate change and health: A health worker eyewitness report. Get the report…

This landmark report – a global first – kickstarts our campaign to ensure that health workers in the Global South are recognized as:

  • The people already having to manage the impacts of climate change on health.
  • An essential voice to listen to in order to understand climate impacts on health.
  • A potentially critical group to work with to protect the health of communities in the face of a changing climate.

Before, during, and after COP28, we are advocating for the recognition and support of health workers as trusted advisers to communities bearing the brunt of climate change effects on health.

Watch the Special Event: From community to planet: Health professionals on the frontlines of climate change

Rethinking Workplace Learning and Development

Learning-based complex work: how to reframe learning and development

About me, Global health, Interviews, Published articles, The Geneva Learning Foundation

The following is excerpted from Watkins, K.E. and Marsick, V.J., 2023. Chapter 4. Learning informally at work: Reframing learning and development. In Rethinking Workplace Learning and Development. Edward Elgar Publishing.

This chapter’s final example illustrates the way in which organically arising IIL (informal and incidental learning) is paired with opportunities to build knowledge through a combination of structured education and informal learning by peers working in frequently complex circumstances.

Reda Sadki, president of The Geneva Learning Foundation (TGLF), rethought L&D for immunization workers in many roles in low- and middle-income countries (LMICs).

Adapting to technology available to participants from the countries that joined this effort, Sadki designed a mix of experiences that broke out of the limits of “training” as it was often designed.

He addressed, the inability to scale up to reach large audiences; difficulty to transfer what is learned; inability to accommodate different learners’ starting places; the need to teach learners to solve complex problems; and the inability to develop sufficient expertise in a timely way. (Marsick et al., 2021, p. 15)

This led his organization, to invite front-line staff from all levels of immunization systems in low- and middle-income countries (LMICs) to create and share new learning in response to the social and behavioral challenges they faced.

Sadki designed L&D for “in-depth engagement on priority topics,” insights into “the raw, unfiltered perspectives of frontline staff,” and peer dialogue that “gives a voice to front-line workers” (The Geneva Learning Foundation, 2022).

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What learning science underpins peer learning for Global Health?

What learning science underpins peer learning for Global Health?

Events, Global health

Watch Reda Sadki’s presentation at the Annual Meeting of the American Society for Tropical Medicine and Hygiene (ASTMH) Symposium on 19 October 2023

Most significant learning that contributes to improved performance takes place outside of formal training.

It occurs through informal and incidental forms of learning between peers.

Effective use of peer learning requires realizing how much we can learn from each other (peer learning), experiencing the power of defying distance to solve problems together (remote learning), and feeling a growing sense of belonging to a community (social learning), emergent across country borders and health system levels (networked learning).

At the ASTMH annual meeting Symposium organized by Julie Jacobson, two TGLF Alumnae, María Monzón from Argentina and Ruth Allotey from Ghana, will be sharing their analyses and reflections of how they turned peer learning into action, results, and impact.

In his presentation, Reda Sadki, president of The Geneva Learning Foundation (TGLF), will explore:

  1. What do we need to understand about digital learning?
  2. Networked learning: rethinking learning architecture in the Digital Age
  3. Social learning: peer learning is about making human connections
  4. Practical examples of TGLF peer learning systems for WHO, Wellcome, UNICEF, and Bridges to Development that connect learning to change, results, and impact.
  5. Emergent peer learning systems driven by local practitioner and community needs and priorities.

Join this Peer Learning symposium on Day 2 of the Annual Meeting of the American Society for Tropical Medicine and Hygiene (ASTMH).

TechNet conference how to to open access to global health conferences-small

What did we learn from the Movement for Immunization Agenda 2030 (IA2030) in its first two years?

Global health, Innovation, The Geneva Learning Foundation

At a World Health Organization conference in Panama, The Geneva Learning Foundation is hosting an Innovations Café today.

The session’s title is “Connected learning to accelerate local impact at global scale: Year 1 of the Movement for Immunization Agenda 2030 (IA2030)”.

What is the Movement for Immunization Agenda 2030 (IA2030)?

Immunization Agenda 2030 (IA2030) is the world’s strategy, adopted by the World Health Assembly in 2020, to achieve the global goals for immunization.

In March 2022, The Geneva Learning Foundation (TGLF) launched a call to form a movement in support of IA2030.

By June 2023, over 16,000 health workers were participating.

More than 80% work in districts and health facilities and over half are government workers.

70% work in fragile contexts such as armed conflict, remote areas, urban poverty, and other challenges.

This ground-up commitment has the potential to complement the top-down work of the IA2030 global partners, if this community of practitioners is recognized, empowered, and listened to by global health agencies and donors.

In today’s session, you will hear first-hand from IA2030 Movement Members.

How has participation in this Movement helped them to better serve the immunization and primary health care needs of the local communities they serve?

In Year 1 of this Movement, we demonstrated the feasibility of establishing a global peer learning platform for immunization practitioners, with the creation of a movement of more than 10,000 health workers in support of IA2030 goals. Learn more about Year 1 outcomes.

In Year 2, as the Movement continued to grow rapidly in over 100 countries, we generated evidence of practitioner demand and public health impact, captured in academic papers and multiple detailed case studies. Request your invitation to the IA2030 Movement’s Knowledge-to-Action Hub to get access to research outputs.

Learn more about how new digital learning approach can open access to international global health conferences otherwise restricted to the select few.

Health performance management in complex adaptive systems

How do we reframe health performance management within complex adaptive systems?

Global health, Learning, Research

We need a conceptual framework that situates health performance management within complex adaptive systems.

This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to performance management in a given context.

Existing performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies.

Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change.

In my view, this important paper mends an important broken link in theories of change that try to consider learning beyond training.

The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to be balanced with enabling approaches that foster collective responsibility and empower teams to self-organise and use data for shared sensemaking and decision-making.

Directive approaches may be more effective where workers are primarily extrinsically motivated, in less complex systems where there is higher certainty over how outcomes should be achieved, where there are sufficient resources and decision space, and where informal relationships do not subvert formal management levers.

Enabling approaches may be more effective in contexts of higher complexity and uncertainty and where there are higher levels of trust, teamwork, and intrinsic motivation, as well as appropriate leadership.

Directive and enabling approaches are not ‘either-or’: designers of performance management systems must strive for an appropriate balance between them.

The greater the dissonance between designing a performance management system and the real context in which it is implemented, the more likely it is to trigger perverse, unintended consequences.

Interventions must be carefully calibrated to the context of the health system, the culture of its organisations, and the motivations of its individuals.

By considering each factor and their interdependencies, actors can minimise perverse unintended consequences while attaining a contextually appropriate balance between directive or enabling approaches.

The complexity of the framework and the interdependencies it describes reinforce that there is no ‘one-size-fits-all’ blueprint for performance management.

For higher-order learning and whole-system improvement to occur, practical and tacit knowledge needs to flow among system actors and organisations, thus leveraging the power of networks and social connections (eg, learning exchanges and communities of practice).

Read the full paper: Newton-Lewis, T., Munar, W., Chanturidze, T., 2021. Performance management in complex adaptive systems: a conceptual framework for health systems. BMJ Glob Health 6, e005582. https://doi.org/10.1136/bmjgh-2021-005582l

Collective Intelligence Cambridge Digital Education Futures Initiative

The COVID-19 Peer Hub as an example of Collective Intelligence (CI) in practice

Global health, The Geneva Learning Foundation

A new article by colleagues at the Cambridge Digital Education Futures Initiative (DEFI) illustrates academic understanding of Collective Intelligence (CI) through the COVID-19 Peer Hub, a peer learning initiative organized by over 6,000 frontline health workers in Africa, Asia, and Latin America, with support from The Geneva Learning Foundation (TGLF), in response to the initial shock of the pandemic on immunization services that placed 80 million children at risk of missing lifesaving vaccines. Learn more about the COVID-19 Peer Hub…

From the abstract:

Collective Intelligence (CI) is important for groups that seek to address shared problems.

CI in human groups can be mediated by educational technologies.

The current paper presents a framework to support design thinking in relation to CI educational technologies.

Our framework is grounded in an organismic-contextualist developmental perspective that orients enquiry to the design of increasingly complex and integrated CI systems that support coordinated group problem solving behaviour.

We focus on pedagogies and infrastructure and we argue that project-based learning provides a sound basis for CI education, allowing for different forms of CI behaviour to be integrated, including swarm behaviour, stigmergy, and collaborative behaviour.

We highlight CI technologies already being used in educational environments while also pointing to opportunities and needs for further creative designs to support the development of CI capabilities across the lifespan.

We argue that CI education grounded in dialogue and the application of CI methods across a range of project-based learning challenges can provide a common bridge for diverse transitions into public and private sector jobs and a shared learning experience that supports cooperative public-private partnerships, which can further reinforce advanced human capabilities in system design.

Article excerpt:

As an example of CI in practice, in 2020–2021, more than 6000 health workers joined The Geneva Learning Foundation (TGLF) COVID-19 Peer Hub.

Participants shared more than 1200 ideas or practices for managing the pandemic in their contexts within 10 days. Relevant peer ideas and practices were then referenced as participants produced individual, context-specific action plans that were then reviewed by peers before finalisation and implementation.

Mapping of action plan citations (C3L 2022) demonstrate patterns of peer learning, between countries, organisations and system levels.

In parallel, TGLF synthesises data generated by peer learners in formats legitimised by the global health knowledge system (e.g. Moore et al. 2022).

The biggest challenge to CI in this context remains one of legitimacy: how can collective intelligence compete with the perceived gold standard of academic publication within this expert-led culture?

We argue that as CI education is further developed and extends across the lifespan from school learning environment to work and organisational environments, CI technologies and practices will be further developed, evaluated, and refined and will gain legitimacy as part of broader societal capabilities in CI that are cultivated and reinforced on an ongoing basis.

References cited in this excerpt:

Kovanovic, V. et al. (2022) The power of learning networks for global health: The Geneva Learning Foundation COVID-19 Peer Hub Project Evaluation Report. Centre for Change and Complexity in Learning.

Moore, Katie, Barbara Muzzulini, Tamara Roldán, Juliet Bedford, and Heidi Larson. 2022. Overcoming barriers to vaccine acceptance in the community: Key learning from the experiences of 734 frontline health workers (1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.6965355

Full article: Hogan, M.J., Barton, A., Twiner, A., James, C., Ahmed, F., Casebourne, I., Steed, I., Hamilton, P., Shi, S., Zhao, Y., Harney, O.M., Wegerif, R., 2023. Education for collective intelligence. Irish Educational Studies 1–30. https://doi.org/10.1080/03323315.2023.2250309