544 health care workers from 44 countries have already confirmed their participation. 80% of participants are sub-national staff working in fragile contexts. Most work for their country’s ministry of health.
Chris deBode spent decades on assignments, traveling around the globe for various NGOs, magazines, and newspapers.
Now, he has partnered with the Geneva Learning Foundation (TGLF) to share his experience with health practitioners who are there every day, as they learn to tell their own visual stories about immunization, the impacts of climate change on health, and other issues that matter for the communities they serve.
“Technical knowledge is not decisive in making your picture”, says Chris. “The person behind the camera makes the difference. You are the source of your image.”
The workshop is reserved for health professionals who contributed photos to the 2022 and 2023 Immunization Agenda 2030 (IA2030) Movement’s International Photo Exhibitions for World Immunization Week. However, it will also be livestreamed for everyone who has not previously been able to participate.
In 2022 and 2023, over 2,000 photos were shared by immunization staff from all over the world.
On 18 March 2024, health professionals from the following countries will be participating: Afghanistan, Angola, Bangladesh, Belgium, Benin, Burkina Faso, Burundi, Cameroon, Canada, Central African Republic, Chad, Comoros, Congo, Costa Rica, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, France, Gabon, Gambia, Germany, Ghana, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Kenya, Lebanon, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Morocco, Niger, Nigeria, Pakistan, Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sri Lanka, Sudan, Tanzania, Togo, Tunisia, Turkey, Uganda, United States, Zambia, Zimbabwe.
Photo by Chris deBode: Eleven-year-old Wilberforce runs along an unpaved road near his home in Gulu, Northen Uganda where he lives with his parents and 6 siblings. He says: “I want to be the fastest. I want my parents, my school and country to be proud of me. Every day I run. I dream of coming home with the biggest trophy.”
Watch the inauguration of the First International Photography Exhibition for Immunization Agenda 2030
Watch the Special Event: World Immunization Week 2023
Watch the Special Event: World Immunization Week 2022
A new interdisciplinary review from the ARQ National Psychotrauma Centre and VU Amsterdam provides an in-depth analysis of the mental health impacts, cultural and historical factors shaping coping and help-seeking, the evolving humanitarian response, and recommendations for strengthening mental health and psychosocial support (MHPSS) in Ukraine.
The report is an interdisciplinary literature review supplemented by key informant interviews. It synthesizes academic publications, gray literature, media reports and policy documents in English, Ukrainian and Russian. The review team included Ukrainian practitioners and regional experts to identify additional Ukrainian-language sources.
The review found that the war has led to high levels of acute psychological distress, increased risk of the development of future mental health problems, exacerbation of chronic mental health conditions, psychosocial problems, and an increase in substance use. Exposure to war-related trauma and violence, coupled with the loss of social support systems, poses lifelong risks for a range of mental health issues. Internally displaced persons (IDPs) are particularly vulnerable, with previous research showing that “32% of IDPs in Ukraine experienced post-traumatic stress disorder (PTSD) and 22% had depression.”
Children’s mental health is a critical concern, with “three out of four parents report[ing] signs of psychological trauma in their children” such as “impaired memory, inattention, and learning difficulties.” Over 1.2 million children are internally displaced, with approximately 91,000 separated from family care. These are “the most vulnerable children […] living outside their families, residential institutions for children without parental care or boarding schools, unaccompanied and separated children, and children with disabilities.” Displacement disrupts education, social networks and routines. Adolescents struggle most to adapt and connect with new peers. Older children are taking on caregiver roles for younger siblings. The review identifies a lack of policies and programs specifically targeting child and adolescent mental health as a key gap.
Ukraine’s complex history has shaped current attitudes and practices around mental health. The review notes that “Ukraine’s historical memory is fragmented, with evaluations of events varying significantly among different population groups,” compounded by “Russia’s historic and contemporary efforts to rewrite Ukrainian history.” Soviet-era legacies of stigma, institutionalization, and the misuse of psychiatry have bred mistrust of formal mental health services, according to the review. Instead, “help seeking behaviour tends to be directed toward spiritual leaders (clergy) and practices.” Religious beliefs and leaders play an important role in mental health coping and support.
High levels of societal stigma toward mental illness persist, rooted in cultural norms that view psychological distress as a personal weakness or moral failing. Many Ukrainians hide their struggles and avoid seeking professional help due to fears of being perceived as ‘weak,’ receiving a diagnosis that could jeopardize employment, or being involuntarily hospitalized. “Ukrainians still perceive psychiatrists as being highly likely to disclose information about mental health and psychosocial disorders with employers, and therefore, even a single visit to a psychiatric hospital may destroy the future […] There is a particular tendency to hide suicidal thoughts due to high levels of fear of involuntary hospitalisation”, says the report.
Since 2014, conflict-affected areas in Eastern Ukraine have seen an influx of MHPSS services through humanitarian efforts, while recent national reforms have aimed to decentralize and deinstitutionalize mental healthcare. However, the current crisis has disrupted these reform efforts while dramatically increasing MHPSS needs. This presents both challenges and opportunities to “build on available resources” and integrate “successes of the emergency response into building more sustainable mental health care systems.”
The review highlights the stark regional disparities in MHPSS needs and capacities due to variations in conflict exposure, displacement patterns, infrastructure damage, and pre-existing resources. Areas affected by armed conflict face acute challenges, including widespread mine contamination, community distrust, and decimated health services. Meanwhile, safer areas in Western Ukraine are straining to meet the needs of large displaced populations. However, they also have more MHPSS responders and opportunities for longer-term interventions.
To address these complex challenges, the authors stress the importance of cross-sectoral coordination, building on local capacities and cultural resources, and strengthening partnerships between government, civil society, and faith-based organizations. Rigorous research on MHPSS interventions in conflict-affected Ukraine can inform evidence-based responses in the country and globally.
The review provides a roadmap for strengthening Ukraine’s MHPSS response through a focus on sustainable, locally-grounded, and trauma-informed approaches. While the needs are vast, there are also opportunities to transform mental healthcare and build resilience.
Reference: Iryna Frankova, Megan Leigh Bahmad, Ganna Goloktionova, Orest Suvalo, Kateryna Khyzhniak, 2024. Mental Health and Psychosocial Support in Ukraine: Coping, Help-seeking and Health Systems Strengthening in Times of War. ARQ National Psychotrauma Centre and VU Amsterdam, Amsterdam, Netherlands.
GENEVA, Switzerland, 8 March 2024 – The Geneva Learning Foundation (TGLF) is sharing a collection of stories titled “Women inspiring women”, shared by 177 women on the frontlines of health and humanitarian action.
The collection is a vibrant tapestry of women’s voices from the frontlines of health and humanitarian action, woven together to showcase the resilience, passion, and leadership of women who are making a difference in the face of war, disease, and climate change.
TGLF reached out to women in its global network of more than 60,000 health workers, inviting them to share their heartfelt advice and vision for the future with young women and girls.
Health workers in this network, men and women, are on the frontlines of adversity: they work in remote rural areas or with the urban poor. Many support the needs of nomadic and migrant populations, refugees, and internally-displaced populations (IDPs).
Imagine being able to sit down with a community health worker in Nigeria, a nurse in India, or a doctor in Brazil, and listen to their stories of triumph and struggle. “Women Inspiring Women” makes that possible, bringing together voices that are rarely heard on the global stage.
The responses are raw, honest, and deeply moving.
From remote villages to urban slums, women work to build a better future for their communities.
What makes this collection truly unique is its authenticity and diversity.
“In a world of war, disease, and a worsening climate, literacy is vital for the next generation of women and girls to make better choices concerning health, marriage, and income. Literacy is key in transforming households out of poverty, no matter who they are or where they are born.” – Hauwa Abbas, Public health specialist (MPH), Nigeria
Through their words, these women offer invaluable guidance to the next generation of female leaders. They share the lessons they’ve learned, the challenges they’ve faced, and the hopes they hold for a world where every girl can live a healthy, fulfilling life, no matter where she is born.
“Serving humanity as a health or humanitarian worker is one of the most rewarding careers one can engage in. Though it requires a lot of hard work more importantly and what is usually not thought about is the heart work it involves. The ability to empathize with the sick and those in humanitarian needs is a key ingredient for success.” – Ngozi Kennedy MB ChB, MPH, Public health specialist, Ethiopia
“This collection is a celebration of the incredible resilience and leadership of women health workers and humanitarians worldwide,” said TGLF Executive Director Reda Sadki. “It’s a testament to the power of storytelling to inspire change and unite us in our shared vision for a better future.”
“Insist on making generational impact as a woman against ALL odds! Don’t give up, don’t give in, don’t give way! Persistence wears out resistance! This is my success story today as I battled many challenges to establish rotavirus surveillance in my country as well as rotavirus vaccine introduction advocacy which has finally culminated in the vaccine introduction in Nigeria.” – Professor Beckie Tagbo, Doctor, Institute of Child Health, University of Nigeria Teaching Hospital, Enugu, Nigeria
In the lead up to International Women’s Day, TGLF has been sharing sneak peeks of the stories and quotes on its social media platforms. Follow along on LinkedIn, Twitter/X, Facebook, Instagram and Telegram to get a glimpse of the inspiration that awaits.
“Women Inspiring Women” is more than just a collection of stories. It’s a rallying cry for gender equality, a celebration of women’s leadership, and a reminder of the incredible impact one voice can have. Get ready to be inspired, moved, and empowered by the voices of women health workers and humanitarians worldwide.
Join us in amplifying the voices of these extraordinary women and creating a world where every girl can thrive.
“Resilience and determination in the face of difficulties will be essential – it is vital not to be deterred or discouraged when faced with setbacks of adversity, which are an inevitability in these spheres. Health or humanitarian work is all about people. There may be days where you question your decision and that is where determination keeps you going.” – Genise Pascal-Ferrer Iglesias, Coordinator of Imaging Services, Goodwill, Dominica
“Empowered women empower women. Ever since you were born, I kept you with me in all my philanthropic activities. […] I wish you all the blessings, happiness and success in life. Someday, you will write a similar letter to your own daughter saying, ‘Empowered women empower women’.” – Dr Faiza Rabbani, Public health specialist (MPH), Lahore District, Punjab Province, Pakistan
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:
Helps local actors take action with communities to tackle local challenges, and
provides the tools to build a global network, platform, and community of health workers that can scale up local impact for global health.
GENÈVE, Suisse, le 8 mars 2024 — La Fondation Apprendre Genève (TGLF) partage une collection de récits intitulée « Des femmes pour la santé », partagées par 177 femmes en première ligne de la santé et de l’action humanitaire.
Télécharger la collection: La Fondation Apprendre Genève (2024). Des femmes pour la santé : Journée internationale de la femme 2024 (1.0). https://doi.org/10.5281/zenodo.10792027
La collection réunit des voix de femmes provenant des premières lignes de la santé et de l’action humanitaire. Ensemble, elles mettent en valeur la résilience, la passion et le leadership des femmes qui font la différence face à la guerre, à la maladie et au changement climatique.
La Fondation a lancé l’appel aux femmes de son réseau international de plus de 60 000 professionnels de la santé, les invitant à partager avec les jeunes femmes et les filles leurs conseils sincères et leur vision de l’avenir.
Les membres de ce réseau, hommes et femmes, sont en première ligne face à l’adversité : ils travaillent dans des zones rurales isolées ou auprès des populations urbaines pauvres. Nombre d’entre eux répondent aux besoins des populations nomades et migrantes, des réfugiés et des personnes déplacées à l’intérieur de leur propre pays.
Imaginez que vous puissiez partager un moment avec un agent de santé communautaire au Nigéria, une infirmière en Inde ou un médecin au Brésil, et écouter leurs histoires de triomphe et de lutte. C’est ce que permet « Des femmes pour la santé ».
Les réponses sont sincères et profondément émouvantes.
Des villages reculés aux bidonvilles urbains, les femmes s’efforcent de construire un avenir meilleur pour leurs communautés.
Ce qui rend cette collection vraiment unique, c’est son authenticité et sa diversité.
« Dans un monde marqué par la guerre, la maladie et la détérioration du climat, l’alphabétisation est vitale pour que la prochaine génération de femmes et de jeunes filles puisse faire de meilleurs choix en matière de santé, de mariage et de revenus. L’alphabétisation est essentielle pour sortir les ménages de la pauvreté, quels qu’ils soient et où qu’ils soient nés.» — Hauwa Abbas, spécialiste en santé publique, Nigéria.
Par leurs paroles, ces femmes offrent des conseils inestimables à la prochaine génération de dirigeantes. Elles partagent les leçons qu’elles ont apprises, les défis auxquels elles ont été confrontées et les espoirs qu’elles nourrissent pour un monde où chaque fille peut vivre une vie saine et épanouie, quel que soit son lieu de naissance.
«Servir l’humanité en tant que travailleur sanitaire ou humanitaire est l’une des carrières les plus gratifiantes qui soient. Bien qu’elle exige beaucoup de travail, le plus important, et ce à quoi on ne pense généralement pas, c’est le travail du cœur qu’elle implique. La capacité d’empathie avec les malades et les personnes ayant des besoins humanitaires est un ingrédient clé de la réussite ». — Ngozi Kennedy MB ChB, MPH, spécialiste de la santé publique, Éthiopie
« Cette collection est une célébration de l’incroyable résilience et du leadership des travailleuses de la santé et des humanitaires du monde entier », a déclaré Reda Sadki, directeur exécutif de la Fondation. « Elle témoigne du pouvoir de la narration pour inspirer le changement et nous unir dans notre vision commune d’un avenir meilleur.»
«Insistez pour avoir un impact générationnel en tant que femme contre TOUTE attente ! N’abandonnez pas, ne cédez pas, ne cédez pas ! La persévérance a raison de la résistance ! C’est ma réussite aujourd’hui, car j’ai relevé de nombreux défis pour mettre en place une surveillance du rotavirus dans mon pays ainsi qu’un plaidoyer pour l’introduction du vaccin contre le rotavirus, qui a finalement abouti à l’introduction du vaccin au Nigéria.» — Professeur Beckie Tagbo, médecin, Institut de la santé infantile, hôpital universitaire de l’université du Nigéria, Enugu, Nigéria.
À l’approche de la Journée internationale de la femme, la Fondation a partagé des aperçus des histoires et des citations sur ses plateformes de médias sociaux. Suivez-les sur LinkedIn, Twitter/X, Facebook, Instagram et Telegram pour avoir un aperçu de l’inspiration qui vous attend.
«Les femmes inspirent les femmes » est plus qu’une simple collection d’histoires. C’est un cri de ralliement pour l’égalité des sexes, une célébration du leadership des femmes et un rappel de l’impact incroyable qu’une seule voix peut avoir. Préparez-vous à être inspirés, émus et responsabilisés par les voix des travailleuses de la santé et des humanitaires du monde entier.
Rejoignez-nous pour amplifier les voix de ces femmes extraordinaires et créer un monde où chaque fille peut s’épanouir.
« La résilience et la détermination face aux difficultés seront essentielles — il est vital de ne pas se laisser dissuader ou décourager face aux revers de l’adversité, qui sont une inévitabilité dans ces sphères. Le travail dans le domaine de la santé ou de l’humanitaire est avant tout une affaire de personnes. Il peut y avoir des jours où vous remettez votre décision en question et c’est là que la détermination vous permet de continuer.» — Genise Pascal-Ferrer Iglesias, coordinatrice des services d’imagerie, Goodwill, Dominique
«Les femmes autonomes donnent du pouvoir aux femmes. Depuis votre naissance, je vous ai accompagnée dans toutes mes activités philanthropiques. […] Je vous souhaite toutes les bénédictions, le bonheur et le succès dans la vie. Un jour, vous écrirez une lettre similaire à votre propre fille en lui disant : “Les femmes autonomes autonomisent les femmes.» — Dr Faiza Rabbani, spécialiste de la santé publique (MPH), district de Lahore, province du Pendjab, Pakistan
Créée par un groupe d’innovateurs et de scientifiques de l’apprentissage ayant pour mission de découvrir de nouvelles façons de conduire le changement, l’équipe de la Fondation combine plus de 70 ans d’expérience à la fois avec un travail basé dans le pays (sur le terrain) et avec des partenaires nationaux, régionaux et internationaux.
Notre petite équipe agile, entièrement à distance, soutient déjà plus de 60 000 professionnels de la santé qui conduisent le changement dans 137 pays.
Nous sommes en première ligne : 21 % sont confrontés à des conflits armés ; 25 % travaillent avec des réfugiés ou des populations déplacées à l’intérieur du pays ; 62 % travaillent dans des zones rurales éloignées ; 47 % avec les pauvres des villes ; 36 % soutiennent les besoins des populations nomades/migrantes.
Le modèle innovant de la Fondation :
aide les acteurs locaux à agir avec les communautés pour relever les défis locaux, et
fournit les outils pour construire un réseau mondial, une plateforme et une communauté d’agents de santé qui peuvent augmenter l’impact local pour la santé internationale.
Nearly “one in ten of those affected by war grapple with moderate to severe mental health issues.” This refers to the crisis having significant psychological impacts on those directly impacted or displaced by the conflict.
Over 1 million crisis-affected people have received psychosocial support (PSS) “thanks to specialist staff and more than 124,000 volunteers from 58 countries.”
There are “increased psychological assistance requests…from women heading households” as Ukraine sees heightened risks to families and disruptions to support services due to the conflict.
“Three out of four parents report signs of psychological trauma in their children” including impaired memory, inattention, and learning difficulties. Children are especially vulnerable to the stresses and trauma resulting from the conflict.
Psychological First Aid (PFA) services are provided “at Humanitarian Service Points along refugee routes, through call centers, and at various contact points”.
Overall, the report highlights the substantial scale and complex nature of MHPSS (mental health and psychosocial support) needs driven by the Ukraine conflict as well as the scale and scope of the Red Cross Red Crescent response mobilized so far including through delivery of PFA (Psychological First Aid) and PSS (psychosocial support).
What are the challenges?
The report on mental health and psychosocial needs in Ukraine highlights several key challenges, including:
The vast scale of needs driven by protracted conflict, with 14.6 million people requiring humanitarian assistance. Meeting mental health demands for crisis-affected populations often exceeds available capacity and resources.
Ensuring consistent, sustainable care and support with constrained funding and risk of donor fatigue as the crisis persists long-term. Services must have resilience even as attacks continue disrupting infrastructure.
Reaching vulnerable groups like the elderly and immobile with limited mobility to access care. Specialized outreach and home-based care is essential but demanding to deliver.
Preventing burnout, fatigue and declining wellbeing among staff and volunteers working under intense pressure in risky environments. Their mental health and capacity is vital but often overlooked.
What can we learn about psychological first aid (PFA) for children from this report?
First, we need to understand the specialized terminology used:
The term “MHPSS” (mental health and psychosocial support) refers to a continuum of support aimed at protecting and improving people’s mental health and wellbeing during and after crises. The report notes resourcing this immense and growing scale of MHPSS need remains an acute challenge.
Psychological First Aid(“PFA”) describes a humane, supportive response to a fellow human being who is suffering and who may need support.
Child Friendly Spaces (CFS) are a key element of the Red Cross Red Crescent psychosocial support response in Ukraine. They are “a service to increase children’s access to safe environments and promote their psychosocial well-being.”
We learn that with support from the IFRC Psychosocial Centre, the Ukrainian Red Cross Society:
has provided recreational activities to almost 70,000 children in CFS inside Ukraine over the past year;
trained 319 staff and volunteers in managing CFS;
runs CFS to help children cope with issues like difficulties meeting new people, separation anxiety, and fear when air raid sirens sound.
The report shares anecdotes from children, such as a child who came to a CFS in Kyiv after fleeing heavy shelling. His social anxiety has improved and he asks his mom if he can skip school to go to CFS activities instead.
More data, supported by analysis on outcomes and effectiveness, could further strengthen the report.
How can peer learning be useful?
A peer learning model focused on improving health outcomes is likely to be relevant in addressing these multilayered challenges. It is specifically designed to foster reflection and unlock intrinsic motivation in practitioners to create change.
Peer learning methodologies could help meet capacity gaps by scaling support across affected areas rapidly through digital means.
Peer support networks could enable volunteers and staff caring for others to also care for themselves, preventing fatigue.
By connecting practitioners across borders and sectors, peer learning could help to share innovative, context-appropriate solutions and accelerate their testing and refinement to meet needs.
Reference: Two years on: mental health and psychosocial needs in Ukraine and affected countries. Psychosocial Support Centre, Copenhagen, Denmark.
The finding is based on analysis large-scale learning culture measurements conducted by the Geneva Learning Foundation in 2020 and 2022, with more than 10,000 immunization staff from all levels of the health system, job categories, and contexts, responding from over 90 countries.
Year
n
Continuous learning
Dialogue & Inquiry
Team learning
Embedded Systems
Empowered People
System Connection
Strategic Leadership
2020
3830
3.61
4.68
–
4.81
4.68
5.10
4.83
2022
6185
3.76
4.71
4.86
4.93
4.72
5.23
4.93
TGLF global measurements (2020 and 2022) of learning culture in immunization, using the Dimensions of Learning Organization Questionnaire (DLOQ)
What does this finding about continuous learning actually mean?
In immunization, the following gaps in continuous learning are likely to be hindering performance.
Relatively few learning opportunities for immunization staff
Limitations on the ability for staff to experiment and take risks
Low tolerance for failure when trying something new
A focus on completing immunization tasks rather than developing skills and future capacity
Lack of encouragement for on-the-job learning
This gap hurts more than ever when adapting strategies to reach “zero-dose” children.
These are children who have not been reached when immunization staff carry out what they usually do.
The traditional learning model is one in which knowledge is codified into lengthy guidelines that are then expected to trickle down from the national team to the local levels, with local staff competencies focused on following instructions, not learning, experimenting, or preparing for the future.
For many immunization staff, this is the reference model that has helped eradicate polio, for example, and to achieve impressive gains that have saved millions of children’s lives.
It can therefore be difficult to understand why closing persistent equity gaps and getting life-saving vaccines to every child would now require transforming this model.
Yet, there is growing evidence that peer learning and experience sharing between health workers does help surface creative, context-specific solutions tailored to the barriers faced by under-immunized communities.
Such learning can be embedded into work, unlike formal training that requires staff to stop work (reducing performance to zero) in order to learn.
Yet the predominant culture does little to motivate or empower these workers to recognize or reward such work-based learning.
Furthermore, without opportunities to develop skills, try new approaches, and learn from both successes and failures, staff may become demotivated and ineffective.
This is not an argument to invest in formal training.
Investment in formal training has failed to measurably translate into improved immunization performance.
Worse, the per diem economy of extrinsic incentives for formal training has, in some places, led to absurdity: some health workers may earn more by sitting in classrooms than from doing their work.
With a weak culture of learning, the system likely misses out on practices that make a difference.
This is the “how” that bridges the gap between best practice and what it takes to apply it in a specific context.
The same evidence also demonstrates a consistently-strong correlation between strengthened continuous learning and performance.
Investment in continuous learning is simple, costs surprisingly little given its scalability and effectiveness.
The Geneva Learning Foundation. From exchange to action: Summary report of Gavi Zero-Dose Learning Hub inter-country exchanges. Geneva: The Geneva Learning Foundation, 2023. https://doi.org/10.5281/zenodo.10132961
The Geneva Learning Foundation. Motivation, Learning Culture and Immunization Programme Performance: Practitioner Perspectives (IA2030 Case Study 7) (1.0); Geneva: The Geneva Learning Foundation, 2022. https://doi.org/10.5281/zenodo.7004304
In their article “What Have We Learned That Is Critical in Understanding Leadership Perceptions and Leader-Performance Relations?”, Robert G. Lord and Jessica E. Dinh review research on leadership perceptions and performance, and provide research-based principles that can provide new directions for future leadership theory and research.
What is leadership?
Leadership is tricky to define. The authors state: “Leadership is an art that has significant impact on individuals, groups, organizations, and societies”.
It is not just about one person telling everyone else what to do. Leadership happens in the connections between people – it is something that grows between a leader and followers, almost like a partnership. And it usually does not involve just one leader either. There can be leadership shared across a whole team or organization.
The big question is: how does all this connecting and partnering actually get a team to perform well? That is what researchers are still trying to understand.
What we do know about leadership
Researchers have learned a lot about what makes a leader “seem” effective to the people around them. Certain personality traits, behaviors, speaking styles and even body language can make people think “oh, that person is a good leader.”
But figuring out how those leaders actually influence performance over months and years is tougher. It is hard for scientists to measure stuff that happens slowly over time. More research is still needed to connect the dots between leaders’ actions today and results years later.
How people think about leadership matters
Learning science shows that how people process information shapes their perceptions, emotions and behaviors. So to understand leadership, researchers are now looking into things like:
How do the automatic, gut-level parts of people’s brains affect leadership moments? (This means how emotions and instincts influence leadership)
How do leaders’ and followers’ thinking interact?
How do emotions and body language play a role?
This research might help explain why leadership works or does not work in real teams.
Some pitfalls to avoid
There are a few assumptions that could mislead leadership research:
Surveys might not catch real leadership behavior, because people’s memories are messy. Their responses involve lots of other stuff beyond just the facts.
What worked well for leaders in the past might not keep working in a fast-changing world. They cannot just keep doing the same thing.
Leaders actually have less control than we think. Their organization’s success depends on unpredictable factors way beyond what they do.
The future of leadership research has to focus more on the complex thinking and system-wide stuff that is hard to see but really important. The human brain and human groups are just too complicated for simple explanations.
Reference: Lord, R.G., Dinh, J.E., 2014. What Have We Learned That Is Critical in Understanding Leadership Perceptions and Leader-Performance Relations? Industrial and Organizational Psychology 7, 158–177.
Coaching and mentoring programs sometimes called “fellowships” have been upheld as the gold standard for developing leaders in global health.
For example, a fellowship in the field of immunization was recently advertised in the following manner.
Develop your skills and become an advocate and leader: The fellowship will begin with two months of weekly mandatory live engagements led by [global] staff and immunization experts around topics relating to rebuilding routine immunization, including catch-up vaccination, integration and life course immunization. […]
Craft an implementation plan: Throughout the live engagement series, fellows will develop, revise and submit a COVID-19 recovery strategic plan.
Receive individualized mentoring: Participants with strong plans will be considered for a mentorship program to work 1:1 with experts in the field to further develop and implement their strategies and potentially publish their case studies.
We will not dwell here on the ‘live engagements’, which are expert-led presentations of technical knowledge. We already know that such ‘webinars’ have very limited learning efficacy, and unlikely impact on outcomes. (This may seem like a harsh statement to global health practitioners who have grown comfortable with webinars, but it is substantiated by decades of evidence from learning science research.)
On the surface, the rest of the model sounds highly effective, promising personalized attention and expert guidance.
The use of a project-based learning approach is promising, but it is unclear what support is provided once the implementation plan has been crafted.
It is when you consider the logistical aspects that the cracks begin to show.
The essence of traditional coaching lies in the quality of the one-to-one interaction, making it an inherently limited resource.
Take, for example, a fellowship programme where interest outstrips availability—say, 1,600 aspiring global health leaders are interested, but only 30 will be selected for one-on-one mentoring.
Tailored, one-on-one coaching can be incredibly effective in small, controlled environments.
While these 30 may receive an invaluable experience, what happens to those left behind?
There is an ‘elitist spiral’.
Coaching and mentoring, while intensive, remain exclusive by design, limited to the select few.
This not only restricts scale but also concentrates knowledge among the selected group, perpetuating hierarchies.
Those chosen gain invaluable support.
The majority left out are denied access and implicitly viewed as passive recipients rather than partners in a collective solution.
Doubling the number of ‘fellows’ only marginally improves this situation.
Even if the mentor pool were to grow exponentially, the personalized nature of the engagement limits the rate of diffusion.
When we step back and look at the big picture, we realize there is a problem: these programs are expensive and difficult to scale.
And, in global health, if it does not scale, it is not solving the problem.
So while these programs can make a real difference for a small group of people, they are unlikely to move the needle on a global scale.
That is like trying to fill a swimming pool with a teaspoon—you might make some progress, but you will never get the job done.
The model creates a paradox: the attributes making it effective for individuals intrinsically limit systemic impact.
There is another paradox related to complexity.
Global health issues are inextricably tied to cultural, political and economic factors unique to each country and community.
Complex problems require nuanced solutions.
Yet coaching promotes generalized expertise from a few global, centralized institutions rather than fostering context-specific knowledge.
Even the most brilliant, experienced coach or mentor cannot single-handedly impart the multifaceted understanding needed to drive impact across diverse settings.
A ‘fellowship’ structure also subtly perpetuates the existing hierarchies within global health.
It operates on the tacit assumption that the necessary knowledge and expertise reside in certain centralized locations and among a select cadre of experts.
This sends an implicit message that knowledge flows unidirectionally—from the seasoned experts to the less-experienced practitioners who are perceived as needing to be “coached.”
This means transitioning from hierarchical, top-down development models to flexible platforms amplifying practitioners’ contextual insights.
The gap between need and availability of quality training in global health is too vast for conventional approaches to ever bridge alone.
Instead of desperately chasing an asymptote of expanding elite access, we stand to gain more by embracing approaches that democratize development.
Complex challenges demand platforms unleashing collective wisdom through collaboration. The technologies exist.
In the “fellowship” example, less than five percent of participants were selected to receive feedback from global experts.
A peer learning platform can provide high-quality peer feedback for everyone.
Such a platform democratizes access to knowledge and disrupts traditional hierarchies.
It also moves away from the outdated notion that expertise is concentrated in specific geographical or institutional locations.
What learning science underpins peer learning for global health? Watch this 14-minute presentation at the 2023 annual meeting of the American Society for Tropical Medicine and Hygiene (ASTMH).
What about the perceived trade-off between quality and scale?
Effective digital peer learning platforms negate this zero-sum game.
Research on MOOCs (massive open online courses) has conclusively demonstrated that giving and receiving feedback to and from three peers through structured, rubric-based peer review, achieves reliability comparable, when properly supported, to that of expert feedback alone.
If we are going to make a dent in the global health crises we face, we have to shift from a model that relies on the expertise of the few to one that harnesses the collective wisdom of the many.
Peer learning isn’t a Band-Aid. It is an innovative leap forward that disrupts the status quo, and it’s exactly what the global health sector needs.
Peer learning is not just an incremental improvement. It is a seismic shift in the way we think about learning and capacity-building in global health.
Peer learning is not a compromise. It is an upgrade. We move from a model of scarcity, bound by the limits of individual expertise, to one of collective wisdom.
Peer learning is more than just a useful tool. It is a challenge to the traditional epistemology of global health education.
As we grapple with urgent issues in global health—from pandemic recovery to routine immunization—it is clear that we need collective intelligence and resource sharing on a massive scale.
And for that, we need to move beyond the selective, top-down models of the past.
The collective challenges we face in global health require collective solutions.
And collective solutions require us to question established norms, particularly when those norms serve to maintain existing hierarchies and power imbalances.
Now it is up to us to seize this opportunity and move beyond outmoded, hierarchical models.
There is a path – now, not tomorrow – to truly democratize knowledge, make meaningful progress, and tackle the global health challenges that confront us all.
By connecting practitioners to learn from each other, peer learning facilitates collaborative development. ow does it compare to expert-led coaching and mentoring “fellowships” that are seen as the ‘gold standard’ for professional development in global health?
Scalability in global health matters. (See this article for a comparison of other aspects.)
Simplified mathematical modeling can compare the scalability of expert coaching (“fellowships”) and peer learning
Let N be the total number of learners and M be the number of experts available. Assuming that each expert can coach K learners effectively:
For N>>M×KN>>M×K, it is evident that expert coaching is costly and difficult to scale.
Expert coaching “fellowships” require the availability of experts, which is often optimistic in highly specialized fields.
The number of learners (N) greatly exceeds the product of the number of experts (M) and the capacity per expert (K).
Scalability of one-to-one peer learning
By comparison, peer learning turns the conventional model on its head by transforming each learner into a potential coach who can provide peer feedback.
This has significant advantages in scalability.
Let N be the total number of learners. Assuming a peer-to-peer model, where each learner can learn from any other learner:
In this context, the number of learning interactions scales quadratically with the number of learners. This means that if the number of learners doubles, the total number of learning interactions increases by a factor of four. This quadratic relationship highlights the significant increase in interactions (and potential scalability challenges) as more learners participate in the model.
However, this one-to-one model is difficult to implement: not every learner is going to interact with every other learner in meaningful ways.
A more practical ‘triangular’ peer learning model with no upper limit to scalability
In The Geneva Learning Foundation’s peer learning model, learners give feedback to three peers, and receive feedback from three peers. This is a structured, time-bound process of peer review, guided by an expert-designed rubric.
When each learner gives feedback to 3 different learners and receives feedback from 3 different learners, the model changes significantly from the one-to-one model where every learner could potentially interact with every other learner. In this specific configuration, the total number of interactions can be calculated based on the number of learners N, with each learner being involved in 6 interactions (3 given + 3 received).
The total number of interactions per learner is six. However, since each interaction involves two learners (the giver and the receiver of feedback), we do not need to double-count these interactions for the total count in the system. Hence, the total number of interactions for each learner is directly 6, without further adjustments for double-counting.
Therefore, the total number of learning interactions in the system can be represented as:
Given this setup, the complexity or scalability of the system in terms of learning interactions relative to the number of participants N is linear. This is because the total number of interactions increases directly in proportion to the number of learners. Thus, the Big O notation would be:
This indicates that the total number of learning interactions scales linearly with the number of learners. In this configuration, as the number of learners increases, the total number of interactions increases at a linear rate, which is more scalable and manageable than the quadratic rate seen in the peer-to-peer model where every learner interacts with every other learner. Learn more: There is no scale.
The Geneva Learning Foundation is pleased to announce the tenth edition of Teach to Reach, to be held 20-21 June 2024.
Teach to Reach is a massive, open peer learning event where health professionals network, and learn with colleagues from all over the world. Request your invitation…
Teach to Reach 10 continues a tradition of groundbreaking peer learning started in 2020, when over 3,000 health workers from 80 countries came together to improve immunization training.
17,662 health professionals – over 80% from districts and facilities, half working for government – participated in Teach to Reach 9 in October 2023. Participants shared 940 experiences ahead of the event. See what we learned at Teach to Reach 9 or view Insights Live with Dr Orin Levine.
Teach to Reach is a platform, community, and network to amplify voices from lower-resource settings bearing the greatest burden of disease.
Poor connectivity? You will find the videos on this page in the low-bandwidth, audio-only Teach to Reach podcast on Apple, Spotify, Google, or Amazon Podcasts.
Alongside this theme, other critical health challenges selected by participants for this tenth edition include the Movement for Immunization Agenda 2030 (IA2030), neglected tropical diseases (NTDs), and neglected needs of women’s health.
In this video of a Teach to Reach session, learn about local action led by community-based health workers to tackle Female Genital Schistosomiasis (FGS), a neglected tropical disease that affects an estimated 56 million women and girls.
In the run-up to Teach to Reach 10, participants will share their real-world experience. Every success, lessons learned, and challenge will be shared back with the community and brought to the attention of partners.
A diverse range of over 50 global organizations have partnered with Teach to Reach since 2020, including Gavi the Vaccine Alliance, the Wellcome Trust, and UNICEF.
The next video is a session with UNICEF on reaching zero-dose children in urban settings.
Alongside global partners and ministries of health, local community-based organizations will also be invited to become Teach to Reach partners.
Partners are invited to join the first Partner Briefing on Monday 4 March 2024, bringing together global health organizations with a commitment to listening and learning from health workers and the communities they serve.
