Community-based monitoring for immunization

Integrating community-based monitoring (CBM) into a comprehensive learning-to-action model

Reda SadkiGlobal health

According to Gavi, “community-based monitoring” or “CBM” is a process where service users collect data on various aspects of health service provision to monitor program implementation, identify gaps, and collaboratively develop solutions with providers. By engaging service users, CBM aims to foster greater accountability and responsiveness to local needs. The Geneva Learning Foundation’s innovative learning-to-action model offers a compelling framework within which CBM could be applied to immunization challenges. The model’s comprehensive design creates an enabling environment for effectively integrating diverse monitoring data sources – and this could include community perspectives. Health workers as trusted community advisers… and members of the community A distinctive feature of TGLF’s model is its emphasis on health workers’ role as trusted advisors to the communities they serve. The model recognizes that local health staff are not merely service providers, but often deeply embedded community members with intimate knowledge of local realities. For example, in …

Heini Utenen OpenWHO confusion about methods and learner preferences

Why asking learners what they want is a recipe for confusion

Reda SadkiGlobal health, Theory

A survey of learners on a large, authoritative global health learning platform has me pondering once again the perils of relying too heavily on learner preferences when designing educational experiences. One survey question intended to ask learners for their preferred learning method. The list of options provided includes a range of items. (Some would make the point that the list conflates learning resources and learning methods, but let us leave that aside for now.) Respondents’ top choices (source) were videos, slides, and downloadable documents. At first glance, this seems perfectly reasonable. After all, should we not give learners what they want? As it happens, the main resources offered by this platform are videos, slides, and other downloadable documents. (If we asked learners who participate in our peer learning programmes for their preference, they would likely say that they prefer… peer learning.) Beyond this availability bias, there is a more significant …

Petra Klepac Climate change, malaria and neglected tropical diseases-a scoping review

Klepac and colleagues‘ scoping review of climate change, malaria and neglected tropical diseases: what about the epistemic significance of health worker knowledge?

Reda SadkiGlobal health

By Luchuo E. Bain and Reda Sadki The scoping review by Klepac et al. provides a comprehensive overview of codified academic knowledge about the complex interplay between climate change and a wide range of infectious diseases, including malaria and 20 neglected tropical diseases (NTDs). The review synthesized findings from 511 papers published between 2010 and 2023, revealing that the vast majority of studies focused on malaria, dengue, chikungunya, and leishmaniasis, while other NTDs were relatively understudied. The geographical distribution of studies also varied, with malaria studies concentrated in Africa, Brazil, China, and India, and dengue and chikungunya studies more prevalent in Australia, China, India, Europe, and the USA. One of the most striking findings of the review is the potential for climate change to have profound and varied effects on the distribution and transmission of malaria and NTDs, with impacts likely to vary by disease, location, and time. However, the …

Climate Change and Health Perspectives from Developing Countries

Climate change and health: perspectives from developing countries

Reda SadkiGlobal health

Today, the Geneva Learning Foundation’s Charlotte Mbuh delivered a scientific presentation titled “On the frontline of climate change and health: A health worker eyewitness report” at the University of Hamburg’s Online Expert Seminar on Climate Change and Health: Perspectives from Developing Countries. Mbuh shared insights from a report based on observations from frontline health workers on the impact of climate change on health in their communities. Investing in the health workforce is vital to tackle climate change: A new report shares insights from over 1,200 on the frontline Climate change is a threat to the health of the communities we serve: health workers speak out at COP28 The Geneva Learning Foundation, a Swiss non-profit, facilitated a special event “From community to planet: Health professionals on the frontlines of climate change” on 28 July 2023, engaging 4,700 health practitioners from 68 countries who shared 1,260 observations. “93% of respondents believed that …

Visual storytelling impacts of climate change on health

Making the invisible visible: storytelling the health impacts of climate change

Reda SadkiGlobal health

On March 18, 2024, the Geneva Learning Foundation (TGLF) hosted a workshop bringing together 553 health workers from 55 countries with TGLF’s First Fellow of Photography and award-winning photographer Chris de Bode. Watch the workshop in English and in French. Poor connectivity? Get the audio-only podcast. The dialogue focused on exploring the power of health workers who are there every day to communicate the impacts of climate change on the health of those they serve. Learn more… The Geneva Learning Foundation’s exploration of visual storytelling began, two years ago, with a simple yet powerful call to action for World Immunization Week: “Would you like to share a photo of your daily work, the work that you do every day?” Over 1,000 photos were shared within two weeks. “We repeated this in 2023, to show that it is people who make #VaccinesWork”, explains Charlotte Mbuh, the Foundation’s deputy director. Watch the 2022 …

Examples of double-loop learning in global health

Five examples of double-loop learning in global health

Reda SadkiWriting

Read this first: What is double-loop learning in global health? Example 1: Addressing low uptake of a vaccine program Single–Loop Learning: Improve logistics and supply chain management to ensure consistent vaccine availability at clinics. Double–Loop Learning: Engage with community leaders to understand cultural beliefs and concerns around vaccination, and co-design a more localized and trustworthy immunization strategy. What is the difference? Double-loop learning questions the assumption that the primary goal should be to increase uptake at all costs. It considers whether the program design respects community autonomy and addresses their real concerns. It may surface competing values of public health impact vs. community self-determination. Example 2: Responding to an infectious disease outbreak Single–Loop Learning: Rapidly mobilize health workers and supplies to affected areas to contain the outbreak following established emergency protocols. Double–Loop Learning: Critically examine why the health system was vulnerable to this outbreak, and work with communities to redesign …

Why learning culture is the missing link between learning and performance in global health

Learning culture: the missing link in global health between learning and performance

Reda SadkiGlobal health

Read this first: What is double-loop learning in global health? Learning culture is a critical concept missing from health systems research. It provides a practical and actionable framework to operationalize the notion of ‘learning health systems’ and drive transformative change. Watkins and Marsick describe learning culture as the capacity for change. They identify seven key action imperatives or “essential building blocks” that strengthen it: continuous learning opportunities, inquiry and dialogue, collaboration and team learning, systems to capture and share learning, people empowerment, connection to the environment, and strategic leadership for learning (Watkins & O’Neil, 2013). Crucially, the instrument developed by Watkins and Marsick assesses learning culture by examining perceptions of norms and practices, not just individual behaviors (Watkins & O’Neil, 2013). This aligns with Seye Abimbola’s assertion that learning in health systems should be “people-centred” and occurs at multiple interconnected levels. Furthermore, this research demonstrates that certain dimensions of learning …

What is double loop learning in global health

What is double-loop learning in global health?

Reda SadkiGlobal health

Argyris (1976) defines double-loop learning as occurring “when errors are corrected by changing the governing values and then the actions.” He contrasts this with single-loop learning, where “errors are corrected without altering the underlying governing values.” This is challenging because it can threaten one’s sense of competence and self-image. ‘Are we doing things right?’ vs. ‘Are we doing the right things?’ In global health, double-loop learning means not just asking “Are we doing things right?” but also “Are we doing the right things?” It means being willing to challenge long-held assumptions about what works, for whom, and under what conditions. Epistemological assumptions (“we already know the best way”), methodological orthodoxies (“this is not how we do things”), and apolitical stance (“I do health, not politics”) of epidemiology can predispose practitioners to be dismissive of a concept like double-loop learning.  Learn more: Five examples of double-loop learning in global health Seye …