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: On 1 December 2023, TGLF will be publishing a …

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 …