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Tag: Full Learning Cycle

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

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

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

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

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

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

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

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

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

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

    Experience sharing also helped build confidence and motivation.

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

    The sessions covered a wide range of critical immunization topics.

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

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

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

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

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

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

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

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

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

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

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

    However, the study also identifies areas for improvement.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    References

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

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

    Image: The Geneva Learning Foundation Collection © 2024

  • Pandemic preparedness through connected transnational digital networks of local actors

    Pandemic preparedness through connected transnational digital networks of local actors

    What is the link between pandemic preparedness, digital networks, and local action? In the Geneva Learning Foundation’s approach to effective humanitarian learning, knowledge acquisition and competency development are both necessary but insufficient. This is why, in July 2019, we built the first Impact Accelerator, to support local practitioners beyond learning outcomes all the way to achieving actual health outcomes.

    What we now call the Full Learning Cycle has become a mature package of interventions that covers the full spectrum from knowledge acquisition to implementation and continuous improvement. This package has produced the same effects in every area of work where we have been able to test it: self-motivated groups manifesting remarkable, emergent leadership, connected laterally to each other in each country and between countries, with a remarkable ability to quickly learn and adapt in the face of the unknown. Such networks have obvious relevant for pandemic preparedness.

    In 2020, we got to test this package during the COVID-19 pandemic, co-creating the COVID-19 Peer Hub with over 6,000 frontline health professionals, and building together the Ideas Engine to rapidly share ideas and practices to problem-solve and take action quickly in the face of dramatic consequences of the new virus on immunization services (largely due to fear, risk, and misinformation). By January 2021, over a third of Peer Hub members had successfully implemented their immunization service recovery project, far faster than colleagues who faced the same problems but worked alone, without a global support network. Once connected to each other, these country teams then organized inter-country peer learning to help them figure out “what works” for COVID-19 vaccine introduction and scale-up.

    Such a holistic approach is about mobilizing and connecting country-based impact networks for pandemic preparedness that reach and involve practitioners at the local levels, as well as national MoH leaders and planners – quite different from conventional approaches (whether online or face-to-face) to building capacity and preparedness.

    TGLF’s global health network and platform reach significant numbers of practitioners at all levels of the health system. It is not only the number of people who participate (47,000 as I write this) but also the depth of engagement and diversity of contexts that they work in. Globally, 21.2% face armed conflict; 24.5% work with refugees or internally-displaced populations; 61.6% work in remote rural; 47% with the urban poor; 35.7% support the needs of nomadic/migrant populations. This is across 110 countries, with over 70 percent in “high burden” countries. Many have deep experience in responding to epidemic outbreaks of all kinds. Health professionals who join come from all levels of the health system, but most are (logically) from health facilities and districts, the bottom of the health pyramid.

    Through the network and platform, they build lateral connections, forging bonds not only of knowledge but also of trust. They do this not because they are from the same profession, but primarily (we believe) because they face similar challenges and see the benefit of sharing their experience in support of each other. Engagement is voluntary (ie people opt in and contribute because they want to), with no per diem or other extrinsic incentives offered. The concern for both epidemic outbreak and pandemic preparedness is shared.

    Individuals develop and implement corrective actions to tackle the root causes of the challenges they are taking on, drawing on both peer learning and the best available global guidelines. For the IA2030 Movement, our largest initiative so far, participants are simultaneously implementing 1,024 projects in 99 countries, learning from each other what works, sharing successes, lessons learned, and challenges. Here are four examples of what collective action through digital networks looks like :

    • In Ghana, TGLF’s alumni (including national and regional MoH EPI directors) decided to organize online sessions country-wide to share the latest information about COVID-19 with local staff, starting in April 2020. They had learned how to use digital tools to find the best available global knowledge and to combine it with their local expertise and experience to inform collective action.
    • In Burkina Faso, the national EPI manager entrusted the first “masked” vaccination campaign to the TGLF alumni team, which has organized itself country-wide, with over half of alumni working in conflict-affected areas. He told me no one else had the network and the capacity for change to figure out quickly how to get this right.
    • In the Democratic Republic of Congo, the TGLF alumni team is increasingly being asked by national EPI to contribute to various activities, due to their effectiveness in connecting and coordinating. The alumni network is country-wide and includes many from very remote areas. When Monkeypox was reported in Europe and North America, we were already seeing a steady stream of information through the DRC and other country networks.

    We believe that this continuous learning and action is actually the definition of pandemic preparedness. Trying to imagine preparedness and response to new pandemics using old, failed methods of training and capacity building – whether face-to-face or online – is both dangerous and irrational.

    Image: Remote villages illuminated by rays of light, with mountains beyond mountains in the background. The Geneva Learning Foundation Collection.