Humanitarian, global health, and development organizations confront an unprecedented crisis. Donor funding is in a downward spiral, while needs intensify across every sector. Organizations face stark choices: reduce programs, cut staff, or fundamentally transform how they deliver results.
Traditional capacity building models have become economically unsustainable. Technical assistance, expert-led workshops, international travel, and venue-based training are examples of high-cost, low-volume activities that organizations may no longer be able to afford.
Yet the need for learning, coordination, and adaptive capacity has never been greater.
The opportunity cost of inaction
Organizations that fail to adapt face systematic disadvantage. Traditional approaches cannot survive current funding constraints while maintaining effectiveness. Meanwhile, global challenges intensify: climate change drives new disease patterns; conflict disrupts health systems; demographic transitions strain capacity.
These complex, interconnected challenges require adaptive systems that respond at the speed and scale of emerging threats. Organizations continuing expensive, ineffective approaches will face programmatic obsolescence.
Working with governments and trusted partners that include UNICEF, WHO, Gates Foundation, Wellcome Trust, and Gavi (as part of the Zero-Dose Learning Hub), the Geneva Learning Foundation’s peer learning networks have consistently demonstrated they can deliver measurably superior outcomes while reducing costs by up to 86% compared to conventional approaches.
Peer learning networks offer both immediate financial relief and strategic positioning for long-term sustainability. The evidence spans nine years, 137 countries, and collaborations with the most credible institutions in global health, humanitarian response, and research.
The unsustainable economics of traditional capacity building
A comprehensive analysis reveals the structural inefficiencies of conventional approaches. Expert consultants command daily rates of $800 or more, plus travel expenses. International workshops may require $15,000-30,000 for venues alone. Participant travel and accommodation averages $2,000 per person. A standard 50-participant workshop costs upward of $200,000.
When factoring limited sustainability, the economics become even more problematic. Traditional approaches achieve measurable implementation by only 15-20% of participants within six months. This translates to effective costs of $10,000-20,000 per participant who actually implements new practices.
A rudimentary cost-benefit analysis demonstrates how peer learning networks restructure these economics fundamentally.
Value for money requires clear attribution between investments and outcomes.
In January 2020, we compared outcomes between two groups. Both had intent to take action to achieve results. Health workers using structured peer learning were seven times more likely to implement effective strategies resulting in improved outcomes, compared to the other group that relied on conventional approaches.
In July 2024, working with Nigeria’s National Primary Health Care Development Agency (NPHCDA) and UNICEF, we connected 4,300 health workers across all states and 300+ local government areas within two weeks. Over 600 local organizations including government facilities, civil society, faith-based groups, and private sector actors joined this Immunization Collaborative.
With two more weeks, participants produced 409 peer-reviewed root cause analyses. By Week 6, we began to receive credible vaccination coverage improvements after six weeks, especially in conflict-affected northern regions where conventional approaches had consistently failed. The total programme cost was equivalent to 1.5 traditional workshops for 75 participants. Follow-up has shown that more than half of the participants are staying connected long after TGLF’s “jumpstarting” activities, driven by intrinsic motivation.
Côte d’Ivoire demonstrates crisis response capability. Working with Gavi and the Ministry of Health, we recruited 501 health workers from 96 districts (85% of the country) in nine days ahead of the country’s COVID-19 vaccination campaign in November 2021. Connected to each other, they shared local solutions and supported each other, contributing to vaccination of an additional 3.5 million additional people at $0.26 per vaccination delivered.
These cases illustrate the ability of TGLF’s model to address strategic global priorities—equity, resilience, and crisis response—while maximizing efficiency. This model offers a scalable, low-cost alternative that delivers measurable impact across diverse priorities.
Our mission is to share such breakthroughs with other organizations and networks that are willing to try new approaches.
Resource allocation for maximum efficiency
Our partnership analysis reveals optimal resource allocation patterns that maximize impact while minimizing cost:
Human resources (85%): Action-focused approach leveraging human facilitation to foster trust, grow leadership capabilties, and nurture networks with a single-minded goal of supporting implementation to rapidly and sustainably achieve tangible outcomes.
Digital infrastructure (10%): Scalable platform development enabling unlimited concurrent participants across multiple countries.
Travel (5%): Minimal compared to 45% in traditional approaches, limited to essential coordination where social norms require face-to-face meetings, for example in partnership engagement with governments.
This structure enables remarkable economies of scale. While traditional approaches face increasing per-participant costs, peer learning networks demonstrate decreasing unit costs with growth. Global initiatives reaching 20,000+ participants across 60+ countries operate with per-participant costs under $10.
Sustainability through combined government and civil society ownership
Sustainability is critical amidst funding cuts. TGLF’s networks embed organically within government systems, involving both central planners in the capital as well as implementers across the country, at all levels of the health system.
Country ownership: Programs work within existing health system structures and national plans. Networks include 50% government staff and 80% district/community-level practitioners—the people who actually deliver services. In Nigeria, 600+ local organizations – both private and public – collaborated, embedding learning in both civil society and government structures.
Sustainability: In Côte d’Ivoire, 82% sustained engagement without incentives, fostering self-reliant networks. 78% said they no longer needed any assistance from TGLF to continue.
This approach enhances aid effectiveness, reducing dependency on external funding.
Aid effectiveness: Rather than bypassing systems, peer learning strengthens existing infrastructure. Networks continue functioning when external funding decreases because they operate through established government channels linked to civil society networks.
Transparency: Digital platforms create comprehensive audit trails providing unprecedented visibility into program implementation and results for donor oversight.
Implementation pathways for resource-constrained organizations
Organizations can adopt peer learning approaches through flexible pathways designed for immediate deployment.
Rapid response initiatives (2-6 weeks to results): Address critical challenges requiring immediate mobilization. Suitable for disease outbreaks, humanitarian emergencies, or longer-term policy implementation.
Program transformation (3-6 months): Convert existing technical assistance programs to peer learning models, typically reducing costs by 80-90% while expanding reach, inclusion, and outcomes.
Cross-portfolio integration: Single platform investments serve multiple technical areas and geographic regions simultaneously, maximizing efficiency across donor portfolios with marginal costs approaching zero for additional countries or topics.
The strategic choice
The funding environment will not improve. Economic uncertainty in traditional donor countries, competing domestic priorities, and growing skepticism about aid effectiveness create permanent pressure for better value for money.
Organizations face a fundamental choice: continue expensive approaches with limited impact, or transition to emergent models that have already shown they can achieve superior results at dramatically lower cost while building lasting capability.
The question is not whether to change—budget constraints mandate adaptation. The question is whether organizations will choose approaches that thrive under resource constraints or continue hoping that some donors will fill the gaping holes left by funding cuts.
The evidence demonstrates that peer learning networks achieve 86% cost reduction while delivering 4x implementation rates and 30x longer engagement. These gains are not theoretical—they represent verified outcomes from active partnerships with leading global institutions.
In an era of permanent resource constraints and intensifying challenges, organizations that embrace this transformation will maximize their mission impact. Those that do not will find themselves increasingly unable to serve the communities that depend on their work.
Since 2019, when The Geneva Learning Foundation (TGLF) launched its first AI pilot project, we have been exploring how the Second Machine Age is reshaping learning. Ahead of the release of the first framework for AI in global health, I had a chance to sit down with a group of Swiss business leaders at the PanoramAI conference in Lausanne on 5 June 2025 to share TGLF’s insights about the significance and potential of artificial intelligence for global health and humanitarian response. Here is the article posted by the conference to recap a few of the take-aways.
The Global Equity Challenger
At the Panoramai AI Summit, Reda Sadki, leader of The Geneva Learning Foundation, delivered provocative insights about AI’s impact on global equity and the future of human work. Drawing from humanitarian emergency response and global health networks, he challenged comfortable assumptions about AI’s societal implications.
The job displacement reality
Reda directly confronted panel optimism about job preservation: “One of the things I’ve heard from fellow panelists is this idea that we can tell employees AI is not coming for your job. And I struggle to see that as anything other than deceitful or misleading at best. ”
Eliminating knowledge worker positions in education
“In one of our programmes, after six months we were able to use AI to replace key functions initially performed by humans. Humans helped us figure out how to do it. We then refocused a smaller team on tasks that we cannot or do not want to automate. We tried to do this openly.”
What’s left for humans to do?
“These machines are already learning faster and better than us, and they are doing so exponentially. Right now, what’s left for humans currently is the facilitation, facilitating connections in a peer learning system. We do not yet have agents that can facilitate, that can read the room, that can help humans understand.”
Global access inequities
Reda highlighted three critical equity challenges: geographic access restrictions (‘geolocking’), transparency expectations around AI usage, and punitive accountability systems that discourage innovation in humanitarian contexts. “Somebody who uses AI in that context is more likely to be punished than rewarded, even if the outcomes are better and the costs are lower. ”
Emerging markets disconnect
“Even though that’s where the future markets are likely to be for AI, ” Reda observed limited engagement with Africa, Asia, and Latin America among attendees, highlighting a strategic blindness to global AI market evolution.
Organizational evolution question
Reda posed fundamental questions about future organizational structures, questioning whether traditional hierarchical models with management layers will remain dominant “two years or five years down the line. ”
Network-based innovation vision
“We’ve nurtured the emergence of a global network of health workers sharing their observations of climate change impacts on the health of communities they serve. This is already powerful for preparedness and response, but we’re trying to find ways to weave in and embed AI as co-workers and co-thinkers to help health workers harness messy, complex, large-volume climate data.”
Exponential learning challenge
“These machines are already learning faster and better than us and that, and they’re doing so exponentially better than us. It’s pretty clear what, you know, what keeps me awake at night is what what’s left for humans. ”
Key Achievement: Reda demonstrated how honest assessment of AI’s transformative impact requires abandoning comfortable narratives about job preservation, positioning global leaders to address equity challenges while identifying uniquely human capabilities in an AI-augmented world.
Reda Sadki serves as Executive Director of The Geneva Learning Foundation (TGLF), a Swiss non-profit. Concurrently, he maintains his position as Chief Learning Officer at Learning Strategies International (LSi) since 2013, where he helps international organizations improve their change execution capabilities. TGLF, under his guidance, catalyzes large-scale peer networks of frontline actors across 137 countries, developing learning experiences that transform local expertise into innovation and measurable results.
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.
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.
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.
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.
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.
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.
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 learning and development (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 by conventional learning and development practitioners.
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 learning and development 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).
Reda started with an e-learning course, which he supplemented by interactive, community building, and knowledge creation features offered by Scholar, a learning platform developed by Bill Cope and Mary Kalantzis (Marsick et al., 2021, pp. 185-186).
Scholar’s learning analytics enabled him to tailor learning to learner preferences and to continually check outcomes and adjust next steps.
See Figure 4.3, which lays out the full learning cycle, a combination of interventions that Reda assembled over time to support peer learning-based work—“work that privileges learning in order to build individual and organizational capacity to better address emergent challenges or opportunities” (Marsick et al., 2021, p.177).
In his initiative, over a period of 12-18 months, participants develop and implement projects related to local immunization initiatives.
To date, participants have come from 120 countries.
In this vignette, Reda Sadki reflects on how this new model for learning and development evolved over time, and how L&D is transformed in a connected, networked learning environment.
My reframe of learning and development started when I wrote to Bill Cope and Mary Kalantzis, respectively professor and dean of the University of Illinois College of Education, after I was appointed Senior Officer for Learning Systems at the International Federation of Red Cross and Red Crescent Societies (IFRC). I shared my strategy for the organization of facilitation, learning, and sharing of knowledge. I thought my strategy was brilliant. (At the time, I was already thinking that this was about more than learning and development…)
They replied that these were interesting ideas, but I was missing the point because this is not learning. What I shared focused on publishing knowledge in different ways, but not on creation of knowledge as key to the learning process.
That was a shock to me.
So, the first realization about the limits of current thinking about learning and development came from Bill and Mary challenging me by saying: “What are people actually getting to do? You know, that’s where the learning is likely to happen.”
I could see they had a point, but I didn’t know what it meant.
I reflected on recent work I had done for the IFRC, where I was responsible for a pipeline of 80 or so e-learning modules.
These information transmission modules were extremely limited, had very little impact.
But there is a paradox, which is that people across the Red Cross who we were trying to reach were really excited and enthusiastic about them.
I had not designed these modules.
It was 500 screens of information with quizzes at the end.
It violated every principle of learning design.
And yet people loved it and were really proud to have completed it.
The second realization was that what made people excited using the most boring format and medium was that this was the first time in their life that they were connecting in a digital space with something that spoke to their IFRC experience.
So, the driver was learning.
People come to the Red Cross and Red Crescent because they want to learn first aid skills, to prepare for a disaster, or to recover from one.
Previously, that was an entirely brick-and-mortar experience.
You have Red Cross branches pretty much everywhere in the world.
It’s a very powerful social peer learning experience.
The trainer teaching you is likely to be someone like you from your community.
You meet people with like-minded values.
And so, however inadequate, the digital parallel to that existed, and it helped people connect with their Red Cross culture, but in a digital space.
With that insight, the learning platform became the fastest-growing digital system in the entire Red Cross Red Crescent Movement.
That was the connection of learning and development to complexity and networks.
I read Marsick and Watkins in the ’80s and ’90s. Informal and incidental learning mattered then. Its significance would explode with the digital transformation.
In my mind , that is what Siemens tapped into in the 2000s, through the lenses of digital network, complexity, and systems theory.
The Internet leads to a different kind of thinking and doing.
His theory of learning, connectivism, grew out of that difference.
January of 2011, Ivy League universities began to publish massive open online courses (MOOCs), three years after George Siemens and his Canadian colleagues had coined the term while implementing connectivism.
Stanford professors had 150,000 people in their artificial intelligence MOOC, alongside 400 people who took the same course on the Stanford campus.
Learning at scale is an important part of problem-solving complex challenges.
It is also important for peer learning and innovation: the greater the scale, the greater the diversity of inputs that we can use to support each other’s learning.
Nine years later, at the Geneva Learning Foundation, we had digital scaffolding or learning infrastructure already in place.
I had been working, since 2016, with the World Health Organization, to help country-based immunization staff translate global guidelines, norms, and standards into practice.
The COVID-19 Scholar Peer Hub became a digital network hosted by The Geneva Learning Foundation (TGLF) and developed with over 600 health worker alumni from all over the world.
We began to understand not only learningat scale, but also design at scale.
The Peer Hub launched in July 2020 and connected over 6,000 health professionals from 86 countries to contribute to strengthening skills and supporting implementation of country COVID-19 plans of action for vaccination, and to recover from the damage wrought by the pandemic.
Our network, platform, and community tripled in size, in less than six months.
Using social network analysis (SNA), Sasha Poquet explored the value of such a learning environment, one that builds a community of learning professionals, and that has ongoing activities to maintain the community both short- and long term, where you educate through various initiatives rather than create individual communities for each independent offering.
It’s a holistic system of systems, in which everything is connected to everything, and every component is like a fractal embedded in the other components.
This is not an abstract concept. We have found ways to actually implement this, in practical ways, with startling outcomes.
That’s where we have moved in rethinking learning and development.
You help people learn by connecting to each other, and by understanding the informal, incidental nature of learning.
Yet these are two competing frameworks that collide, contradict, and are superimposed on top of each other.
Both are helpful at specific times.
In general, you can recognize the tensions and say: “Well, let’s put each one in front of the problem. Let’s see what we gain by applying each. Let’s reconcile in situ what the contradictory things are that we learn through these different lenses and then make decisions and figure out what the design elements look like.”
What does it give to hold these notions of community and network in creative tension with one another?
It’s kind of like a fruit salad where you mix all these fruits together and the juice you get at the bottom of the bowl tends to be really delicious. That’s the best case.
The flip side can be confusion.
Some categories of learners just feel completely overwhelmed by being presented with multiple ways of doing something, having to make their own decisions in ways they’re simply not used to, being given too many choices or being put in contexts that are too ambiguous for there to be an easy resolution.
But if you think about the skills we need in a digital age—for navigating the unknown, accepting uncertainty, making decisions, that ability to look around the corner—we try to convey the message to people who are uncomfortable that if they don’t figure out how to overcome their discomfort, they’re probably going to struggle and not be ready to function in the age in which we live.
Evolution of a new model for learning and development
Looking back to early 2020, Reda described important insights from an early pre-course symposium offering lived experiences shared by course applicants combined with video archives drawn from prior conferences sponsored by the Bill & Melinda Gates Foundation.
Reda packaged selected recorded talks in a daily sequence, and interspersed it with networking discussions and sharing of experiences of immunization training by field-based practitioners.
For many, it was the first time they could go online and discover the experience of a peer, who could be from anywhere in the world.
It was a process of discovery – realizing you can literally and figuratively connect across distance with people who are like yourself.
We were able to create a conference-like experience, a metaphor that’s familiar to many—the combination of presentation and conversation and shared experience – by basically Scotch-taping together some older videos and editing a few stories from the real world.
Now, it was part of an overall process over several years that got us to that point—where we had formed a community, a digital community that was mature enough, that was sophisticated enough, to overcome the barriers they were facing and participate.
But still, it showed it could be done.
We began to try out our new ideas and practices.
In the first Teach to Reach Conference in January 2021, we designed with an organizing committee composed of over 500 alumni, we set up opportunities for people to pair of and talk to one another about their field experiences with vaccination.
Peer learning mattered more than ever, because participants were immunization staff getting ready to introduce new COVID-19 vaccines in developing countries.
There were no established norms and standards for how to do this.
The conference offered some 56 workshops and other formal sessions, plenaries, and interviews.
However, we discovered that the most meaningful learning was through some 14,000 networking meetings, where you pressed a button and you were randomly matched with someone else at the conference.
People now join group sessions where you listen to peers sharing their insights and experiences of vaccine hesitancy or other topics, and then you go off and network in one-to-one, private meetings and share your own experience, nourished by what happened in that group session; and also continue your learning in that very intimate way that you get through individual conversation that you don’t get in the anonymization of the Zoom rectangles.
Dialogue is great, but we are most interested in action that leads to results.
In every formal course, learners design a project around a real problem that they face, and use multiple learning resources to support learning in the context of that project.
An evaluation showed that people were already implementing projects and doing things with what they had learned.
How could we scaffold not just learning but actual project implementation?
In order to catalyze action, we added a number of components in a sequence, a deliberate pedagogical pattern designed on the basis of evidence from learning science combined with empirical evidence from our practice.
First, the Ideas Engine, where people share ideas and practices, and give and receive feedback on them.
That’s followed by situation analysis really getting to the root cause of the problem they’re facing. We just ask learners to ask “why” fives times. Half of learners found a root cause different from the one they had initially diagnosed.
And third, then, is action planning to clarify: What’s your goal? What are three corrective actions you’re going to take? How will you know that you have achieved your goal?
These are classic, conventional action planning questions.
The difference is the networked, peer learning model. It’s described by some learners as a “superpower”. Defying distance and many other boundaries, each person can tap into collective intelligence to accelerate their progress.
It has taken years to bring together the right components, in the right sequence, to encourage reflective practice, develop analytical competencies, higher-order learning… but in ways that link every step of thinking to doing, and where the end game is about improved health outcomes, not just learning outcomes.
That led us ultimately to the Impact Accelerator—that doesn’t have an end point.
It starts with four weeks of goal setting, focused on continuous quality improvement.
People initially declare very ambitious goals like, “By the end of the month I will have improved immunization coverage.” This is too broad to be useful, and seldom can be achieved within a month.
We help them set specific goals. For example: “By the end of the month, I will have presented the project to my boss and secured some funding”— and even that may be quite ambitious.
We help people figure out for themselves what they can actually do within the constraints they have.
Unlike “Grand Challenges” or other innovation tournaments, you don’t have a competitive element, you don’t have a financial incentive, and it still works.
The heart and soul of it is intrinsic motivation.
After these steps there’s ongoing longitudinal reporting.
Peer learning provides a new kind of accountability, as colleagues challenge each other to do better – and also to present credible results.
Basically, we’ll call you back and ask, what happened to that project you were doing? Did you finish it? Did you get stuck? if so, why? What evidence do you have that it’s made a difference? You share that with us and if you have good news to share, we’ll probably invite you to an inspirational event for the next cycle.
Challenges in inventing a new learning model
If you look at this from the point of view of the learner, the first point of contact is social.
It’s somebody they know who’s going to share with them on WhatsApp the invitation to join the program.
Second are steps that test motivation and commitment because they could be seen as barriers to entry, for example, a long questionnaire for the current full learning cycle.
To join the cycle, 6,185 people in the first two weeks took the time to answer 95 questions, generating over half a million data points and insights.
About 40% of people who start the questionnaire finish it, and then start receiving instructions in a flow of emails, to prepare for the next steps.
We could have reduced the number of questions, lowering the barrier to entry.
We start with didactic steps, combined with some inspirational messages, e.g., asking them to reflect on why they are committed to the program, or how they are going to organize their time.
We don’t know what the program design will look like until we’ve collected the applications and analyzed what people share about their biggest challenges because it’s all challenge-based.
For example, we may think there is a problem due to vaccine hesitancy. We may be right: vaccine hesitancy is frequently given as a significant challenge. But there may be some things that surprise us.
And so, we adapt every part of the design, and we keep doing that every day throughout the program, so there’s no disconnect between the design and the implementation.
The design is the content.
The first thing may be an inspirational event to connect with their intrinsic motivation, which we then tap into throughout the cycle.
In June 2022, for example, we had an event for the network that completed the first part of the full learning cycle.
We challenged people to share photos, showing them in the field, doing their daily work during World Immunization Week.
We received over 1,000 photos in about two weeks.
We organized a community event. It was a slide show: showing photos with music, reading the names of those who had contributed, inviting them to comment each other’s photos.
A big chunk of what we do addresses the affective domain of learning that is critical to complex problem-solving and usually incredibly hard to get to.
And what we saw were people in the room having those moments of coming to consciousness, realizing their problems are shared, and feeling stronger because of it.
It was online, but you could feel the emotion. Something very powerful that we do not quite know how to describe, measure, or evaluate.
People love peer learning in principle but still are wary.
They might wonder how they can trust what their peer says: What’s the proof I can rely on them? What happens if they let me down? How do I feel if I don’t own up to the expectations? What if I’m peer-reviewing the work of somebody who’s far more experienced than I am, or conversely, if I read somebody’s work and judge they didn’t have the time or make the effort to do something good?
We use didactic constraints to scaffold spaces of possibility: If your project is due by Friday, we announce that there will be no extension. By contrast, the choice of project is yours.
We’re not going to tell you what your challenge is in your remote village, so you define it. We will challenge you to put yourself to the test, to demonstrate that this is actually your toughest challenge.
Or to demonstrate that what you think is the cause is the actual root cause.
And then we’ll have a support system that has about 20 different ways in which people can not only receive support, but also give it to others.
For the technical support sessions, for example, we’ll say there are two reasons for joining. Either you have a technical issue you want to solve; or you’re doing so well, you have a little bit of time to give to help your colleagues.
This is just one example of how we encourage connections between peers.
It took us years to find the right way to formulate the dialectic between those who are doing well, and those who are not. Are they really peers?
Over time, we gained confidence in peer learning after we adopted it.
We had prior experiences with learners who wanted an expert to tell them if their assignment was good or not.
Getting people to trust peer learning forced us to think through how we articulate the value of peer learning.
How do we help people understand that the limitations are there, but that they do not limit the learning?
An assumption in global health is that, in order to teach, you need technical expertise.
So if you are a technical expert, it is assumed that you can teach what you know.
We consider subject matter expertise, but if you are an expert and come to our event, you’re actually asked to listen, as a guide on the side rather than a sage on the stage.
You do not get to make a presentation, at least not until learners have experienced the power of peer leraning.
You listen to what people are sharing about their experiences.
Then, you have a really important role, that is to respond to what you’ve heard and demonstrate that your expertise is relevant and helpful to people who are facing these challenges.
That has sometimes led to opposition when experts realize to what extent we flipped the prevailing model around.
Some people really embrace it.
Others get really scared.
One of the most recent shifts we have made is that we stopped talking about courses.
Courses are a very useful metaphor, but we are now talking about a movement for immunization.
In the past, we observed that people who dropped out felt shame and stopped participating.
Even if you are not actively participating, you’re still a member of the immunization movement.
People have participated as health professionals, as government workers, as members of civil society, in various kinds of movements since decolonization.
So the “movement” metaphor has a different resonance than that of “courses”.
We used to call the Monday weekly meeting a discussion group.
We’re now calling it a weekly assembly.
It is a term that speaks to the religiosity of many learners, as well as to those with social commitments in their local communities.
About ten years ago, I began to think of my goal for these discussion groups like the musician, the artist that you most appreciate, who really moves your soul, moves you, your every fiber and your body and your soul and your mind.
I remember in 1989 I went to a Pink Floyd concert.
When we left the concert, we were drenched in sweat.
I was exhausted and just had an exhilarating experience.
That’s what I would like people who participate in our events to feel.
I believe that’s key to fostering the dynamics that will lead to effective teaching and learning and change as an outcome.
We’re still light years away from that.
A global health researcher told me that when she joins our events, she feels like she is in church in her home country of Nigeria.
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.
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 Collective Intelligence 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 Collective Intelligence 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 Collective Intelligence 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.
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
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
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
Teach to Reach are fast-paced, dynamic digital events connecting local and global practitioners to each other in a new, potentially transformative shared dialogue.
Teach to Reach and other TGLF special events rally thousands, serving as powerful moments of inspiration, providing the amazing sensation of being connected with thousands of fellow, like-minded people and the impetus to transform this feeling into shared purpose and action.
Meet, network, and learn with colleagues from all over the world
Successive editions of TGLF’s flagship event series, “Teach to Reach: Connect”, enabled a cumulative total of 27,000 health professionals to share experiences, test approaches, and identify solutions with international experts listening and learning with them.
The global immunization community is now focused on “the big catch-up”, dealing with recovery of immunization services from the consequences of the COVID-19 pandemic, as countries – and immunization staff on the frontlines – work toward the goals of Immunization Agenda 2030 (IA2030).
At the Seventy-Fourth World Health Assembly, the Director General of the World Health Organization had called for “a broad social movement for immunization that will ensure that immunization remains high on global and regional health agendas and help to generate a groundswell of support or social movement for immunization”.
A Movement is larger than any one individual or organization. The Geneva Learning Foundation is one of many working to support this Movement. In March 2022, we launched a call for immunization staff at all levels of the health system to connect across boundaries of geography and hierarchy – to commit to working together to achieve the goals of Immunization Agenda 2030 (IA2030).
In 2022, over 10,000 health professionals, primarily government workers from districts and facilities, joined this movement and shared ideas and practices, analyzed root causes of their local immunization challenges, and developed and implemented corrective actions to tackle them, together. Learn more…
Today, we share an open-source Manifesto for how health services could develop in ways that we think would make them more effective, recognizing health workers and communities – and the expertise and experience they hold because they are “there every day” – at the centre of public health systems.
No vision or strategy can or should be developed as a pronouncement by a single organization of how things should be.
This Manifesto is an open-source draft because, in today’s complex world, we tackle challenges that no one country or organization can possibly overcome alone.
For such a manifesto to be meaningful requires the participation, and contribution of those on the frontlines of global health, in dialogue with global, regional, and country leaders.
This is why we are inviting you – along with more than 10,000 members of the Movement for Immunization Agenda 2030 (IA2030 – to bring to life and shape this Manifesto.
Version 1.0 of the manifesto was first shared in a special issue of The Double Loop, the Geneva Learning Foundation’s insights newsletter. Learn more…