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Tag: Charlotte Mbuh

  • 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

  • Climate change and health: perspectives from developing countries

    Climate change and health: perspectives from developing countries

    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 there was a link between climate change and health, and they reported a direct local experience of a wide range of climatic and environmental impacts,” Mbuh stated.

    The most commonly reported impacts were on farming and farmland, the distribution of disease-carrying insects, and urban areas becoming hotter.

    Health impacts linked to these climatic and environmental changes included increased malnutrition and/or undernutrition, increased waterborne diseases, and changes to the incidence and distribution of vector-borne diseases.

    Mbuh emphasized that these impacts were particularly prevalent in smaller communities or mid-sized towns.

    Mbuh highlighted the unique role of frontline health workers as trusted advisors to their communities: “Frontline health workers are trusted advisors of the communities that they serve, and they have unique insights to local realities and are strategically positioned to bring about change,” she said.

    The Geneva Learning Foundation aims to leverage its digitally-enabled peer learning network of health workers to drive change across different levels of the health system and geographical boundaries.

    Mbuh concluded : “These experiences demonstrate the importance of community engagement, sustainable practices, and support from relevant stakeholders in addressing the climate health nexus and building resilience in the face of a changing climate.”

    The presentation underscored the urgent need to invest in frontline health workers at the local level to build resilience against the impacts of climate change on health, particularly in vulnerable communities in developing countries.

    The event was organized by the International Expert Centre of Climate Change and Health (IECCCH) at the Research and Transfer Centre Sustainable Development and Climate Change Management, Hamburg University of Applied Sciences, in collaboration with the European School of Sustainability Science and Research (ESSSR), the UK Consortium on Sustainability Research (UK-CSR), and the Inter-University Sustainable Development Research Programme (IUSDRP).

    Photo: The Geneva Learning Foundation Collection © 2024

  • Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

    Climate change is a threat to the health of the communities we serve: health workers speak out at COP28

    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.

    By standing together, we all stand to do better.

    Thank you.

  • Learning from Frontline Health Workers in the Climate Change Era

    Learning from Frontline Health Workers in the Climate Change Era

    By Julie Jacobson, Alan Brooks, Charlotte Mbuh, and Reda Sadki

    The escalating threats of climate change cast long shadows over global health, including increases in disease epidemics, profound impacts on mental health, disruptions to health infrastructure, and alterations in the severity and geographical distribution of diseases.

    Mitigating the impact of such shadows on communities will test the resilience of health infrastructure in low- and middle-income countries (LMICs) and especially challenge frontline health workers. The need for effective and cost-efficient public health interventions, such as immunization, will evolve and grow.

    Health workers, approximately 70% of which are women, that provide immunization and other health services will be trusted local resources to the communities they serve, further amplifying their centrality in resilient health systems.

    Listening to and building upon the experiences and insights of frontline health workers as they live with and increasingly work to address the manifestations of climate change on health is pivotal to the collective, global response today and in the years to come.

    We imagine a future of health workers connected to each other, learning directly from the successes and challenges of others by choosing to engage in digital, peer-supported, peer-learning networks regardless of the remoteness or location of their communities. Success will lie in a nimbleness and ability to quickly see new emerging patterns and respond to evolving needs of individuals and communities.

    Such a future shines a light on the importance of new ways of thinking about global health, leadership, who should have a “voice”, starting from a position of equity not hierarchy, and the value that peers ascribe to each other. The hyperlocal impact of climate change on health cannot be mitigated only through global pronouncements and national policies. It requires local knowledge and understanding.

    Recognizing this unique position of health workers, Bridges to Development and The Geneva Learning Foundation, two Swiss non-profits, are supporting this first-ever, large peer-learning event for frontline health workers to share their experiences and insights on climate change and health.

    More than 1,100 health workers have already shared their observations of changes in climate and health affecting the communities they serve in over 60 countries. They will be sharing their stories and insights at the Special Event: From community to planet: Health professionals on the frontlines of climate change, but you can already read short summaries from Guatemala; India and Mongolia; Bénin, Gambia, and Kenya.

    Starting from a Call to Action shared through the Movement for Immunization Agenda (IA2030), the call has “gone viral” through local communities and districts: over 4,500 people – most of them government workers involved in primary health care services in LMICs – registered to participate and contribute.

    Almost every health worker responding says that they are very worried about climate change, and that, for them, it is already a grave threat to the health of the communities they serve.

    Taken together, their observations, while imperfect, paint a daunting picture. This picture, consistent with global statistics and other data, helps to bring to life global pronouncements of the dire implications of climate change for health in LMICs.

    Amid this immense and dire challenge lies an opportunity to shift from a rigid, academically-dominated approach to a decentralized, democratized recognition and learning about the health impacts of climate change. This shift underscores the importance of amplifying insights from those who are bearing the brunt of the consequences of climate change, and recognizing the special role of health service workers as bridges between their communities and those working elsewhere to address similar challenges.

    This perspective requires those of us working at the global level to critically evaluate and challenge our biases and assumptions. The notion that only climate or health specialists can offer meaningful insights or credible solutions should be questioned. The understanding of climate change’s impact on epidemiology of disease, mental health and other manifestations – and the strategies employed to mitigate them – can be substantially enriched and sharpened by welcoming the voices of those on the frontlines. By doing so, we can foster a more comprehensive, inclusive, equitable and effective response to the challenges posed by climate change.

    The thousands of members of the Movement for the Immunization Agenda 2030 (IA2030) and others who have initiated this global dialogue around climate and health may be forging a new path, showing the feasibility and value of the global health community listening to and supporting the potential of frontline health workers to shine the brightest of lights into the shadow cast worldwide by climate change.

    This editorial is a contribution to the Special Event: From community to planet: Health professionals on the frontlines of climate change.

    About the authors

    Julie Jacobson and Alan Brooks are co-founders and managing partners of Bridges to Development. Jacobson was the president of the American Society for Tropical Medicine and Hygiene (ASTMH) in 2020-2021. Bridges to Development, a nonprofit founded in 2018 based in Europe and the US, strives to build on the world’s significant progress to date towards a stronger and more resilient future.

    Reda Sadki and Charlotte Mbuh lead the Geneva Learning Foundation (TGLF). The Geneva Learning Foundation (TGLF) is a non-profit implementing its vision to catalyze transformation through large scale peer and mentoring networks led by frontline actors facing critical threats to our societies. Learn more: https://doi.org/10.5281/zenodo.7316466.

    Illustration: The Geneva Learning Foundation Collection © 2023. All rights reserved.