Tag: funding crisis

  • When funding shrinks, impact must grow: the economic case for peer learning networks

    When funding shrinks, impact must grow: the economic case for peer learning networks

    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.

    ComponentTraditional approachPeer learning networksEfficiency gain
    Cost per participant$1,850$26786% reduction
    Implementation rate15-20%70-80%4x higher success
    Duration of engagement2-3 days90+ days30x longer
    Post-training supportNoneContinuous networkSustained capacity

    Learn more: Calculating the relative effectiveness of expert coaching, peer learning, and cascade training

    Evidence of measurable impact at scale

    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.

    What about speed and scale?

    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.

    TGLF’s model empowers health workers to share knowledge, solve local challenges, and implement solutions via a digital platform. Unlike top-down training and technical assistance, it fosters collective intelligence, enabling rapid adaptation to crises. Since 2016, TGLF has mobilized networks for immunization, COVID-19 response, neglected tropical diseases (NTDs), mental health and psychosocial support, noncommunicable diseases, and climate-health resilience.

    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.

    1. 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.
    2. 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.
    3. 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.

    Image: The Geneva Learning Foundation Collection © 2025

  • Global health: learning to do more with less

    Global health: learning to do more with less

    In a climate of funding uncertainty, what if the most cost-effective investments in global health weren’t about supplies or infrastructure, but human networks that turn learning into action? In this short review article, we explore how peer learning networks that connect human beings to learn from and support each other can transform health outcomes with minimal resources.

    The common thread uniting the different themes below reveals a powerful principle for our resource-constrained era: structured peer learning networks consistently deliver outsized impact relative to their cost.

    Whether connecting health workers battling vaccine hesitancy in rural communities, maintaining essential immunization services during a global pandemic, supporting practitioners helping traumatized Ukrainian children, integrating AI tools ethically, or amplifying women’s voices from the frontlines – each case demonstrates how connecting practitioners across geographical and hierarchical boundaries transforms individual knowledge into collective action.

    When health systems face funding shortfalls, these examples suggest that investing in human knowledge networks may be the most efficient approach available: they adapt to local contexts, identify solutions that work without additional resources, spread innovations rapidly, and build resilience that extends beyond any single intervention.

    As one practitioner noted, “There’s a lot of trust in our network” – a resource that, unlike material supplies, grows stronger the more it’s used.

    Sustaining gains in HPV vaccination coverage without additional resources

    Recent analysis from TGLF’s Teach to Reach programme is providing valuable insights that both confirm and extend our understanding about what drives successful vaccination campaigns.

    “Through peer learning networks, we discovered, for example, that tribal communities may show less vaccine hesitancy than urban populations, teachers could be more influential than health workers in driving vaccination acceptance, and religious institutions can become powerful allies,” explains TGLF’s Charlotte Mbuh. Other strategies include cancer survivors serving as advocates, WhatsApp groups connecting community health workers, and schoolchildren becoming effective messengers to initiate family conversations about vaccination

    TGLF’s findings are based on analysis of implementation strategies shared by over 16,000 health professionals. Because they emerged through peer learning activities, participants got an immediate benefit. Now the real question is whether global partners and funders are recognize the significance and value of such field-based insights.

    Most remarkably, analysis revealed that “success was often independent of resource levels” and “informal networks proved more important than formal ones” in sustaining high HPV vaccination coverage – suggesting that alongside material inputs, knowledge connections play a critical and often undervalued role.

    Read the full article: HPV vaccination: New learning and leadership to bridge the gap between planning and implementation

    5 years on: what the COVID-19 Peer Hub taught us about pandemic preparedness

    When routine immunization services faced severe disruption in 2020, placing over 80 million children at risk, TGLF and the Bill & Melinda Gates Foundation (BMGF) supported a digital network connecting more than 6,000 frontline health workers across Africa, Asia, and Latin America. The results demonstrate why knowledge networks matter during crises.

    Within just 10 days, the network generated 1,200+ ideas and developed 700 peer-reviewed action plans. Most significantly, implementation rates were seven times higher than conventional approaches, with collaborative participants achieving 30% better outcomes in maintaining essential health services.

    “This approach complemented traditional models by recognizing frontline workers as experts in their own contexts,” says Mbuh. Quantitative assessment showed structured peer learning achieved efficacy scores of 3.2 on a 4-point scale, compared to 1.4 for traditional cascade training – providing evidence that practitioners benefit from both expert guidance and structured horizontal connections.

    Read the full article: How can we reliably spread evidence-based practices at the speed and scale modern health challenges demand?

    Peer learning for Psychological First Aid: Supporting Ukrainian children

    The EU-funded programme on Psychological First Aid (PFA) for children affected by the humanitarian crisis in Ukraine reveals how peer learning creates value that enhances technical training.

    During a recent ChildHub webinar, TGLF’s Reda Sadki outlined five unique benefits practitioners gain: contextual wisdom that complements standardized guidance, pattern recognition across diverse cases, validation of experiential knowledge, real-time problem-solving for urgent challenges, and professional resilience in difficult circumstances.

    One practitioner, Serhii Federov, helped a frightened girl during rocket strikes by focusing on her teddy bear – illustrating how field adaptations enrich formal protocols. Another noted: “There is a lot of trust in our network,” highlighting how sharing experiences reduces isolation while building technical capacity.

    With multiple entry points from microlearning modules to intensive peer learning exercises, this programme demonstrates how even in active crisis zones, structured knowledge sharing can deliver immediate improvements in service quality.

    Artificial Intelligence as co-worker: Redefining power in global health

    As technological tools transform global health practice, a new thought-provoking podcast (led, of course, by Artificial Intelligence hosts) examines how AI could reshape knowledge production in resource-constrained settings.

    Based on TGLF’s Reda Sadki’s new article and framework for AI in global health, the podcast uses a specific case study to explore the “transparency paradox” practitioners face – navigating how to incorporate AI tools within existing global health accountability structures.

    The podcast outlines TGLF’s framework for integrating AI responsibly in global health contexts, emphasizing: “It’s not about replacing human expertise, it’s about making it stronger.” This approach prioritizes local context and community empowerment while ensuring ethical considerations remain central.

    As technological adoption accelerates across global health settings, frameworks that recognize existing dynamics become increasingly essential for ensuring equitable benefits.

    Read the full article: Artificial intelligence, accountability, and authenticity: knowledge production and power in global health crisis

    Women inspiring women: Amplifying voices from the frontlines

    The “Women Inspiring Women” initiative amplifies the experiences of 177 women health workers from Africa, Asia, and Latin America through both a published book and peer learning course launched on International Women’s Day (IWD).

    These women share personal stories and advice written as letters to their daughters, offering unique perspectives from cities, villages, refugee camps, and conflict zones. Dr. Eugenia Norah Chigamane from Malawi writes: “Pursuing a career in health work is not for the faint hearted,” while Kinda Ida Louise, a midwife from Burkina Faso, advises: “Never give up in the face of obstacles and difficulties, because there is always a positive point in every situation.”

    The initiative follows TGLF’s proven methodology: immersion in stories, personal reflection, peer exchange, and developing action plans – transforming personal narratives into structured learning that drives institutional change. With women forming two-thirds of the global health workforce yet remaining underrepresented in leadership, this approach addresses both individual empowerment and systemic transformation.

    Get the book “Women inspiring women” and enroll in the free learning course here.

    As we face an era of unprecedented funding constraints in global health, these examples demonstrate a powerful truth: networked learning approaches consistently deliver remarkable outcomes across diverse contexts.

    By connecting practitioners across boundaries, The Geneva Learning Foundation facilitates the transformation of individual knowledge into collective action – creating the resilience and adaptability our health systems urgently need.

    The evidence is compelling: investing in human knowledge networks may be among the most efficient pathways to sustainable health impact.

    Image: The Geneva Learning Foundation Collection © 2025