Tag: The Geneva Learning Foundation

  • Ten eyewitness reports from the frontline of climate change and health

    Ten eyewitness reports from the frontline of climate change and health

    The Geneva Learning Foundation (TGLF) has created a platform enabling health workers to describe the impacts of climate change on their local communities. Here are ten of the most striking reports.

    Published on 30 November 2023 on the Gavi #VaccinesWork blog. Written by Ian Jones for Gavi.

    In July 2023, more than 1,200 health workers from 68 countries shared their experiences of changes in climate and health at a unique Geneva Learning Foundation event designed to shed light on the realities of climate impacts on the health of the communities they serve.

    A special TGLF report – On the frontline of climate change and health: A health worker eyewitness report – includes a compendium and analysis of these 1,200 health workers’ observations and insights. Here are ten of the most striking.

    Samuel Chukwuemeka Obasi, who works for the Ministry of Health in Abuja, Nigeria, has noticed big changes to the environment.

    “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.”

    Iruoma Chinedu Ofortube, who works at the district level in Lagos State, Nigeria, recounts two stories that illustrate the lethal impact of extreme weather.

    “A family embarked on a journey without potentially expecting any danger. Sadly, on their way, heavy rainfall started. The family was oblivious to the reality that the rain started ahead of them while they were en route to their destination. Unfortunately, they ran into a massive flood near a river. The force and the current from the flood swept their vehicle down the river, and before help could come for them, they drowned helplessly alongside other victims of the same circumstances.

    “There was also a pregnant woman in labour. Unfortunately, they couldn’t get a strong boat or canoe that could stand the high current and waves coming from the seaside. In the process of searching for a better means of taking her to the nearest health centre, she got exhausted and died.”

    Assoumane Mahamadou Issifou, who works for an NGO in Agadez, Niger, points out how food shortages are leading to malnutrition and anaemia, particularly in women and children.

    “During the five years that I served in the health service in the Agadez region, I observed significant changes, particularly in the occurrence of heavy rains, which were uncommon in the past. These heavy rains have led to flooding and the displacement of populations, often forcing them to settle wherever they can. Due to their vulnerability during these challenging times, children and women suffer greatly.

    “This situation, especially prevalent among newborns and children under five, contributes to malnutrition. The challenges persist because the Agadez region is situated in a desert area with very low rainfall.

    “However, even with minimal rain, the region faces immense difficulties. Nutritional foods are insufficient, and environmental degradation compounds the issue. As a result, the population struggles to access daily sustenance. Pregnant women and children lack foods rich in vitamins, leading to undernourishment and subsequent diseases such as malnutrition and anaemia.

    “Historically, Agadez was known for its scarcity of rain. With the recent climate change-induced increase in rainfall, few people have come to accept and understand this phenomenon. The region’s architecture is outdated, and the city has transformed into a migratory hub where diverse behaviours converge. New diseases emerge, and the indigenous population is grappling with illnesses that were previously unknown to them.”

    A woman working for the Ministry of Health in the DRC, based in Kinshasa, describes how water level changes are affecting insect proliferation and leading to changing patterns of malaria and other diseases.

    “A drought, characterised by a drop in rainfall during recent rainy seasons, has affected the City Province of Kinshasa, particularly in the Makelele District (located in the Bandalungwa commune) where I live.

    “This area is bordered by two rivers, Mâkelele 1 and 2. The scarcity of rain in the region during the past rainy seasons has led to a significant reduction in water flow within these two rivers. Consequently, rubbish and debris have accumulated along the riverbanks.

    “This situation has resulted in the proliferation of mosquitoes and other unidentified insects. This increase in insect activity has not only led to a rise in malaria cases, but has also given rise to a newly emerging form of dermatosis, the exact nature of which is yet to be determined. It is suspected that these skin lesions develop due to scratching after insect bites. Disturbingly, over 10% of the population within the municipality has been affected by this condition.”

    Dieudonne Tanasngar, who works for the Ministry of Health in Chad, explains how displacement contributes to poor sanitation practices, leading to increased spread of water-borne diseases.

    “In Lake Chad, during the rainy season, the various arms of the lake expand, causing flooding that affects the villages situated along its shores. This flooding often forces the inhabitants to relocate to higher ground.

    “However, a significant portion of the population around the lake lacks proper sanitation facilities, leading to open defecation near the water’s edge. As the water levels rise, this practice contributes to the spread of diseases, particularly when access to health care facilities becomes challenging.

    “Access to health care centres is hindered by the need to cross one or two bodies of water before reaching the nearest facility. This geographical challenge adds to the difficulties faced by the affected population. Consequently, a range of diseases can emerge and afflict the community due to these conditions.

    “The combination of poor sanitation practices, flooding, and limited access to health care facilities creates a complex situation that requires concerted efforts to improve living conditions, sanitation infrastructure, and health care access for the people living around Lake Chad.”

    Coulibaly Seydou, who works for the Ministry of Health in Boussé District, Burkina Faso, has noted how changing dietary habits, alongside declining mental wellbeing, is leading to an increased risk of non-communicable diseases such as high blood pressure and diabetes.

    “For several years, the pattern of rainfall has been becoming increasingly irregular. The duration of the rainy season is progressively getting shorter, interspersed with periods of drought. This unpredictability makes it challenging for farmers to adjust their crop choices according to the rainfall pattern, leading to growing concerns. Discussions about the upcoming rainy season can induce anxiety and worry among rural communities.

    “When it comes to the impact of climate change on mental health, we can observe a significant disturbance in the well-being of farmers. Even just a couple of days without rainfall can trigger a sense of sadness among them. Instances of minor depression have been noted among household heads who helplessly witness their crops withering due to inadequate moisture.

    “In terms of physical health, there has been an uptick in the prevalence of diseases and conditions that can be attributed to changes in dietary habits. Conditions such as hypertension, diabetes and obesity are on the rise. This can be linked to the shift towards consuming industrially processed foods that are low in nutritional value and high in chemical additives.”

    A man working for the Ministry of Health in Beni in the DRC describes the tragic case of a family driven into poverty and unable to afford health care for the children.

    “As a result of the disruption in the seasonal shifts, a modest family reliant solely on agriculture experienced the tragic death of their young son within their community.

    “The critical factors involved were as follows: their crop yield plummeted to zero due to their inability to manage the erratic changes in the seasons, and malnutrition, likely compounded by other illnesses, afflicted the family. Faced with financial constraints stemming from the complete failure of their agricultural efforts, they resorted to providing home-based care for their family.

    “Tragically, their youngest son paid the ultimate price with his life. In summary, the ever-changing climate dynamics have left us disoriented and uncertain about the future.”

    Fokzia Elijah, who works for the Ministry of Health in the Province of Batha, Chad, highlights how climate change is having multiple health and social impacts, particularly on pastoralists.

    “Batha is the first pastoral province, often experiencing prolonged droughts followed by irregular and sometimes excessive rainfall. These climatic variations lead to challenges in cattle herding, house collapses, and difficulties in sustaining pastoralism, which typically lasts only two to three months.

    “Pastoralists often migrate southward with women and children following them. Consequently, malnutrition prevails, affecting over 14% of the population, with women and children being the most vulnerable. Women who remain in the villages demonstrate resilience by engaging in limited market gardening and gathering wild oilseeds to produce sweet syrup for porridge.

    “A significant issue is the death of animals between March and June due to inadequate pasture and water. This impacts the most vulnerable, particularly women and children. Batha Province, once renowned for its diverse flora and fauna, has seen the disappearance of most animals except for birds. Hyena attacks have become frequent as they search for food in communities, often targeting domestic pets.”

    Linda Raji, who works for an NGO in the Kaida and Waru communities in Nigeria, highlights the implication of enviornmental change for young women – one of a range of gender-specific impacts of climate change.

    “Prolonged drought dries up the dirty community stream that serves both livestock and residents. This makes it difficult for community members to access water and much harder for menstrual hygiene management for teenage girls leading to an increase in infections in the unbearable heat.

    “Due to the difficulty in managing the monthly menstrual cycle due to limited access to water sanitation hygiene and period poverty, many teenage girls prefer to get pregnant to save them the worry of menstruating monthly for nine months.”

    Dr Chinedu Anthony Iwu, who works at a health facility in Orlu Local Government Area in Nigeria, describes how working with communities can build resilience to climate change impacts.

    “The changing climate has brought about an increase in the prevalence of vector-borne diseases. Mosquitoes are now breeding and transmitting diseases like malaria more intensely. The community lacked proper health care facilities and resources to effectively combat these diseases, leading to a rise in illness and mortality rates. Mothers’ means of livelihood were usually disrupted due to the time and effort spent in caring for their sick children with a significant impact on household welfare.

    “Recognising the urgent need to address these climate-related health challenges, we engaged in community-led initiatives that included comprehensive health awareness campaigns to provide education on sanitation and hygiene practices, and education of residents about preventive measures against vector-borne diseases. By engaging our community health extension workers, we were able to organise regular health check-ups in the communities, focusing on early detection and treatment of illnesses.

    “Over time, these collective efforts began to yield positive results. The mothers in the communities witnessed improvements in income as they progressively began to spend less time pursuing children’s health care challenges due to the adoption of preventive measures, thereby becoming more resilient to the changing climate.

    This experience highlights the challenges faced by rural communities in Nigeria due to climate change. It demonstrates 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.”

    Photo credit: Aerial view of a flooded urban residential area of Dera Allah yar city in Jaffarabad District, Baluchistan Province, Pakistan. Credit: Gavi/2022/Asad Zaidi

  • Learning-based complex work: how to reframe learning and development

    Learning-based complex work: how to reframe learning and development

    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).

    Figure 4.3 The TGLF full learning cycle

    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.

    The third insight was reading what George Siemens was writing in 2006.

    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.

    I began experimenting with MOOCs at that time, turning a lecture series into a networked learning experience led by peers.

    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.

    That helped us to rapidly support learning and action by health workers facing the consequences of the COVID-19 pandemic.

    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 learning at 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.

    Figure 4.1 Marsick and Watkins' informal and incidental learning model

    A colleague commented that in today’s world, you’re better of talking about digital networks than you are about communities of practice.

    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 depends on the context.

    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.

    That gave birth to a quarterly event dedicated entirely to such networking, which has continued to grow and thrive since.

    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.

    But then entry would be far less meaningful.

    Learning needs to mean something.

    Universities substitute meaning through assessment, credentialing, and accreditation.

    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 a particularly challenging course that led to a breakthrough.

    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.

    So, light years away, but making some progress.

    Reference

    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. https://www.e-elgar.com/shop/gbp/rethinking-workplace-learning-and-development-9781802203769.html

  • Teach to Reach: peer learning at scale

    Teach to Reach: peer learning at scale

    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. 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • 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.

  • How we make sense of complexity, together, at the Geneva Learning Foundation

    How we make sense of complexity, together, at the Geneva Learning Foundation

    Unique learning experiences generate not just data points but complex stories about what it takes to make change actually happenBy connecting the dots between ideas and implementation, we can zero in on the highest-value insights. 

    Our Insights Unit uses the latest advances in learning analytics to map how ideas and practices shared between countries and system levels make a difference. 

    The Unit facilitates international partners to work hand-in-hand with local practitioners. 

    In addition to thousands of local practitioners contributing and using insights to drive shared learning and action, our Insights Unit’s work is being used by leading global agencies. Examples include: 

    • Effective strategies to overcome vaccine hesitancy in districts and health facilities (BMGF) 
    • Motivation of local health professionals for COVID-19 vaccination (Gavi, the Vaccine Alliance) 
    • Learning culture as a key driver of frontline health worker performance (Wellcome Trust) 
    • Gender barriers, vaccine confidence, and other immunization challenges (WellcomeTrust) 
    • Analysis of implementation of recovery plans in TGLF’s COVID-19 peer support programme (WHO and USAID Momentum) 

    We are exploring affordable, practical ways to extract meaning from large data sets 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • How does the Geneva Learning Foundation’s approach break the norm?

    How does the Geneva Learning Foundation’s approach break the norm?

    100% digital 100% human: using the latest learning technologies and interfaces, we adapt our digital networking interfaces to learner needs and habits to augment their digital and networking capabilities. 

    Grounded in experience: we foster problem-solving that values both participants’ lived experience and the world’s best available global knowledge. 

    We open access: participation can be opened for all, across geographic, sectoral or institutional barriers. 

    New knowledge is created through peer learning: national and international practitioners sharing experience, giving and receiving feedback, and using this new knowledge to solve problems together. 

    We build trust and mutual respect: safe spaces encourage authentic sharing of experiences to learn what actually works, how, and why. 

    Driven by intrinsic motivation: proven high engagement rates with no per diem or other extrinsic incentives. 

    Sustainability built-in: 78% of TGLF programme participants feel “capable” of using TGLF’s methodology for their own needs, and 82% want to organize their own activities using it with their colleagues. 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • The Geneva Learning Foundation: Localizing programming and grounding policy

    The Geneva Learning Foundation: Localizing programming and grounding policy

    By defying distance to connect with each other, practitioners expand the realm of what they are able to know beyond their local boundaries. 

    Listening to these diverse voices and experiences is critical to inform programming, policy and decision-making and build bridges across sectoral silos and other boundaries, by providing: 

    • A direct, unmediated connection to the priorities and challenges of frontline staff, as well as their perceptions of key obstacles and enablers of progress. 
    • Impactful learning and knowledge building by and for frontline responders and practitioners. 
    • A “reality check” to assess whether current global assumptions match those of frontline workers. 
    • A “test bed” to co-design, develop and pilot tools or resources. 

    Thousands of ideas are turned into action, results, and impact 

    In every TGLF programme, practitioners develop action plans and then report to each other as they implement, documenting results, outcomes, and impact to help each other. 

    Such peer accountability has proven more reliable, in some cases, than conventional monitoring and evaluation mechanisms. 

    For individuals, TGLF enables: 

    • Increased knowledge of low-cost digital tools for learning and networking at scale. 
    • Opportunities to blossom as a leader, no matter who you are or where you are. 
    • Sense of community across system level, sectoral, geographic and institutional boundaries. 

    Measurable impact in countries: Examples of outcomes tracked in immunization since July 2019 

    • Following up on finding and vaccinating zero dose and defaulting children 
    • Tracking and vaccinating migrant populations 
    • Setting up a Missed Opportunities in Vaccination (MOV) system to ensure eligible children present at outpatient/other PHC “stations” in a facility receive vaccinations 
    • Improving geographic equity by increasing outreach sites in hard- to-reach areas 
    • Increasing frequency of services in higher volume urban facilities 
    • Using community engagement approaches to bring on board leaders to support immunization, who were previously opposed. 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • The Geneva Learning Foundation: Scale, reach, and sustainability

    The Geneva Learning Foundation: Scale, reach, and sustainability

    In its first years of operation, the Geneva Learning Foundation (TGLF) built digital infrastructure to foster and support several global networks and platforms connecting practitioners.

    Communities supported included:
    •  immunization and primary health care professionals,
    •  humanitarian workers advocating gender equality during disasters and other emergency operations,
    •  doctors, other health workers, and communities addressing neglected needs in women’s health, and
    •  health workers tackling neglected tropical diseases.

    This digital infrastructure enabled TGLF to rapidly respond to the challenges of the COVID-19 pandemic.

    In the first two years of the pandemic, a team of three people developed and implemented… 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • The Geneva Learning Foundation: Spanning the full spectrum of learning

    The Geneva Learning Foundation: Spanning the full spectrum of learning

    We empower practitioners to tailor learning experiences that fit their own needs to drive change: Participants do not  stop work to learn, every step of the process is embedded in and focused on their daily work.

    Typical learning events include:  

    “Hackathons”: 2 to 4 days fast-paced context and challenge analysis and idea generation

    “Peer learning exercises” : 2 to 4 weeks, on and offline facilitated learning among and between practitioners and international experts, including knowledge sharing, situational analysis and action planning.  

     “Full Learning Cycles”, a nurturing space for learners and leaders over several months to explore and take action together, identifying common challenges, generating and sharing ideas, testing innovative solutions, and implementing action plans.

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.

  • Motivation and connection for transformation at the heart of the Geneva Learning Foundation’s approach

    Our approach based on intrinsic motivation, continuous learning and problem–solving leads to impact. Practical implementation with peer support accelerates progress to get results and document impact. 

    To learn more about the Geneva Learning Foundation (TGLF), download our brochure, listen to our podcast, view our latest livestreams, subscribe to our insights, and follow us on Instagram, LinkedIn, Facebook, Twitter, and YouTube. Or introduce yourself to our Partnerships team.