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454 results for “redasadki”
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RT @DrFloGabriel: 📢 My colleagues and I are delighted to announce the launch of our new academic journal, Learning Letters.
Discover our inaugural issue and details on submitting proposals by visiting our website: https://t.co/h4P8CIoDX7
#EducationInnovation
#LearningSciences #AIED #learning https://t.co/jb26iWicU3 -
RT @Shams_Syed: An important one! Just released by @WHO. #primaryhealthcare
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RT @Shams_Syed: An important one! Just released by @WHO. #primaryhealthcare
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What is your experience strengthening COVID-19 and malaria vaccine roll-out? Learn more #IA2030 Movement Leader Kingsley Nignere from #Ghana, in the latest issue of #TheDoubleLoop, @DigitalScholarX #globalhealth insights newsletter #VaccinesWork https://t.co/ZEwFNYZlm0
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Really proud to be helping community of committed health professionals meet, connect, and learn from each other about the effects of climate on health. #climate #health #CommunityHealthWorkers #communityhealth https://t.co/Uo342HbQVQ
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Heat generated by the voices and collective commitment of thousands of local health workers mobilizing and learning together to take action will only evaporate into thin air if the global community fails to listen, respond, and support them #IA2030
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Looking forward to exploring health worker education and employment at the Forum.
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RT @GHWNetwork
⏳Don’t miss the 5th Global Forum Roundtable on #healthworker #education & employment in support of #UHCAdvanced registration required 👉http://bit.ly/3ZQbuZy
☑️select *Register Now*
See you there! #ProtectInvestTogether #HealthForAll #jobs @Siofitz @MarsdenPa @Working4H
https://twitter.com/GHWNetwork/status/1636372863455461379 -
Just had a remarkable experience listening and learning with branch leaders from more than 350 #RedCrossRedCrescent branches all around the world. #localization #frontlines #volunteering
An amazing and indeed very special event. Bravo @ian_steed ! And thank you @CharlotteMbuh
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Connect peers, link local practice to global guidance, tailor to local contexts and communities, harness experience, strengthen learning culture…
creates opportunities to…
empower professionals and drive improvement from the ground up #IA2030 @Kate_L_OBrien
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Do we need to ‘go back to routine immunization’ or do we need to ‘build back better’…? #IA2030 @Kate_L_OBrien
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What if ‘country’ is no longer the right unit of analysis? #IA2030
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Rethinking human resources for malaria control and elimination in Africa
The comprehensive policy review by Halima Mwenesi and colleagues “Rethinking human resources and capacity building needs for malaria control and elimination in Africa” argues that the stagnation in global malaria progress is fundamentally a human resources crisis rather than solely a biological or technical failure.
The authors posit that the current workforce is insufficient in number and ill-equipped with the necessary skills to navigate the complex transition from malaria control to elimination.
It is a critical indictment of the status quo in malaria training and offers a roadmap for structural reform.
This article summarizes key points from the policy review and examines how The Geneva Learning Foundation’s peer learning-to-action model could be used by national programmes to transform the health workforce.
The mismatch between training and operational needs
The authors identify a severe imbalance in training priorities where capacity building has historically favored biomedical and basic sciences such as entomology and parasitology.
While essential, this focus has led to a neglect of operational, translational, and implementation sciences.
The report highlights that while the global community produces high-level scientists who understand the parasite, it fails to produce “translational scientists” who can bridge the gap between global guidelines and local realities.
This has resulted, they argue, in a workforce lacking the practical competencies to operationalize complex elimination strategies that require precision and adaptation.
The deficit in leadership and social sciences
A major finding is the specific deficit in so-called “soft skills” and social sciences which are increasingly critical as programs move toward elimination.
The authors argue that modern malaria control requires competencies in leadership, health diplomacy, anthropology, sociology, and political analysis.
Program managers currently lack the training to navigate complex political landscapes, mobilize domestic resources, or engage effectively with communities to sustain interventions.
The review emphasizes that understanding community behavior and social determinants is as critical as understanding vector behavior but this is rarely reflected in curricula.
Data illiteracy and the failure of surveillance
The paper identifies pervasive “data illiteracy” across the workforce.
Health workers collect vast amounts of data to satisfy donor reporting requirements but often lack the skills to interpret or use it for local decision-making.
This results in a “data-rich but information-poor” environment.
As countries move toward elimination, the need for real-time, granular surveillance becomes paramount.
The current workforce is unable to perform the rapid data analysis required to detect and respond to outbreaks at the sub-national level.
Fragmentation and lack of coordination
The review critiques the fragmentation of investments in training, capacity-building, and technical assistance driven by donor agendas.
It notes a lack of coordination among donors and agencies which leads to a proliferation of uncoordinated short courses and workshops that do not necessarily align with national strategic plans.
This fragmentation is exacerbated by a lack of data on the workforce itself.
Many countries lack a central registry of malaria personnel which makes it impossible to forecast needs, plan for attrition, or manage career pathways.
The call for structural transformation
The authors call for a radical shift toward “South-South” collaboration where African institutions take the lead in training.
They advocate for moving away from ad hoc workshops toward institutionalized, long-term capacity building.
Crucially, they recommend the use of digital platforms to democratize access to knowledge for mid-level and community-based cadres who are often excluded from elite fellowships.
How can learning science help transform malaria training investments into tangible health worker performance?
For a global health epidemiologist accustomed to viewing disease control through the lens of biological interventions and coverage rates, the human resource crisis described by Mwenesi and colleagues represents a “delivery failure” of validated tools.
The Geneva Learning Foundation (TGLF) learning science model functions as a structural intervention designed to repair broken delivery mechanisms in global health and humanitarian response.
The following analysis translates the TGLF approach into terms recognizable to an epidemiologist or program manager who operates with the assumption that training is primarily about the transmission of technical knowledge.
Moving from passive transmission to implementation fidelity
Epidemiologists understand that a vaccine with high efficacy in a trial often has low effectiveness in the real world due to poor administration or cold chain failure.
Similarly, Mwenesi et al. identify that technical malaria guidelines fail because the “human infrastructure” cannot implement them.
Traditional training assumes that if you lecture health workers on a protocol, which is a transmission of information, they will execute it.
This is a “single-loop” assumption.
The TGLF model introduces an “implementation loop.”
Instead of merely receiving information, learners in the TGLF network must design a micro-project to apply the new guideline in their specific district, execute it, and report back on the results using their own local data.
This turns the workforce from passive recipients of protocols into active testers of implementation fidelity.
It directly addresses the “translational science” gap identified in the paper by forcing the learner to translate theory into practice immediately.
Sceptics often argue that this approach places an undue burden on an already overworked workforce.
However, the TGLF model embeds learning into the workflow itself.
This is not additional work but rather “learning-based work.”
Participants do not create hypothetical projects.
They identify a bottleneck they are currently facing, such as a specific pocket of malaria transmission, and use the learning cycle to address it.
This transforms the training from an external interruption into an operational support mechanism.
By embedding learning into the workflow, it operationalizes Mwenesi’s call for translational science.
It considers the daily struggle of the health worker as a form of structured scientific inquiry: they hypothesize a solution, test it, and report the results.
This is implementation as science.
Operationalizing data use for local decision-making
Mwenesi notes that health workers collect data but do not use it.
In the TGLF model, data is not something sent “up” to the ministry.
It is the raw material for peer support and feedback.
In a TGLF peer learning exercise, a district medical officer in Ghana shares their case management data to compare performance with a peer in Uganda.
They share because they want to, not because they are required to.
This creates a social incentive to understand and analyze one’s own data.
It builds the “data literacy” the authors call for not through abstract statistics courses but through the practical necessity of explaining one’s own performance to a colleague.
This process transforms data from a compliance burden into a tool for local problem-solving.
Is there a risk that peer learning will pool ignorance?
Is there a valid concern regarding the risk of “pooled ignorance” where peers might reinforce incorrect practices?
The TGLF model mitigates this through “structured emergence.”
The model does not dismiss expert knowledge but uses global guidelines as the “anchor” for local problem-solving.
In this system, a health worker cannot simply state an opinion.
They must submit an action plan that is peer-reviewed against a rubric derived from WHO guidelines.
This process ensures fidelity to technical standards while allowing for necessary local adaptation.
The aggregation of thousands of these peer-reviewed plans creates a new form of rigorous, practice-based evidence that complements expert guidance.
Scaling “soft skills” through structured peer review
The review calls for leadership and diplomacy skills but notes these are hard to teach in workshops.
The TGLF model builds these skills implicitly through its pedagogical structure.
When a participant submits an action plan, they must receive and respond to critical feedback from peers in other countries.
They must negotiate differing viewpoints and defend their technical choices.
This mimics the “health diplomacy” and leadership dynamics required in real-world program management.
Furthermore, because they must engage community stakeholders to implement their projects, they practice the anthropological and social engagement skills Mwenesi identifies as missing.
They learn leadership not by studying a theory of leadership but by leading a change initiative in their facility.
While some experts argue that soft skills require “hard contact” in physical spaces, TGLF results suggest that physical proximity often limits a worker to their known environment and existing biases.
The TGLF model introduces a form of “cosmopolitan localism.”
When a nurse in rural Nigeria must explain her challenge to a peer in urban India, she is forced to articulate her context with a clarity and diplomacy not required when speaking to a neighbor.
This defiance of distance fosters a quantum leap in communication capabilities.
Participants report that the skills learned in negotiating these digital, cross-cultural peer relationships directly translate to better engagement with their physical-world colleagues and community leaders.
Addressing the incentive structure and correcting expertise asymmetry
The paper critiques the “brain drain” and the reliance on experts from the Global North.
TGLF operationalizes the “South-South” collaboration recommended by the authors by creating a flat digital hierarchy.
In this model, the “expert” is not a visiting consultant from Geneva but a peer who has successfully solved the problem in their own context.
A nurse in Nigeria learns how to improve bed net usage from a nurse in Kenya who solved that exact refusal issue last month.
This actually results in greater interest, comprehension, and use of official guidelines.
It also validates local knowledge and creates the “critical mass of thinking professionals” that Mwenesi argues is essential for elimination.
It shifts the source of authority from external experts to the collective intelligence of the network.
Transforming the economy of per diem
A common critique of moving away from face-to-face training is the reliance of health workers on per diems for financial survival.
Mwenesi implies that the current system is unsustainable.
The TGLF model operates on the evidence that per diem-driven training often restricts access to a “training aristocracy” of recurrent participants while excluding the frontline workers who most need the knowledge.
TGLF replaces the financial incentive with a professional survival incentive.
In the Nigeria Immunization Collaborative, over 4,300 health workers participated without per diems.
They did so because the program addressed the specific pain points of their daily work.
This filters the workforce for “positive deviants,” or those with high intrinsic motivation who are most likely to drive elimination efforts, rather than those primarily motivated by daily subsistence allowances.
A “surveillance system” for human resources and performance
Finally, the review notes the lack of registries and data on the workforce itself.
The TGLF digital network acts as a real-time sensor of workforce capacity.
By engaging thousands of health workers simultaneously, the platform generates data on who is active, what problems they are facing, and where their skills are deficient.
For an epidemiologist, this is equivalent to a surveillance system for human resources.
It provides the visibility needed to forecast gaps and target interventions precisely, replacing the “blind” proliferation of uncoordinated workshops with a data-driven approach to capacity building.
Regarding concerns that digital platforms fail in low-resource settings due to poor connectivity, TGLF utilizes a “cognitively quiet” design that functions on low-bandwidth connections and mobile devices.
This design respects the technological reality of the African context.
Data from the Teach to Reach program, which has engaged over 60,000 participants in remote, ongoing peer learning activities , demonstrates that when the technology is adapted to the user rather than the other way around, participation rates exceed those of physical workshops.
This scale allows for the identification of systemic patterns and workforce gaps that would be invisible in a smaller, face-to-face cohort.
Reference
Mwenesi, H., Mbogo, C., Casamitjana, N., Castro, M.C., Itoe, M.A., Okonofua, F., Tanner, M., 2022. Rethinking human resources and capacity building needs for malaria control and elimination in Africa. PLOS Glob Public Health 2, e0000210. https://doi.org/10.1371/journal.pgph.0000210
Reda Sadki (2023). How do we reframe health performance management within complex adaptive systems?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/mx5qr-qet97
Reda Sadki (2024). Prioritizing the health and care workforce shortage: protect, invest, together. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/zzqr4-9g482
Reda Sadki (2024). Protect, invest, together: strengthening health workforce through new learning models. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/g24b4-7fj64
Reda Sadki (2024). What is double-loop learning in global health?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/s4xtw-b7274
Reda Sadki (2024). World Malaria Day 2024: We need new ways to support health workers leading change with local communities. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/yrn1r-hpz62
#brainDrain #cosmopolitanLocalism #dataQualityAndUse #doubleLoopLearning #HalimaMwenesi #healthWorkerMotivation #healthWorkerPerformance #healthWorkforce #HRH #implementationScience #leadership #learningStrategy #learningBasedWork #localization #malaria #peerLearning #performance #softSkills #TeachToReach #translationalScience -
Rethinking human resources for malaria control and elimination in Africa
The comprehensive policy review by Halima Mwenesi and colleagues “Rethinking human resources and capacity building needs for malaria control and elimination in Africa” argues that the stagnation in global malaria progress is fundamentally a human resources crisis rather than solely a biological or technical failure.
The authors posit that the current workforce is insufficient in number and ill-equipped with the necessary skills to navigate the complex transition from malaria control to elimination.
It is a critical indictment of the status quo in malaria training and offers a roadmap for structural reform.
This article summarizes key points from the policy review and examines how The Geneva Learning Foundation’s peer learning-to-action model could be used by national programmes to transform the health workforce.
The mismatch between training and operational needs
The authors identify a severe imbalance in training priorities where capacity building has historically favored biomedical and basic sciences such as entomology and parasitology.
While essential, this focus has led to a neglect of operational, translational, and implementation sciences.
The report highlights that while the global community produces high-level scientists who understand the parasite, it fails to produce “translational scientists” who can bridge the gap between global guidelines and local realities.
This has resulted, they argue, in a workforce lacking the practical competencies to operationalize complex elimination strategies that require precision and adaptation.
The deficit in leadership and social sciences
A major finding is the specific deficit in so-called “soft skills” and social sciences which are increasingly critical as programs move toward elimination.
The authors argue that modern malaria control requires competencies in leadership, health diplomacy, anthropology, sociology, and political analysis.
Program managers currently lack the training to navigate complex political landscapes, mobilize domestic resources, or engage effectively with communities to sustain interventions.
The review emphasizes that understanding community behavior and social determinants is as critical as understanding vector behavior but this is rarely reflected in curricula.
Data illiteracy and the failure of surveillance
The paper identifies pervasive “data illiteracy” across the workforce.
Health workers collect vast amounts of data to satisfy donor reporting requirements but often lack the skills to interpret or use it for local decision-making.
This results in a “data-rich but information-poor” environment.
As countries move toward elimination, the need for real-time, granular surveillance becomes paramount.
The current workforce is unable to perform the rapid data analysis required to detect and respond to outbreaks at the sub-national level.
Fragmentation and lack of coordination
The review critiques the fragmentation of investments in training, capacity-building, and technical assistance driven by donor agendas.
It notes a lack of coordination among donors and agencies which leads to a proliferation of uncoordinated short courses and workshops that do not necessarily align with national strategic plans.
This fragmentation is exacerbated by a lack of data on the workforce itself.
Many countries lack a central registry of malaria personnel which makes it impossible to forecast needs, plan for attrition, or manage career pathways.
The call for structural transformation
The authors call for a radical shift toward “South-South” collaboration where African institutions take the lead in training.
They advocate for moving away from ad hoc workshops toward institutionalized, long-term capacity building.
Crucially, they recommend the use of digital platforms to democratize access to knowledge for mid-level and community-based cadres who are often excluded from elite fellowships.
How can learning science help transform malaria training investments into tangible health worker performance?
For a global health epidemiologist accustomed to viewing disease control through the lens of biological interventions and coverage rates, the human resource crisis described by Mwenesi and colleagues represents a “delivery failure” of validated tools.
The Geneva Learning Foundation (TGLF) learning science model functions as a structural intervention designed to repair broken delivery mechanisms in global health and humanitarian response.
The following analysis translates the TGLF approach into terms recognizable to an epidemiologist or program manager who operates with the assumption that training is primarily about the transmission of technical knowledge.
Moving from passive transmission to implementation fidelity
Epidemiologists understand that a vaccine with high efficacy in a trial often has low effectiveness in the real world due to poor administration or cold chain failure.
Similarly, Mwenesi et al. identify that technical malaria guidelines fail because the “human infrastructure” cannot implement them.
Traditional training assumes that if you lecture health workers on a protocol, which is a transmission of information, they will execute it.
This is a “single-loop” assumption.
The TGLF model introduces an “implementation loop.”
Instead of merely receiving information, learners in the TGLF network must design a micro-project to apply the new guideline in their specific district, execute it, and report back on the results using their own local data.
This turns the workforce from passive recipients of protocols into active testers of implementation fidelity.
It directly addresses the “translational science” gap identified in the paper by forcing the learner to translate theory into practice immediately.
Sceptics often argue that this approach places an undue burden on an already overworked workforce.
However, the TGLF model embeds learning into the workflow itself.
This is not additional work but rather “learning-based work.”
Participants do not create hypothetical projects.
They identify a bottleneck they are currently facing, such as a specific pocket of malaria transmission, and use the learning cycle to address it.
This transforms the training from an external interruption into an operational support mechanism.
By embedding learning into the workflow, it operationalizes Mwenesi’s call for translational science.
It considers the daily struggle of the health worker as a form of structured scientific inquiry: they hypothesize a solution, test it, and report the results.
This is implementation as science.
Operationalizing data use for local decision-making
Mwenesi notes that health workers collect data but do not use it.
In the TGLF model, data is not something sent “up” to the ministry.
It is the raw material for peer support and feedback.
In a TGLF peer learning exercise, a district medical officer in Ghana shares their case management data to compare performance with a peer in Uganda.
They share because they want to, not because they are required to.
This creates a social incentive to understand and analyze one’s own data.
It builds the “data literacy” the authors call for not through abstract statistics courses but through the practical necessity of explaining one’s own performance to a colleague.
This process transforms data from a compliance burden into a tool for local problem-solving.
Is there a risk that peer learning will pool ignorance?
Is there a valid concern regarding the risk of “pooled ignorance” where peers might reinforce incorrect practices?
The TGLF model mitigates this through “structured emergence.”
The model does not dismiss expert knowledge but uses global guidelines as the “anchor” for local problem-solving.
In this system, a health worker cannot simply state an opinion.
They must submit an action plan that is peer-reviewed against a rubric derived from WHO guidelines.
This process ensures fidelity to technical standards while allowing for necessary local adaptation.
The aggregation of thousands of these peer-reviewed plans creates a new form of rigorous, practice-based evidence that complements expert guidance.
Scaling “soft skills” through structured peer review
The review calls for leadership and diplomacy skills but notes these are hard to teach in workshops.
The TGLF model builds these skills implicitly through its pedagogical structure.
When a participant submits an action plan, they must receive and respond to critical feedback from peers in other countries.
They must negotiate differing viewpoints and defend their technical choices.
This mimics the “health diplomacy” and leadership dynamics required in real-world program management.
Furthermore, because they must engage community stakeholders to implement their projects, they practice the anthropological and social engagement skills Mwenesi identifies as missing.
They learn leadership not by studying a theory of leadership but by leading a change initiative in their facility.
While some experts argue that soft skills require “hard contact” in physical spaces, TGLF results suggest that physical proximity often limits a worker to their known environment and existing biases.
The TGLF model introduces a form of “cosmopolitan localism.”
When a nurse in rural Nigeria must explain her challenge to a peer in urban India, she is forced to articulate her context with a clarity and diplomacy not required when speaking to a neighbor.
This defiance of distance fosters a quantum leap in communication capabilities.
Participants report that the skills learned in negotiating these digital, cross-cultural peer relationships directly translate to better engagement with their physical-world colleagues and community leaders.
Addressing the incentive structure and correcting expertise asymmetry
The paper critiques the “brain drain” and the reliance on experts from the Global North.
TGLF operationalizes the “South-South” collaboration recommended by the authors by creating a flat digital hierarchy.
In this model, the “expert” is not a visiting consultant from Geneva but a peer who has successfully solved the problem in their own context.
A nurse in Nigeria learns how to improve bed net usage from a nurse in Kenya who solved that exact refusal issue last month.
This actually results in greater interest, comprehension, and use of official guidelines.
It also validates local knowledge and creates the “critical mass of thinking professionals” that Mwenesi argues is essential for elimination.
It shifts the source of authority from external experts to the collective intelligence of the network.
Transforming the economy of per diem
A common critique of moving away from face-to-face training is the reliance of health workers on per diems for financial survival.
Mwenesi implies that the current system is unsustainable.
The TGLF model operates on the evidence that per diem-driven training often restricts access to a “training aristocracy” of recurrent participants while excluding the frontline workers who most need the knowledge.
TGLF replaces the financial incentive with a professional survival incentive.
In the Nigeria Immunization Collaborative, over 4,300 health workers participated without per diems.
They did so because the program addressed the specific pain points of their daily work.
This filters the workforce for “positive deviants,” or those with high intrinsic motivation who are most likely to drive elimination efforts, rather than those primarily motivated by daily subsistence allowances.
A “surveillance system” for human resources and performance
Finally, the review notes the lack of registries and data on the workforce itself.
The TGLF digital network acts as a real-time sensor of workforce capacity.
By engaging thousands of health workers simultaneously, the platform generates data on who is active, what problems they are facing, and where their skills are deficient.
For an epidemiologist, this is equivalent to a surveillance system for human resources.
It provides the visibility needed to forecast gaps and target interventions precisely, replacing the “blind” proliferation of uncoordinated workshops with a data-driven approach to capacity building.
Regarding concerns that digital platforms fail in low-resource settings due to poor connectivity, TGLF utilizes a “cognitively quiet” design that functions on low-bandwidth connections and mobile devices.
This design respects the technological reality of the African context.
Data from the Teach to Reach program, which has engaged over 60,000 participants in remote, ongoing peer learning activities , demonstrates that when the technology is adapted to the user rather than the other way around, participation rates exceed those of physical workshops.
This scale allows for the identification of systemic patterns and workforce gaps that would be invisible in a smaller, face-to-face cohort.
Reference
Mwenesi, H., Mbogo, C., Casamitjana, N., Castro, M.C., Itoe, M.A., Okonofua, F., Tanner, M., 2022. Rethinking human resources and capacity building needs for malaria control and elimination in Africa. PLOS Glob Public Health 2, e0000210. https://doi.org/10.1371/journal.pgph.0000210
Reda Sadki (2023). How do we reframe health performance management within complex adaptive systems?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/mx5qr-qet97
Reda Sadki (2024). Prioritizing the health and care workforce shortage: protect, invest, together. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/zzqr4-9g482
Reda Sadki (2024). Protect, invest, together: strengthening health workforce through new learning models. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/g24b4-7fj64
Reda Sadki (2024). What is double-loop learning in global health?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/s4xtw-b7274
Reda Sadki (2024). World Malaria Day 2024: We need new ways to support health workers leading change with local communities. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/yrn1r-hpz62
#brainDrain #cosmopolitanLocalism #dataQualityAndUse #doubleLoopLearning #HalimaMwenesi #healthWorkerMotivation #healthWorkerPerformance #healthWorkforce #HRH #implementationScience #leadership #learningStrategy #learningBasedWork #localization #malaria #peerLearning #performance #softSkills #TeachToReach #translationalScience -
Evaluation of a capacity building intervention on malaria treatment for children
The study by Ayodele Jegede and colleagues “Evaluation of a capacity building intervention on malaria treatment for under-fives in rural health facilities in Niger State, Nigeria” provides a rigorous evaluation of a standard “cascade training” intervention.
The intervention followed the classic global health model where national experts trained state trainers who then trained local government area facilitators who were supposed to train frontline health workers.
The results expose deep structural flaws in this approach.
The most damning finding was the “reach gap.”
Despite the intervention being fully funded and implemented, the cascade broke down before reaching the frontline.
Only 54% of the health workers who actually treat febrile children reported receiving the training.
The transmission of knowledge stopped at the facility in-charge level and did not filter down to the lower-level cadres who manage the bulk of the patient load.
Consequently, the study found no statistically significant difference in appropriate treatment practices between the intervention and control groups.
The study also illuminated the persistence of the “know-do” gap.
Even where testing rates increased, appropriate treatment did not necessarily follow.
A critical finding was that while health workers in the intervention arm correctly withheld artemisinin-based combination therapies (ACTs) from children who tested negative for malaria, they frequently substituted them with other inappropriate antimalarials or antibiotics.
This suggests that the training taught them the technical rule (“no ACT for negatives”) but failed to teach the adaptive clinical skill of how to manage a negative diagnosis and patient expectations.
Finally, the study highlighted the futility of training in the absence of system support.
Significant stock-outs of Rapid Diagnostic Tests (RDTs) and ACTs occurred in the intervention facilities.
On many visit days, half the facilities had no ACTs available.
The authors conclude that capacity building cannot be an isolated activity and must be embedded within a functioning supply chain and health system.
Analysis through the lens of learning science
This study provides the empirical “counter-factual” that justifies TGLF’s evidence-based rejection of the cascade training model.
It illustrates precisely why a digital-first and direct-to-learner approach is necessary from an epidemiological and operational perspective.
Overcoming transmission loss
The finding that the cascade reached only 54% of workers is a powerful argument for TGLF’s networked learning approach.
By using digital platforms to connect directly with individual health workers on their own devices, TGLF bypasses the “frozen middle” layers of hierarchy where cascade training stalls.
TGLF does not rely on a facility manager to pass on a message but invites both the frontline worker and the manager to join the conversation directly.
From rote compliance to critical thinking
The behavior of the health workers who stopped giving ACTs but switched to other inappropriate drugs demonstrates the failure of “single-loop” learning.
They learned the what (do not give ACT) but not the why or the how (clinical reasoning and stewardship).
TGLF’s “double-loop” learning model addresses this by engaging workers in peer dialogue about why they feel compelled to prescribe drugs for negative cases.
This might include patient pressure or fear of complications.
The model helps them develop strategies to manage those pressures rather than just memorizing a guideline.
Resilience in the face of system failure
The study shows that stock-outs rendered the training ineffective.
In a traditional model, the health worker is a passive victim of these stock-outs.
In TGLF’s “challenge-based” learning model, a worker is likely to be the first one to identify “frequent stock-outs” as their primary challenge.
The network would then connect them with peers who have solved similar supply chain issues.
This might be through better forecasting, redistribution from nearby clinics or advocacy with district officials.
TGLF aims to transform the worker from a passive recipient of training into an active agent of system change who can navigate the very barriers that defeated the intervention in Niger State.
Reference
Jegede, A., Willey, B., Hamade, P., Oshiname, F., Chandramohan, D., Ajayi, I., Falade, C., Baba, E., Webster, J., 2020. Evaluation of a capacity building intervention on malaria treatment for under-fives in rural health facilities in Niger State, Nigeria. Malar J 19, 90. https://doi.org/10.1186/s12936-020-03167-y
Reda Sadki (2024). Why does cascade training fail?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/j8vg0-yng46
Reda Sadki (2024). What is double-loop learning in global health?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/s4xtw-b7274
#AyodeleJegede #capacityBuilding #cascadeTraining #doubleLoopLearning #knowDoGap #malaria #Nigeria #peerLearning -
Evaluation of a capacity building intervention on malaria treatment for children
The study by Ayodele Jegede and colleagues “Evaluation of a capacity building intervention on malaria treatment for under-fives in rural health facilities in Niger State, Nigeria” provides a rigorous evaluation of a standard “cascade training” intervention.
The intervention followed the classic global health model where national experts trained state trainers who then trained local government area facilitators who were supposed to train frontline health workers.
The results expose deep structural flaws in this approach.
The most damning finding was the “reach gap.”
Despite the intervention being fully funded and implemented, the cascade broke down before reaching the frontline.
Only 54% of the health workers who actually treat febrile children reported receiving the training.
The transmission of knowledge stopped at the facility in-charge level and did not filter down to the lower-level cadres who manage the bulk of the patient load.
Consequently, the study found no statistically significant difference in appropriate treatment practices between the intervention and control groups.
The study also illuminated the persistence of the “know-do” gap.
Even where testing rates increased, appropriate treatment did not necessarily follow.
A critical finding was that while health workers in the intervention arm correctly withheld artemisinin-based combination therapies (ACTs) from children who tested negative for malaria, they frequently substituted them with other inappropriate antimalarials or antibiotics.
This suggests that the training taught them the technical rule (“no ACT for negatives”) but failed to teach the adaptive clinical skill of how to manage a negative diagnosis and patient expectations.
Finally, the study highlighted the futility of training in the absence of system support.
Significant stock-outs of Rapid Diagnostic Tests (RDTs) and ACTs occurred in the intervention facilities.
On many visit days, half the facilities had no ACTs available.
The authors conclude that capacity building cannot be an isolated activity and must be embedded within a functioning supply chain and health system.
Analysis through the lens of learning science
This study provides the empirical “counter-factual” that justifies TGLF’s evidence-based rejection of the cascade training model.
It illustrates precisely why a digital-first and direct-to-learner approach is necessary from an epidemiological and operational perspective.
Overcoming transmission loss
The finding that the cascade reached only 54% of workers is a powerful argument for TGLF’s networked learning approach.
By using digital platforms to connect directly with individual health workers on their own devices, TGLF bypasses the “frozen middle” layers of hierarchy where cascade training stalls.
TGLF does not rely on a facility manager to pass on a message but invites both the frontline worker and the manager to join the conversation directly.
From rote compliance to critical thinking
The behavior of the health workers who stopped giving ACTs but switched to other inappropriate drugs demonstrates the failure of “single-loop” learning.
They learned the what (do not give ACT) but not the why or the how (clinical reasoning and stewardship).
TGLF’s “double-loop” learning model addresses this by engaging workers in peer dialogue about why they feel compelled to prescribe drugs for negative cases.
This might include patient pressure or fear of complications.
The model helps them develop strategies to manage those pressures rather than just memorizing a guideline.
Resilience in the face of system failure
The study shows that stock-outs rendered the training ineffective.
In a traditional model, the health worker is a passive victim of these stock-outs.
In TGLF’s “challenge-based” learning model, a worker is likely to be the first one to identify “frequent stock-outs” as their primary challenge.
The network would then connect them with peers who have solved similar supply chain issues.
This might be through better forecasting, redistribution from nearby clinics or advocacy with district officials.
TGLF aims to transform the worker from a passive recipient of training into an active agent of system change who can navigate the very barriers that defeated the intervention in Niger State.
Reference
Jegede, A., Willey, B., Hamade, P., Oshiname, F., Chandramohan, D., Ajayi, I., Falade, C., Baba, E., Webster, J., 2020. Evaluation of a capacity building intervention on malaria treatment for under-fives in rural health facilities in Niger State, Nigeria. Malar J 19, 90. https://doi.org/10.1186/s12936-020-03167-y
Reda Sadki (2024). Why does cascade training fail?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/j8vg0-yng46
Reda Sadki (2024). What is double-loop learning in global health?. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/s4xtw-b7274
#AyodeleJegede #capacityBuilding #cascadeTraining #doubleLoopLearning #knowDoGap #malaria #Nigeria #peerLearning -
5 surprising insights from the science of successful learning
The work of Reda Sadki offers a provocative, often counter-intuitive critique of how we learn, lead, and solve complex problems.
Here are five surprising insights from his body of work.
1. Text is superior to video for learning
In an era where educational technology is obsessed with video content, immersive simulations, and flashy multimedia, Sadki argues for the humble written word.
He asserts that the push for multimedia is often a “deception” that confuses engagement with entertainment.
In Richard Mayer’s research on multimedia for learning actually proves text works better, Sadki re-examines the foundational science of instructional design.
He points out that multimedia often creates “cognitive waste” by forcing the brain to split attention between visual and auditory streams.
He argues that well-structured text is “cognitively quiet” and far better suited for the high-level critical thinking required in complex fields.
He doubles down on this in Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content.
Here, he describes multimedia as an economic dead end.
He argues that text is not only cheaper and easier to update but also creates a more equitable learning environment for professionals in low-bandwidth settings.
2. Gamification is a “disaster” for humanitarian learning
While many organizations rush to “gamify” learning with badges, points, and leaderboards, Sadki calls this trend a “dead end.”
He argues that gamification is simply “lipstick on the pig of behaviorism,” a discredited theory that treats learners like rats in a maze responding to stimuli.
In Why gamification is a disaster for humanitarian learning, he makes a blistering case that games fail to model the complexity of the real world.
He points out that the dominant culture of video games often relies on violence and competition, which are antithetical to humanitarian values.
He argues that professionals facing life-and-death decisions need critical reasoning skills, not the artificial dopamine hits of a game.
3. Low completion rates can be a sign of success, not failure
In the world of online courses, a low completion rate is usually seen as a failure of design.
Sadki flips this metric on its head.
He suggests that in professional settings, “completion” is a vanity metric, part of the legacy of education systems that kept learners in closed environments.
In Online learning completion rates in context: Rethinking success in digital learning networks, he argues that busy professionals often engage with learning to solve a specific problem.
Once they find the solution, they leave.
This “drop-off” is actually efficient learning in action.
He warns that optimizing for completion often leads to dumbing down content rather than increasing its impact.
4. The “transparency paradox”: health workers are using AI in secret
One of Sadki’s most startling recent observations comes from his work with frontline health workers.
He reveals that professionals in the Global South are already using advanced Artificial Intelligence (AI) tools, but they are forced to hide this fact.
In Artificial intelligence, accountability, and authenticity: knowledge production and power in global health crisis, he describes a “transparency paradox.”
Global health systems are often punitive.
If a health worker admits to using AI to help draft a report or analyze data, their work is devalued as “inauthentic,” even if the quality is higher.
This forces innovation underground and prevents organizations from learning how to effectively partner with AI.
He expands on the solution in A global health framework for Artificial Intelligence as co-worker to support networked learning and local action, arguing that we must legitimize AI as a “co-worker” rather than a cheat.
5. Cascade training is mathematically doomed to fail
Finally, Sadki uses simple mathematics to dismantle one of the most common methods of training in the world: the “cascade” model, where experts train trainers, who train others.
In Why does cascade training fail?, he demonstrates that information loss at every level of the cascade is inevitable.
He argues that this model persists not because it works, but because it is convenient for hierarchical organizations.
He offers a stark alternative in Calculating the relative effectiveness of expert coaching, peer learning, and cascade training, where he proves that peer learning networks are the only model capable of scaling without losing quality.
#ArtificialIntelligence #completionRates #gamification #globalHealth #learningStrategy #multimediaLearning #RichardMayer #TheGenevaLearningFoundation -
5 surprising insights from the science of successful learning
The work of Reda Sadki offers a provocative, often counter-intuitive critique of how we learn, lead, and solve complex problems.
Here are five surprising insights from his body of work.
1. Text is superior to video for learning
In an era where educational technology is obsessed with video content, immersive simulations, and flashy multimedia, Sadki argues for the humble written word.
He asserts that the push for multimedia is often a “deception” that confuses engagement with entertainment.
In Richard Mayer’s research on multimedia for learning actually proves text works better, Sadki re-examines the foundational science of instructional design.
He points out that multimedia often creates “cognitive waste” by forcing the brain to split attention between visual and auditory streams.
He argues that well-structured text is “cognitively quiet” and far better suited for the high-level critical thinking required in complex fields.
He doubles down on this in Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content.
Here, he describes multimedia as an economic dead end.
He argues that text is not only cheaper and easier to update but also creates a more equitable learning environment for professionals in low-bandwidth settings.
2. Gamification is a “disaster” for humanitarian learning
While many organizations rush to “gamify” learning with badges, points, and leaderboards, Sadki calls this trend a “dead end.”
He argues that gamification is simply “lipstick on the pig of behaviorism,” a discredited theory that treats learners like rats in a maze responding to stimuli.
In Why gamification is a disaster for humanitarian learning, he makes a blistering case that games fail to model the complexity of the real world.
He points out that the dominant culture of video games often relies on violence and competition, which are antithetical to humanitarian values.
He argues that professionals facing life-and-death decisions need critical reasoning skills, not the artificial dopamine hits of a game.
3. Low completion rates can be a sign of success, not failure
In the world of online courses, a low completion rate is usually seen as a failure of design.
Sadki flips this metric on its head.
He suggests that in professional settings, “completion” is a vanity metric, part of the legacy of education systems that kept learners in closed environments.
In Online learning completion rates in context: Rethinking success in digital learning networks, he argues that busy professionals often engage with learning to solve a specific problem.
Once they find the solution, they leave.
This “drop-off” is actually efficient learning in action.
He warns that optimizing for completion often leads to dumbing down content rather than increasing its impact.
4. The “transparency paradox”: health workers are using AI in secret
One of Sadki’s most startling recent observations comes from his work with frontline health workers.
He reveals that professionals in the Global South are already using advanced Artificial Intelligence (AI) tools, but they are forced to hide this fact.
In Artificial intelligence, accountability, and authenticity: knowledge production and power in global health crisis, he describes a “transparency paradox.”
Global health systems are often punitive.
If a health worker admits to using AI to help draft a report or analyze data, their work is devalued as “inauthentic,” even if the quality is higher.
This forces innovation underground and prevents organizations from learning how to effectively partner with AI.
He expands on the solution in A global health framework for Artificial Intelligence as co-worker to support networked learning and local action, arguing that we must legitimize AI as a “co-worker” rather than a cheat.
5. Cascade training is mathematically doomed to fail
Finally, Sadki uses simple mathematics to dismantle one of the most common methods of training in the world: the “cascade” model, where experts train trainers, who train others.
In Why does cascade training fail?, he demonstrates that information loss at every level of the cascade is inevitable.
He argues that this model persists not because it works, but because it is convenient for hierarchical organizations.
He offers a stark alternative in Calculating the relative effectiveness of expert coaching, peer learning, and cascade training, where he proves that peer learning networks are the only model capable of scaling without losing quality.
#ArtificialIntelligence #completionRates #gamification #globalHealth #learningStrategy #multimediaLearning #RichardMayer #TheGenevaLearningFoundation -
5 reasons why our current systems of learning are broken – and how to fix them
Reda Sadki’s writing explores how systems of learning matter when tackling complex challenges across global health, humanitarian aid, and education.
Over twelve years of articles on his blog, he has built a cohesive argument for why our current systems of learning are broken and how we might fix them.
Since 2016, his work at The Geneva Learning Foundation has demonstrated how to turn such rethinking into new ways to learn and lead in the face of critical threats to our societies.
Here are five themes that define his work.
1. The failure of traditional systems of learning and the peer learning alternative
One of Sadki’s most persistent arguments is that the humanitarian and global health sectors are addicted to ineffective models of training.
He questions the “workshop culture” that flies experts around the world at great cost with little measurable impact.
He argues that this “sage on the stage” model assumes knowledge flows only one way: from the expert to the ignorant practitioner.
He is equally critical of digital replacements that merely replicate this dynamic.
In Why gamification is a disaster for humanitarian learning, he warns that dressing up behaviorist drills with points and badges does not foster the critical thinking needed in crisis zones.
He expands on this in Experience and blended learning: two heads of the humanitarian training chimera, arguing that “transmissive” learning fails to prepare professionals for volatility and complexity.
Instead, Sadki advocates for peer learning networks where practitioners teach and learn from each other.
As he explains in What learning science underpins peer learning for Global Health?, the goal is not to transmit information but to foster the “co-creation” of new knowledge that is directly applicable to local contexts.
2. Epistemic justice: valuing communities as systems of learning
Sadki frequently uses the philosophy of Donald Schön to distinguish between the “high ground” of theory and the “swampy lowlands” of practice.
He argues that global health suffers from “epistemic injustice” – a systematic devaluation of the experiential knowledge held by local health workers.
In Knowing-in-action: Bridging the theory-practice divide in global health, he makes the case that the gap between global guidelines and local reality can only be bridged by recognizing frontline workers as knowledge creators, not just recipients.
He challenges the hierarchy that dismisses local insights as mere “anecdote.”
In Anecdote or lived experience: reimagining knowledge for climate-resilient health systems, he proposes a new framework where the collective stories of thousands of health workers shape a new, rigorous form of evidence.
In Critical evidence gaps in the Lancet Countdown on health and climate change, he points out that the most rigorous science can miss the vital signals that only those working in communities can see.
3. Artificial intelligence as a co-worker
While many in education view Artificial Intelligence (AI) as a threat to integrity or a tool for cheating, Sadki frames it as a transformative partner.
He argues that we are entering a new epoch where AI will not just be a tool we use, but a “co-worker” we collaborate with.
In A global health framework for Artificial Intelligence as co-worker to support networked learning and local action, he outlines how AI can support the “human” parts of learning – such as feedback and synthesis – without replacing human agency.
He explores the profound shifts in how we will interact with technology in The agentic AI revolution: what does it mean for workforce development?, describing a future where “AI agents” handle coordination, freeing humans to focus on judgment and ethics.
He pushes this further in Why YouTube is obsolete: From linear video content consumption to AI-mediated multimodal knowledge production, suggesting that AI will fundamentally change how we consume information, moving us away from linear formats like video lectures toward dynamic, interactive knowledge creation and retrieval.
4. Learning culture as the driver of learning systems
Sadki insists that learning is not an event but a culture.
Drawing heavily on the research of Karen E. Watkins and Victoria Marsick, he argues that an organization’s “learning culture” is the single best predictor of its ability to adapt and perform.
In Learning culture: the missing link in global health between learning and performance, he explains that without a culture that supports inquiry, dialogue, and risk-taking, even the best training programs will fail.
He identifies specific weaknesses in current systems, noting in Why lack of continuous learning is the Achilles heel of immunization that health systems often prioritize task completion over the continuous learning necessary to improve those tasks.
This theme connects deeply to leadership.
He argues in What is the relationship between leadership and performance? that true leadership is not about authority but about fostering an environment where learning can happen at every level of the hierarchy.
5. New ways to bridge the gap from policy to action
Finally, Sadki focuses relentlessly on the “know-do” gap, the disconnect between global policy and local implementation.
He argues that guidelines often fail because they are designed without the input of those who must implement them.
In Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems, he dissects how the separation of “thinkers” (global experts) and “doers” (local staff) dooms many initiatives.
He offers concrete examples of how to close this gap, such as in The Nigeria Immunization Collaborative: Early learning from a novel sector-wide approach model for zero-dose challenges, where thousands of health workers used peer learning to identify root causes of vaccine inequity that central planners had missed.
This theme emphasizes that the solution is not more “technical assistance” from the outside, but better mechanisms to unlock the problem-solving capacity that already exists within communities.
Beyond learning: a new operating system in global development
Taken together, these themes provide the specifications for a new operating system in global development, one that moves beyond the limitations of the models of today.
- Sadki’s work challenges the sector to recognize its most undervalued asset: the collective intelligence of the health and humanitarian workforce.
- By dismantling the barriers between the “high ground” of policy and the “swampy lowlands” of practice, his framework constructs a learning ecosystem where artificial intelligence amplifies human connection and local insights continuously refine global strategy.
- This evolution—from episodic workshops to continuous, networked problem-solving—offers a pragmatic path to close the persistent gap between investment and outcome.
In a resource-constrained world, unlocking this latent capacity is not merely an ethical choice, but a strategic imperative to build systems resilient enough for an unpredictable future.
#blendedLearning #epistemicJustice #learning #learningStrategy #peerLearning #workshopCulture -
5 reasons why our current systems of learning are broken – and how to fix them
Reda Sadki’s writing explores how systems of learning matter when tackling complex challenges across global health, humanitarian aid, and education.
Over twelve years of articles on his blog, he has built a cohesive argument for why our current systems of learning are broken and how we might fix them.
Since 2016, his work at The Geneva Learning Foundation has demonstrated how to turn such rethinking into new ways to learn and lead in the face of critical threats to our societies.
Here are five themes that define his work.
1. The failure of traditional systems of learning and the peer learning alternative
One of Sadki’s most persistent arguments is that the humanitarian and global health sectors are addicted to ineffective models of training.
He questions the “workshop culture” that flies experts around the world at great cost with little measurable impact.
He argues that this “sage on the stage” model assumes knowledge flows only one way: from the expert to the ignorant practitioner.
He is equally critical of digital replacements that merely replicate this dynamic.
In Why gamification is a disaster for humanitarian learning, he warns that dressing up behaviorist drills with points and badges does not foster the critical thinking needed in crisis zones.
He expands on this in Experience and blended learning: two heads of the humanitarian training chimera, arguing that “transmissive” learning fails to prepare professionals for volatility and complexity.
Instead, Sadki advocates for peer learning networks where practitioners teach and learn from each other.
As he explains in What learning science underpins peer learning for Global Health?, the goal is not to transmit information but to foster the “co-creation” of new knowledge that is directly applicable to local contexts.
2. Epistemic justice: valuing communities as systems of learning
Sadki frequently uses the philosophy of Donald Schön to distinguish between the “high ground” of theory and the “swampy lowlands” of practice.
He argues that global health suffers from “epistemic injustice” – a systematic devaluation of the experiential knowledge held by local health workers.
In Knowing-in-action: Bridging the theory-practice divide in global health, he makes the case that the gap between global guidelines and local reality can only be bridged by recognizing frontline workers as knowledge creators, not just recipients.
He challenges the hierarchy that dismisses local insights as mere “anecdote.”
In Anecdote or lived experience: reimagining knowledge for climate-resilient health systems, he proposes a new framework where the collective stories of thousands of health workers shape a new, rigorous form of evidence.
In Critical evidence gaps in the Lancet Countdown on health and climate change, he points out that the most rigorous science can miss the vital signals that only those working in communities can see.
3. Artificial intelligence as a co-worker
While many in education view Artificial Intelligence (AI) as a threat to integrity or a tool for cheating, Sadki frames it as a transformative partner.
He argues that we are entering a new epoch where AI will not just be a tool we use, but a “co-worker” we collaborate with.
In A global health framework for Artificial Intelligence as co-worker to support networked learning and local action, he outlines how AI can support the “human” parts of learning – such as feedback and synthesis – without replacing human agency.
He explores the profound shifts in how we will interact with technology in The agentic AI revolution: what does it mean for workforce development?, describing a future where “AI agents” handle coordination, freeing humans to focus on judgment and ethics.
He pushes this further in Why YouTube is obsolete: From linear video content consumption to AI-mediated multimodal knowledge production, suggesting that AI will fundamentally change how we consume information, moving us away from linear formats like video lectures toward dynamic, interactive knowledge creation and retrieval.
4. Learning culture as the driver of learning systems
Sadki insists that learning is not an event but a culture.
Drawing heavily on the research of Karen E. Watkins and Victoria Marsick, he argues that an organization’s “learning culture” is the single best predictor of its ability to adapt and perform.
In Learning culture: the missing link in global health between learning and performance, he explains that without a culture that supports inquiry, dialogue, and risk-taking, even the best training programs will fail.
He identifies specific weaknesses in current systems, noting in Why lack of continuous learning is the Achilles heel of immunization that health systems often prioritize task completion over the continuous learning necessary to improve those tasks.
This theme connects deeply to leadership.
He argues in What is the relationship between leadership and performance? that true leadership is not about authority but about fostering an environment where learning can happen at every level of the hierarchy.
5. New ways to bridge the gap from policy to action
Finally, Sadki focuses relentlessly on the “know-do” gap, the disconnect between global policy and local implementation.
He argues that guidelines often fail because they are designed without the input of those who must implement them.
In Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems, he dissects how the separation of “thinkers” (global experts) and “doers” (local staff) dooms many initiatives.
He offers concrete examples of how to close this gap, such as in The Nigeria Immunization Collaborative: Early learning from a novel sector-wide approach model for zero-dose challenges, where thousands of health workers used peer learning to identify root causes of vaccine inequity that central planners had missed.
This theme emphasizes that the solution is not more “technical assistance” from the outside, but better mechanisms to unlock the problem-solving capacity that already exists within communities.
Beyond learning: a new operating system in global development
Taken together, these themes provide the specifications for a new operating system in global development, one that moves beyond the limitations of the models of today.
- Sadki’s work challenges the sector to recognize its most undervalued asset: the collective intelligence of the health and humanitarian workforce.
- By dismantling the barriers between the “high ground” of policy and the “swampy lowlands” of practice, his framework constructs a learning ecosystem where artificial intelligence amplifies human connection and local insights continuously refine global strategy.
- This evolution—from episodic workshops to continuous, networked problem-solving—offers a pragmatic path to close the persistent gap between investment and outcome.
In a resource-constrained world, unlocking this latent capacity is not merely an ethical choice, but a strategic imperative to build systems resilient enough for an unpredictable future.
#blendedLearning #epistemicJustice #learning #learningStrategy #peerLearning #workshopCulture -
Retention and completion in online learning: recommended strategies for improvement
Why learner support is the heart of an effective program
If you are designing an online or blended program for busy professionals, the single most powerful lever you control is how you support learners.
When support is strong, people are more likely to stay in the program, complete activities, and actually change what they do in practice.
When support is weak or confusing, even well designed courses with great content lose many if not most learners along the way.
The three layers of support you need
You can think about learner support as three layers that reinforce each other.
- Institutional support that makes it possible for people to participate.
- Facilitator support that guides learning week by week.
- Peer support that turns a group of individuals into a learning community.
For professional development, all three layers matter, because participants are usually working full time, may be coping with professional and personal crises, and trying to apply learning in messy real-world contexts.
Institutional support: remove friction and signal that people matter
Formal education studies show that institutional support is the top factor leaders associate with online course completion. Learners themselves say that the absence of support matters (although what learners perceive may not always be useful).
For professional development, the same holds, with a few practical priorities.
Design for these.
- Clear onboarding. One simple, concrete explanation of what the program is for, what time it will take, what the main milestones are, and what support is available.
- Early interventions. Use simple data, such as missed activities or logins, to spot people who are falling behind, and reach out with short, human messages that ask what is happening and how you can help.
- All the time support. Offer at least one channel where participants can ask questions at any point, for example an email address, messaging group, or simple help desk, and respond quickly with practical answers.
- Realistic policies. Align deadlines and expectations with the reality that people are working, caring for others, and responding to emergencies, for example by allowing extensions for workload peaks, not just medical reasons.
- Support for facilitators. Provide facilitators with training, mentoring, and simple tools so that they can give good support without burning out.
In an international online professional development program for teachers, for example, adding personalized support such as short one-to-one sessions and encouragement messages increased completion rates by about ten percent for some groups.
Instructor support: scaffolding learning so no one is left alone
Research with university students shows that learners in online courses expect instructors to help them feel connected, understand what to do, and stay on track, and that weak instructor presence is linked to withdrawal.
In professional development, instructors or facilitators play a similar role, but with more emphasis on helping people apply ideas in their own context.
This is where scaffolding comes in.
Scaffolding means giving targeted support that helps learners do something today that they would not yet manage alone, then gradually reducing that support as they gain confidence and skill.
Here are five practical scaffolding moves you can build into your program.
- Start strong with procedural guidance. At the beginning, be very explicit about how to use the platform, where to find things, what a successful piece of work looks like, and how to ask for help.
- Use regular, short check ins. Weekly announcements, quick videos, or short written updates help participants know what to focus on next and reduce the sense of being lost.
- Give timely, formative feedback. Comment on early attempts while there is still time to adjust, focusing on specific behaviours that are within the learner’s control, and point them to next steps rather than only judging.
- Anticipate pressure points. Increase guidance and availability before key deadlines, because research shows that this is when learners feel the most stress and are at higher risk of dropping out.
- Fade support as people progress. As the group gains experience, shift from detailed instructions to open questions, peer advice, and reflection so that they take more responsibility for their own learning.
In an online leadership course, for example, students described scaffolding as a kind of coaching, where lecturers monitored engagement, encouraged them, corrected misconceptions, and gave direction when needed, which helped them persist and complete.
Peer support: building a community that carries learners through
Multiple studies of online and blended learning find that peer interaction is one of the strongest predictors of engagement and persistence, especially in intensive or demanding programs.
In professional development, peers also bring real world experience, local knowledge, and emotional support that no central team can fully provide.
To make peer support work, you need to design it.
Concrete peer structures you can use include:
- Small, stable groups. Place participants in small teams that stay together, so that they can get to know each other and feel safe enough to share challenges.
- Peer learning tasks. Ask peers to review each other’s plans, case examples, or reflections using simple guiding questions or checklists, so that feedback is focused and constructive.
- Shared problem solving. Use forums or live sessions where participants bring real problems from their practice, and others suggest options, share similar experiences, and adapt ideas together.
- Peer mentors. In longer programs, involve experienced alumni or more advanced participants as peer mentors, which has been shown to support both mentees and mentors.
A grounded theory study of an authentic online professional development program found that learning happened in a web of interactions where peers and mentors were central, and content and technology played a supporting role, which is directly applicable to professional communities of practice.
Translating formal education evidence to professional development
Most of the detailed evidence on retention and support comes from higher education students. Nevertheless, some patterns make sense for professional development, if you adjust for context.
Here are three insights from higher education that apply to in-service professional development:
- Many adults underestimate the time and effort that online learning will require, so you need to help them plan and manage time, not only give them content.
- Clear structure and signalling of what matters this week reduce cognitive load and make it easier to fit learning around work and family.
- Emotional connection and a sense of belonging are just as important for professionals as for students, because feeling part of something bigger makes it easier to keep going when life is difficult.
Online professional development reviews also point to some specific needs of professionals.
- Relevance and authenticity. Adults stay engaged when activities are directly tied to their real work and invite them to try things out and report back.
- Flexibility with accountability. Professionals value flexible timing, but completion improves when there are clear milestones, visible progress, and light touch reminders.
- Pathways for application. Support should include help in adapting ideas to local constraints, for example through coaching, team based projects, or mentoring, not only through individual reflection.
Designing your next program with support at the center
When you design or redesign a program, start by sketching the support system, not only the curriculum.
Ask yourself three practical questions.
- How will participants experience institutional support from the moment they hear about the program until after it ends?
- How will facilitators scaffold learning over time so that no one is left alone at the hardest points?
- How will peers help each other to stay motivated, solve problems, and turn ideas into action?
If you can give clear, concrete answers to those questions, grounded in the evidence above, you will have moved a long way toward an effective, humane program that busy professionals can complete and use in practice.
References
da Rosa Ferrarelli, L., 2015. Online scaffolding in a fully online educational leadership course. Journal of Open, Flexible and Distance Learning, 19(2), pp.24–35. (Repository record, no DOI reported.) Available at: https://researchcommons.waikato.ac.nz/items/94bfea8f-a990-4509-b7e6-b93c1a20949e.
Leary, H., Dopp, C., Turley, C., Cheney, M., Simmons, Z., Graham, C.R. and Larsen, R., 2020. Professional development for online teaching: A literature review. Online Learning, 24(4), pp.254–275. Available at: https://doi.org/10.24059/olj.v24i4.2198.
Muljana, P.S. and Luo, T., 2019. Factors contributing to student retention in online learning and recommended strategies for improvement: A systematic literature review. Journal of Information Technology Education: Research, 18, pp.19–57. Available at: https://doi.org/10.28945/4182.
Roddy, C., 2017. A grounded theory of professional learning in an authentic online professional development program. International Review of Research in Open and Distributed Learning, 18(7), pp.141–160. Available at: https://doi.org/10.19173/irrodl.v18i7.2923.
Roddy, C., Amiet, D.L., Chung, J., Holt, C., Shaw, L., McKenzie, S., Garivaldis, F., Lodge, J.M. and Mundy, M.E., 2017. Applying best practice online learning, teaching, and support to intensive online environments: An integrative review. Frontiers in Education, 2, 59. Available at: https://doi.org/10.3389/feduc.2017.00059.
Sadki, R. (2024). Why asking learners what they want is a recipe for confusion. Reda Sadki. https://doi.org/10.59350/6z9yb-r4b94
Sadki, R. (2025). Online learning completion rates in context: Rethinking success in digital learning networks. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/qadwd-87309
Sadki, R. (2025). The great unlearning: notes on the Empower Learners for the Age of AI conference. Reda Sadki. https://doi.org/10.59350/859ed-e8148
Sharman, R., 2015. A model of peer learning incorporating scaffolding strategies. Doctoral dissertation, Virginia Polytechnic Institute and State University. (No DOI, institutional repository.) Available at: https://vtechworks.lib.vt.edu/server/api/core/bitstreams/2d867c26-49b0-4474-b7f3-11d452e7d9bd/content.
#completion #facilitatorSupport #FactorsContributingToStudentRetentionInOnlineLearningAndRecommendedStrategiesForImprovement #peerSupport #professionalDevelopment #retention #scaffolding -
Retention and completion in online learning: recommended strategies for improvement
Why learner support is the heart of an effective program
If you are designing an online or blended program for busy professionals, the single most powerful lever you control is how you support learners.
When support is strong, people are more likely to stay in the program, complete activities, and actually change what they do in practice.
When support is weak or confusing, even well designed courses with great content lose many if not most learners along the way.
The three layers of support you need
You can think about learner support as three layers that reinforce each other.
- Institutional support that makes it possible for people to participate.
- Facilitator support that guides learning week by week.
- Peer support that turns a group of individuals into a learning community.
For professional development, all three layers matter, because participants are usually working full time, may be coping with professional and personal crises, and trying to apply learning in messy real-world contexts.
Institutional support: remove friction and signal that people matter
Formal education studies show that institutional support is the top factor leaders associate with online course completion. Learners themselves say that the absence of support matters (although what learners perceive may not always be useful).
For professional development, the same holds, with a few practical priorities.
Design for these.
- Clear onboarding. One simple, concrete explanation of what the program is for, what time it will take, what the main milestones are, and what support is available.
- Early interventions. Use simple data, such as missed activities or logins, to spot people who are falling behind, and reach out with short, human messages that ask what is happening and how you can help.
- All the time support. Offer at least one channel where participants can ask questions at any point, for example an email address, messaging group, or simple help desk, and respond quickly with practical answers.
- Realistic policies. Align deadlines and expectations with the reality that people are working, caring for others, and responding to emergencies, for example by allowing extensions for workload peaks, not just medical reasons.
- Support for facilitators. Provide facilitators with training, mentoring, and simple tools so that they can give good support without burning out.
In an international online professional development program for teachers, for example, adding personalized support such as short one-to-one sessions and encouragement messages increased completion rates by about ten percent for some groups.
Instructor support: scaffolding learning so no one is left alone
Research with university students shows that learners in online courses expect instructors to help them feel connected, understand what to do, and stay on track, and that weak instructor presence is linked to withdrawal.
In professional development, instructors or facilitators play a similar role, but with more emphasis on helping people apply ideas in their own context.
This is where scaffolding comes in.
Scaffolding means giving targeted support that helps learners do something today that they would not yet manage alone, then gradually reducing that support as they gain confidence and skill.
Here are five practical scaffolding moves you can build into your program.
- Start strong with procedural guidance. At the beginning, be very explicit about how to use the platform, where to find things, what a successful piece of work looks like, and how to ask for help.
- Use regular, short check ins. Weekly announcements, quick videos, or short written updates help participants know what to focus on next and reduce the sense of being lost.
- Give timely, formative feedback. Comment on early attempts while there is still time to adjust, focusing on specific behaviours that are within the learner’s control, and point them to next steps rather than only judging.
- Anticipate pressure points. Increase guidance and availability before key deadlines, because research shows that this is when learners feel the most stress and are at higher risk of dropping out.
- Fade support as people progress. As the group gains experience, shift from detailed instructions to open questions, peer advice, and reflection so that they take more responsibility for their own learning.
In an online leadership course, for example, students described scaffolding as a kind of coaching, where lecturers monitored engagement, encouraged them, corrected misconceptions, and gave direction when needed, which helped them persist and complete.
Peer support: building a community that carries learners through
Multiple studies of online and blended learning find that peer interaction is one of the strongest predictors of engagement and persistence, especially in intensive or demanding programs.
In professional development, peers also bring real world experience, local knowledge, and emotional support that no central team can fully provide.
To make peer support work, you need to design it.
Concrete peer structures you can use include:
- Small, stable groups. Place participants in small teams that stay together, so that they can get to know each other and feel safe enough to share challenges.
- Peer learning tasks. Ask peers to review each other’s plans, case examples, or reflections using simple guiding questions or checklists, so that feedback is focused and constructive.
- Shared problem solving. Use forums or live sessions where participants bring real problems from their practice, and others suggest options, share similar experiences, and adapt ideas together.
- Peer mentors. In longer programs, involve experienced alumni or more advanced participants as peer mentors, which has been shown to support both mentees and mentors.
A grounded theory study of an authentic online professional development program found that learning happened in a web of interactions where peers and mentors were central, and content and technology played a supporting role, which is directly applicable to professional communities of practice.
Translating formal education evidence to professional development
Most of the detailed evidence on retention and support comes from higher education students. Nevertheless, some patterns make sense for professional development, if you adjust for context.
Here are three insights from higher education that apply to in-service professional development:
- Many adults underestimate the time and effort that online learning will require, so you need to help them plan and manage time, not only give them content.
- Clear structure and signalling of what matters this week reduce cognitive load and make it easier to fit learning around work and family.
- Emotional connection and a sense of belonging are just as important for professionals as for students, because feeling part of something bigger makes it easier to keep going when life is difficult.
Online professional development reviews also point to some specific needs of professionals.
- Relevance and authenticity. Adults stay engaged when activities are directly tied to their real work and invite them to try things out and report back.
- Flexibility with accountability. Professionals value flexible timing, but completion improves when there are clear milestones, visible progress, and light touch reminders.
- Pathways for application. Support should include help in adapting ideas to local constraints, for example through coaching, team based projects, or mentoring, not only through individual reflection.
Designing your next program with support at the center
When you design or redesign a program, start by sketching the support system, not only the curriculum.
Ask yourself three practical questions.
- How will participants experience institutional support from the moment they hear about the program until after it ends?
- How will facilitators scaffold learning over time so that no one is left alone at the hardest points?
- How will peers help each other to stay motivated, solve problems, and turn ideas into action?
If you can give clear, concrete answers to those questions, grounded in the evidence above, you will have moved a long way toward an effective, humane program that busy professionals can complete and use in practice.
References
da Rosa Ferrarelli, L., 2015. Online scaffolding in a fully online educational leadership course. Journal of Open, Flexible and Distance Learning, 19(2), pp.24–35. (Repository record, no DOI reported.) Available at: https://researchcommons.waikato.ac.nz/items/94bfea8f-a990-4509-b7e6-b93c1a20949e.
Leary, H., Dopp, C., Turley, C., Cheney, M., Simmons, Z., Graham, C.R. and Larsen, R., 2020. Professional development for online teaching: A literature review. Online Learning, 24(4), pp.254–275. Available at: https://doi.org/10.24059/olj.v24i4.2198.
Muljana, P.S. and Luo, T., 2019. Factors contributing to student retention in online learning and recommended strategies for improvement: A systematic literature review. Journal of Information Technology Education: Research, 18, pp.19–57. Available at: https://doi.org/10.28945/4182.
Roddy, C., 2017. A grounded theory of professional learning in an authentic online professional development program. International Review of Research in Open and Distributed Learning, 18(7), pp.141–160. Available at: https://doi.org/10.19173/irrodl.v18i7.2923.
Roddy, C., Amiet, D.L., Chung, J., Holt, C., Shaw, L., McKenzie, S., Garivaldis, F., Lodge, J.M. and Mundy, M.E., 2017. Applying best practice online learning, teaching, and support to intensive online environments: An integrative review. Frontiers in Education, 2, 59. Available at: https://doi.org/10.3389/feduc.2017.00059.
Sadki, R. (2024). Why asking learners what they want is a recipe for confusion. Reda Sadki. https://doi.org/10.59350/6z9yb-r4b94
Sadki, R. (2025). Online learning completion rates in context: Rethinking success in digital learning networks. Reda Sadki: Learning to make a difference. https://doi.org/10.59350/qadwd-87309
Sadki, R. (2025). The great unlearning: notes on the Empower Learners for the Age of AI conference. Reda Sadki. https://doi.org/10.59350/859ed-e8148
Sharman, R., 2015. A model of peer learning incorporating scaffolding strategies. Doctoral dissertation, Virginia Polytechnic Institute and State University. (No DOI, institutional repository.) Available at: https://vtechworks.lib.vt.edu/server/api/core/bitstreams/2d867c26-49b0-4474-b7f3-11d452e7d9bd/content.
#completion #facilitatorSupport #FactorsContributingToStudentRetentionInOnlineLearningAndRecommendedStrategiesForImprovement #peerSupport #professionalDevelopment #retention #scaffolding -
Digital propinquity: how to engineer serendipity and build connection in remote teams
We cannot teleport physical proximity, but we can replicate its psychological effects in remote teams. This has everything to do with propinquity.
If the physical world provided connection by accident, the digital world requires connection by design.
The most critical loss in the shift to remote work is “propinquity,” a fancy word for physical nearness.
In the 1950s, psychologists discovered that the single best predictor of whether two people would become friends was how close their apartments were to each other.
In the professional world, this is the “hallway track” at a conference.
It is inefficient, but it is highly effective because it facilitates passive, frequent interactions.
You bump into someone at the coffee station.
You exchange a nod.
You accumulate data points about them that transform a transactional contact into a human relationship.
In a remote setting, propinquity does not happen by accident.
There is no digital equivalent of bumping into a donor at the water cooler unless someone deliberately builds it.
This requires a pivot to “Digital Propinquity.”
At The Geneva Learning Foundation, A Swiss non-profit that works globally, we have found that a sense of nearness can be cultivated digitally if we align the right factors.
In our work with health professionals globally, we utilize a concept called “structured serendipity”.
For example, one simple and surprisingly effective method we use is the “Randomized Coffee Trial”, or just “remote coffee”.
In this model, participants opt-in to be randomly paired with a stranger from the network for a short conversation based on a non-work prompt.
This mechanism builds “weak ties,” the casual connections that sociologists know are essential for innovation.
We have also found that we can change how we facilitate dialogue and connections between people and organizations online.
Traditional remote management is often rooted in a culture of surveillance.
It focuses on reporting and asks “Have you done the work?”.
This erodes trust, turning connection into suspicion.
Instead, we implement what we call “digital accompaniment”.
Derived from physical-world experiences of working side-by-side with a shared purpose, this model uses technology to provide sustained, high-touch presence.
The use of technology results in losing some of the signals we are most familiar with, grounded in our experience of the physical world.
We also gain new signals from defying distance to include those who might otherwise never meet.
The challenge is learning to listen to these signals, and how to respond to them.
That is core to our model for facilitation.
We use digital channels that are already part of people’s lives to ask: “How are you navigating this challenge?”.
This initiates and then sustains dialogue on local challenges.
Challenges in very different locations turn out to be remarkably similar.
This approach prioritizes psychological proximity over supervision, no matter how supportive the latter may be intended to be.
By establishing what we call Accompaniment Pods mediated by Foundation-supported facilitators, such networks can provide the psychological closeness usually found in face-to-face mentorship.
The facilitator acts as a sensor for the network, for example to detect early signs of distress before a participant disengages.
By treating the digital space as a distinct social architecture with its own ‘physics’, we have been able to reconstruct a new kind of intimacy or kinship that distance negates.
A new peer learning programme for those leading change across distance
Distance is no longer a barrier to partnership. It is the condition for a new kind of “augmented reality” where collaboration can be more inclusive and effective than in the physical world. The Geneva Learning Foundation’s Certificate peer learning programme in Artificial Intelligence includes a tactical primer to master the essentials of digital, remote work and partnering with both humans and machines as co-workers. The primer serves as the stepping stone to a broader strategic transformation, where you will learn to build communities of action that scale expertise and deliver results faster. By rejecting the “digital dualism” that treats online interaction as a deficit, you will turn the necessity of working apart into a decisive organizational advantage. Get The Geneva Learning Foundation’s AI framework now. You will then receive the invitation to join the primer on the essentials of partnering and work in the Age of AI.
References
- Allen, T.J. (1977) Managing the Flow of Technology: Technology Transfer and the Dissemination of Technological Information within the R&D Organization. Cambridge, MA: MIT Press.
- Festinger, L., Schachter, S. and Back, K. (1950) Social Pressures in Informal Groups: A Study of Human Factors in Housing. Stanford: Stanford University Press.
- Granovetter, M.S. (1973) ‘The Strength of Weak Ties’, American Journal of Sociology, 78(6), pp. 1360–1380. Available at: https://doi.org/10.1086/225469
- Korzenny, F. (1978) ‘A Theory of Electronic Propinquity: Mediated Communication in Organizations’, Communication Research, 5(1), pp. 3–24. Available at: https://doi.org/10.1177/009365027800500101
- Sadki, R., 2023. Digital bridges cannot cross analog gates. https://doi.org/10.59350/srvap-txc24
- Soto, M., 2013. Institutionalising Serendipity via Productive Coffee Breaks. Nesta. URL https://www.nesta.org.uk/blog/institutionalising-serendipity-productive-coffee-breaks (accessed 2.8.18).
- Watkins, K.E., Sadki, R., Kim, K., Suh, B., 2019. Changing Learning Paradigms in a Global Health Agency, in: Evidence-Based Initiatives for Organizational Change and Development. IGI Global, pp. 693–703. https://doi.org/10.4018/978-1-5225-6155-2.ch050
About the image
Near, Without Touch © The Geneva Learning Foundation 2025. This installation arranges a series of carved forms in deliberate proximity, each distinct yet subtly responsive to the others. The surfaces twist and lean as if drawn together by an unseen force, suggesting closeness that is sensed rather than physically realized. Made from the same living material but shaped along different trajectories, the figures evoke how connection can emerge through alignment, attention, and shared orientation rather than direct contact. The work reflects on proximity as something that can be engineered and cultivated, reminding us that nearness is not only a matter of distance, but of how carefully space is shaped to allow encounters to happen.
#AccompanimentPods #connectivism #digitalAccompaniment #networks #physicalPresence #propinquity #remoteTeams -
Digital propinquity: how to engineer serendipity and build connection in remote teams
We cannot teleport physical proximity, but we can replicate its psychological effects in remote teams. This has everything to do with propinquity.
If the physical world provided connection by accident, the digital world requires connection by design.
The most critical loss in the shift to remote work is “propinquity,” a fancy word for physical nearness.
In the 1950s, psychologists discovered that the single best predictor of whether two people would become friends was how close their apartments were to each other.
In the professional world, this is the “hallway track” at a conference.
It is inefficient, but it is highly effective because it facilitates passive, frequent interactions.
You bump into someone at the coffee station.
You exchange a nod.
You accumulate data points about them that transform a transactional contact into a human relationship.
In a remote setting, propinquity does not happen by accident.
There is no digital equivalent of bumping into a donor at the water cooler unless someone deliberately builds it.
This requires a pivot to “Digital Propinquity.”
At The Geneva Learning Foundation, A Swiss non-profit that works globally, we have found that a sense of nearness can be cultivated digitally if we align the right factors.
In our work with health professionals globally, we utilize a concept called “structured serendipity”.
For example, one simple and surprisingly effective method we use is the “Randomized Coffee Trial”, or just “remote coffee”.
In this model, participants opt-in to be randomly paired with a stranger from the network for a short conversation based on a non-work prompt.
This mechanism builds “weak ties,” the casual connections that sociologists know are essential for innovation.
We have also found that we can change how we facilitate dialogue and connections between people and organizations online.
Traditional remote management is often rooted in a culture of surveillance.
It focuses on reporting and asks “Have you done the work?”.
This erodes trust, turning connection into suspicion.
Instead, we implement what we call “digital accompaniment”.
Derived from physical-world experiences of working side-by-side with a shared purpose, this model uses technology to provide sustained, high-touch presence.
The use of technology results in losing some of the signals we are most familiar with, grounded in our experience of the physical world.
We also gain new signals from defying distance to include those who might otherwise never meet.
The challenge is learning to listen to these signals, and how to respond to them.
That is core to our model for facilitation.
We use digital channels that are already part of people’s lives to ask: “How are you navigating this challenge?”.
This initiates and then sustains dialogue on local challenges.
Challenges in very different locations turn out to be remarkably similar.
This approach prioritizes psychological proximity over supervision, no matter how supportive the latter may be intended to be.
By establishing what we call Accompaniment Pods mediated by Foundation-supported facilitators, such networks can provide the psychological closeness usually found in face-to-face mentorship.
The facilitator acts as a sensor for the network, for example to detect early signs of distress before a participant disengages.
By treating the digital space as a distinct social architecture with its own ‘physics’, we have been able to reconstruct a new kind of intimacy or kinship that distance negates.
A new peer learning programme for those leading change across distance
Distance is no longer a barrier to partnership. It is the condition for a new kind of “augmented reality” where collaboration can be more inclusive and effective than in the physical world. The Geneva Learning Foundation’s Certificate peer learning programme in Artificial Intelligence includes a tactical primer to master the essentials of digital, remote work and partnering with both humans and machines as co-workers. The primer serves as the stepping stone to a broader strategic transformation, where you will learn to build communities of action that scale expertise and deliver results faster. By rejecting the “digital dualism” that treats online interaction as a deficit, you will turn the necessity of working apart into a decisive organizational advantage. Get The Geneva Learning Foundation’s AI framework now. You will then receive the invitation to join the primer on the essentials of partnering and work in the Age of AI.
References
- Allen, T.J. (1977) Managing the Flow of Technology: Technology Transfer and the Dissemination of Technological Information within the R&D Organization. Cambridge, MA: MIT Press.
- Festinger, L., Schachter, S. and Back, K. (1950) Social Pressures in Informal Groups: A Study of Human Factors in Housing. Stanford: Stanford University Press.
- Granovetter, M.S. (1973) ‘The Strength of Weak Ties’, American Journal of Sociology, 78(6), pp. 1360–1380. Available at: https://doi.org/10.1086/225469
- Korzenny, F. (1978) ‘A Theory of Electronic Propinquity: Mediated Communication in Organizations’, Communication Research, 5(1), pp. 3–24. Available at: https://doi.org/10.1177/009365027800500101
- Sadki, R., 2023. Digital bridges cannot cross analog gates. https://doi.org/10.59350/srvap-txc24
- Soto, M., 2013. Institutionalising Serendipity via Productive Coffee Breaks. Nesta. URL https://www.nesta.org.uk/blog/institutionalising-serendipity-productive-coffee-breaks (accessed 2.8.18).
- Watkins, K.E., Sadki, R., Kim, K., Suh, B., 2019. Changing Learning Paradigms in a Global Health Agency, in: Evidence-Based Initiatives for Organizational Change and Development. IGI Global, pp. 693–703. https://doi.org/10.4018/978-1-5225-6155-2.ch050
About the image
Near, Without Touch © The Geneva Learning Foundation 2025. This installation arranges a series of carved forms in deliberate proximity, each distinct yet subtly responsive to the others. The surfaces twist and lean as if drawn together by an unseen force, suggesting closeness that is sensed rather than physically realized. Made from the same living material but shaped along different trajectories, the figures evoke how connection can emerge through alignment, attention, and shared orientation rather than direct contact. The work reflects on proximity as something that can be engineered and cultivated, reminding us that nearness is not only a matter of distance, but of how carefully space is shaped to allow encounters to happen.
#AccompanimentPods #connectivism #digitalAccompaniment #networks #physicalPresence #propinquity #remoteTeams -
How can governments protect and promote mental health and well-being across sectors?
For decades, global health policy has approached mental illness primarily as a clinical challenge, a condition to be managed within the walls of hospitals and clinics by medical professionals. This biomedical focus, while essential, has often obscured the broader context in which mental health is shaped. A new publication from the World Health Organization, Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors, marks a significant shift in normative standards. It posits that mental health is not merely a health outcome but a structural one, determined as much by the fiscal policy, urban planning, and labor laws of governments as by psychiatric care.
A technical framework for cross-sectoral governance
The guidance emerges against a backdrop of escalating costs. The global economic burden of mental health conditions is projected to reach US$6 trillion by 2030. In response, the WHO outlines a “whole-of-government” approach, moving beyond general advocacy to provide specific policy directives for ministries that have historically operated independently of mental health considerations.
The document details an eight-step implementation cycle, requiring high-level political dialogue, rigorous situational analysis, and the drafting of sector-specific policies. It assigns distinct responsibilities to key government sectors:
- Finance and Treasury: The guidance suggests that fiscal policies – including tax rates and welfare allocations – must be evaluated for their impact on health equity, rather than viewing mental health funding solely as a healthcare expenditure.
- Interior and Justice: It recommends a shift in the role of police and prisons, advocating for the retraining of first responders to manage crises through de-escalation rather than coercion, and establishing independent mechanisms to report abuse.
- Education and Employment: The framework calls for schools to embed social-emotional learning into standard curricula and for labor ministries to enforce standards that mitigate psychosocial risks in the workplace, such as precarious contracts and unsafe working conditions.
This approach frames mental health as a shared liability across the state apparatus, requiring coordinated action to address the social and structural determinants such as poverty, discrimination, and violence that drive poor mental health outcomes.
The challenge of implementation in resource-constrained settings
While the normative framework is clear, the practical pathway to implementation remains complex, particularly in low- and middle-income countries (LMICs). The current development finance landscape is characterized by shrinking budgets and a fracturing of global health funding. Governments in LMICs face the dual challenge of executing complex, multi-sectoral strategies while managing severe fiscal constraints.
One critical question for policymakers is operational: How can a Ministry of Health in a resource-constrained setting effectively engage other sectors – such as finance or justice – to adopt these recommendations without significant new external funding? Moving from high-level policy documents to localized action requires a mechanism that can bridge the gap between statutory intent and the reality of service delivery.
So what are the options to do more with less?
Peer learning as a mechanism for structural change
The Geneva Learning Foundation (TGLF) offers an operational model that addresses this implementation gap by utilizing the existing capacity of the health and social workforce. Rather than relying on traditional, resource-intensive capacity-building or technical assistance models, TGLF employs a “learning-to-action” methodology rooted in structured peer interaction. This approach connects thousands of frontline professionals – ranging from district administrators to social workers – into a structured digital network to learn from and support each other in actual implementation.
This model could support this WHO guidance in three specific ways:
- Generating actionable local data: In contexts where central data is scarce, the network functions as a distributed sensor. In a recent deployment in Nigeria, working with NPHCDA and UNICEF, 4,300 health workers generated over 400 root cause analyses within weeks. By identifying specific local barriers to service delivery the network produced the granular evidence needed to inform the cross-sectoral policies advocated by the WHO, and turn them into practice.
- Facilitating cross-sectoral integration: The WHO guidance necessitates collaboration between siloed professionals. TGLF’s model creates a forum where professionals from different sectors can share experience as they work to drive change, each in their own context. A school nurse can analyze crisis response strategies alongside a social worker from a different district, fostering the “collective intelligence” required to implement complex, multi-agency directives right down to the community level.
- Improving cost-efficiency: By digitizing the peer-learning process and utilizing peer accountability rather than external consultants, the model achieves a cost reduction of approximately 90 percent compared to conventional implementation methods. This efficiency could allow governments to begin operationalizing the WHO guidelines immediately using existing payroll structures, rather than waiting for external grants.
By validating local knowledge and structuring peer accountability, this innovative model provides a practical means to transform the WHO’s technical guidance into sustained administrative action. It demonstrates that the capacity to reform mental health governance lies not only in new financial instruments but in the structured coordination of the workforce already present on the ground.
Image: Crossing Into Clarity, The Geneva Learning Foundation Collection © 2025. A corridor built from carved, interlocking forms – half letters, half symbols – evokes the dense, overlapping pressures that shape mental health across societies. As the viewer steps through this textured passage, the individual ahead emerges into a space of light and openness, suggesting the possibility of coherence after complexity. The piece reflects a core truth of whole-of-government mental health action: when fragmented systems align, even imperfectly, they create pathways that help people move from burden toward balance, and from confusion toward care.
Reference
Michelle Funk, Dévora Kestel, Natalie Drew Bold, Celline Cole, Maria Francesca Moro, 2025. Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors. World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/9789240114388
#governmentSectors #implementationScience #lmics #mentalHealth #peerLearning #genevaLearningFoundation #wellBeing #workforce
-
How can governments protect and promote mental health and well-being across sectors?
For decades, global health policy has approached mental illness primarily as a clinical challenge, a condition to be managed within the walls of hospitals and clinics by medical professionals. This biomedical focus, while essential, has often obscured the broader context in which mental health is shaped. A new publication from the World Health Organization, Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors, marks a significant shift in normative standards. It posits that mental health is not merely a health outcome but a structural one, determined as much by the fiscal policy, urban planning, and labor laws of governments as by psychiatric care.
A technical framework for cross-sectoral governance
The guidance emerges against a backdrop of escalating costs. The global economic burden of mental health conditions is projected to reach US$6 trillion by 2030. In response, the WHO outlines a “whole-of-government” approach, moving beyond general advocacy to provide specific policy directives for ministries that have historically operated independently of mental health considerations.
The document details an eight-step implementation cycle, requiring high-level political dialogue, rigorous situational analysis, and the drafting of sector-specific policies. It assigns distinct responsibilities to key government sectors:
- Finance and Treasury: The guidance suggests that fiscal policies – including tax rates and welfare allocations – must be evaluated for their impact on health equity, rather than viewing mental health funding solely as a healthcare expenditure.
- Interior and Justice: It recommends a shift in the role of police and prisons, advocating for the retraining of first responders to manage crises through de-escalation rather than coercion, and establishing independent mechanisms to report abuse.
- Education and Employment: The framework calls for schools to embed social-emotional learning into standard curricula and for labor ministries to enforce standards that mitigate psychosocial risks in the workplace, such as precarious contracts and unsafe working conditions.
This approach frames mental health as a shared liability across the state apparatus, requiring coordinated action to address the social and structural determinants such as poverty, discrimination, and violence that drive poor mental health outcomes.
The challenge of implementation in resource-constrained settings
While the normative framework is clear, the practical pathway to implementation remains complex, particularly in low- and middle-income countries (LMICs). The current development finance landscape is characterized by shrinking budgets and a fracturing of global health funding. Governments in LMICs face the dual challenge of executing complex, multi-sectoral strategies while managing severe fiscal constraints.
One critical question for policymakers is operational: How can a Ministry of Health in a resource-constrained setting effectively engage other sectors – such as finance or justice – to adopt these recommendations without significant new external funding? Moving from high-level policy documents to localized action requires a mechanism that can bridge the gap between statutory intent and the reality of service delivery.
So what are the options to do more with less?
Peer learning as a mechanism for structural change
The Geneva Learning Foundation (TGLF) offers an operational model that addresses this implementation gap by utilizing the existing capacity of the health and social workforce. Rather than relying on traditional, resource-intensive capacity-building or technical assistance models, TGLF employs a “learning-to-action” methodology rooted in structured peer interaction. This approach connects thousands of frontline professionals – ranging from district administrators to social workers – into a structured digital network to learn from and support each other in actual implementation.
This model could support this WHO guidance in three specific ways:
- Generating actionable local data: In contexts where central data is scarce, the network functions as a distributed sensor. In a recent deployment in Nigeria, working with NPHCDA and UNICEF, 4,300 health workers generated over 400 root cause analyses within weeks. By identifying specific local barriers to service delivery the network produced the granular evidence needed to inform the cross-sectoral policies advocated by the WHO, and turn them into practice.
- Facilitating cross-sectoral integration: The WHO guidance necessitates collaboration between siloed professionals. TGLF’s model creates a forum where professionals from different sectors can share experience as they work to drive change, each in their own context. A school nurse can analyze crisis response strategies alongside a social worker from a different district, fostering the “collective intelligence” required to implement complex, multi-agency directives right down to the community level.
- Improving cost-efficiency: By digitizing the peer-learning process and utilizing peer accountability rather than external consultants, the model achieves a cost reduction of approximately 90 percent compared to conventional implementation methods. This efficiency could allow governments to begin operationalizing the WHO guidelines immediately using existing payroll structures, rather than waiting for external grants.
By validating local knowledge and structuring peer accountability, this innovative model provides a practical means to transform the WHO’s technical guidance into sustained administrative action. It demonstrates that the capacity to reform mental health governance lies not only in new financial instruments but in the structured coordination of the workforce already present on the ground.
Image: Crossing Into Clarity, The Geneva Learning Foundation Collection © 2025. A corridor built from carved, interlocking forms – half letters, half symbols – evokes the dense, overlapping pressures that shape mental health across societies. As the viewer steps through this textured passage, the individual ahead emerges into a space of light and openness, suggesting the possibility of coherence after complexity. The piece reflects a core truth of whole-of-government mental health action: when fragmented systems align, even imperfectly, they create pathways that help people move from burden toward balance, and from confusion toward care.
Reference
Michelle Funk, Dévora Kestel, Natalie Drew Bold, Celline Cole, Maria Francesca Moro, 2025. Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors. World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/9789240114388
#governmentSectors #implementationScience #lmics #mentalHealth #peerLearning #genevaLearningFoundation #wellBeing #workforce
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Subnational tailoring of malaria strategies and interventions: bridging the gap between planning and implementation
The global malaria response is currently navigating a convergence of crises. Epidemiologically, the reduction in mortality has plateaued. Biologically, threats from Anopheles stephensi and partial artemisinin resistance are accelerating. Financially, the 2025 landscape is defined by a severe contraction in foreign assistance, necessitating a radical optimization of resources. In this context, the World Health Organization’s (WHO) new guidance, Subnational tailoring of malaria strategies and interventions (2025), offers a necessary technical framework.
However, the manual relies on an implementation architecture that remains fragile. To succeed, the technical rigor of subnational tailoring (SNT) should be coupled with an operational mechanism capable of mobilizing the workforce in the current context. This article examines how digital peer learning-to-action networks offer a potential mechanism to address the operational deficits of conventional technical assistance and capacity building.
Subnational tailoring of malaria strategies: moving from blanket coverage to allocative efficiency
The rationale for SNT rests on the recognition that transmission heterogeneity – driven by ecology, urbanization, and human behaviour – renders national averages insufficient for operational planning. The WHO guidance codifies a ten-step “Data-to-Action Loop,” designed to be embedded within the National Malaria Strategic Plan (NMSP) cycle. This process moves beyond simple risk mapping to a rigorous cycle of optimization:
- Granular stratification: This involves using composite metrics (combining prevalence, incidence, and mortality) to segment operational units, rather than relying on broad national averages.
- Tailoring and prioritization: This requires developing “ideal scenarios” (what is epidemiologically required) versus “prioritized scenarios” (what is financially feasible). For example, this might involve restricting expensive indoor residual spraying (IRS) to high-burden zones while deploying next-generation nets solely in areas of confirmed pyrethroid resistance.
- Resource optimization: This entails using cost-effectiveness analysis (CEA) to scientifically justify trade-offs, such as cutting lower-impact interventions to preserve life-saving commodities in the face of budget shocks.
The implementation gap: systemic blind spots in subnational tailoring of malaria strategies
While the WHO framework is technically robust, its execution faces systemic “blind spots” that threaten to undermine the strategy:
- The private sector void: In high-burden nations such as Nigeria, the private sector acts as the primary entry point for febrile patients yet remains largely absent from national surveillance data. Without integrating these providers, SNT models risk being built on incomplete datasets, leading to flawed stratification.
- The incentive crisis: The operational culture of many national malaria programmes (NMPs) relies on donor-funded per diems to motivate training and data review. As funding from major donors contracts, this transactional motivation model is fracturing, threatening workforce retention and data quality.
- Centralization of analysis: There is a risk that SNT becomes an extractive process where districts feed data upwards to central planners without retaining analytical ownership. This centralization disempowers the district health teams (DHMTs) expected to execute the tailored strategies.
Operationalizing the subnational tailoring of malaria strategies: the role of digital peer networks
To operationalize SNT in a resource-constrained environment, national malaria programmes require a low-cost mechanism to drive district-level ownership and data quality that goes beyond traditional cascade training. The Geneva Learning Foundation (TGLF) has developed a digital peer-learning model that warrants examination by technical specialists as a complement to standard capacity-building approaches.
- Shifting from incentives to intrinsic motivation: Traditional training workshops often rely on per diems to ensure attendance. In contrast, the TGLF model connects health workers in digital cohorts to share problem-solving strategies without extrinsic financial incentives. Empirical data from recent cohorts involving 1,715 health workers indicate that participants report high levels of practice application (rated 5.13 on a 6-point scale) based purely on professional recognition and peer accountability. This suggests that intrinsic motivation can be sustained digitally, a critical finding as external funding for operational costs diminishes.
- Validating granular data through ground-level intelligence: SNT models depend entirely on the quality of input data. Digital peer networks can serve as a listening mechanism to surface “tacit knowledge” from the frontline that quantitative surveillance misses. For instance, during recent Teach to Reach sessions, health workers provided over 400 narrative accounts of specific local barriers – such as cultural resistance to bed nets due to associations with burial shrouds – that would not appear in DHIS2 reports. This qualitative intelligence provides a necessary layer of validation for stratification maps.
- Devolving analytical capacity to the district: True SNT requires districts to function as data users, not merely data collectors. The peer-learning platform employs a structured “Impact Accelerator” methodology, which guides frontline staff to conduct their own root-cause analyses (for example, using the “Five Whys” technique) rather than receiving top-down instruction. In Nigeria, working with UNICEF and NPHCDA, The Geneva Learning Foundation supported 4,300 health workers to identify and resolve local bottlenecks in a matter of weeks, effectively decentralizing the “tailoring” process to the community level.
- Cost-efficiency and sustainability: Traditional face-to-face training and supervision are resource-intensive. Comparative data suggests the peer-learning model delivers capacity building at approximately 90% lower cost than traditional technical assistance methods. This is primarily by virtue of scalability: costs very little whether there are 10 or 1,000 participants. Furthermore, in a country-specific study, 82% of a cohort reported using TGLF’s peer learning model for their own needs, and 78% said they needed no further assistance from TGLF. More than half of participants stay in touch because they want to. This aligns with both the value for money and sustainability mandates of malaria partners.
We need more than technical precision to overcome operational inertia
The WHO’s Subnational tailoring of malaria strategies and interventions guidance provides the necessary technical standards, stratification algorithms, and modeling tools for the next phase of malaria control. However, technical precision alone cannot overcome operational inertia.
TGLF’s peer-learning model demonstrates that it is possible to shift from top-down instruction to lateral learning, and from extrinsic financial incentives to intrinsic professional motivation. For technical partners and epidemiologists, integrating these two approaches – rigorous technical stratification coupled with broad-based workforce mobilization – could provide an innovative path to sustaining gains in a fragile funding landscape.
Image: “Contours of Local Knowledge”, The Geneva Learning Foundation Collection © 2025. This installation stretches organic planes across a web of taut, intersecting lines, echoing how malaria responses must adapt to the distinct shapes of local realities. The tension between each form –sometimes pulling apart, sometimes holding together – mirrors the work of tailoring strategies to varied terrains, communities, and transmission patterns. By revealing strength in flexibility and coherence in diversity, the piece evokes a central truth of subnational action: health systems become most effective when they align with the textures of the places and people they serve.
References
- Goodman, C., Tougher, S., Shang, T.J., Visser, T., 2024. Improving malaria case management with artemisinin-based combination therapies and malaria rapid diagnostic tests in private medicine retail outlets in sub-Saharan Africa: A systematic review. PLoS ONE 19, e0286718. https://doi.org/10.1371/journal.pone.0286718
- Sadki, R., 2024. Ahead of Teach to Reach 11, health leaders from 45 countries share malaria experiences in REACH network session. https://doi.org/10.59350/vhky9-fvf32
- The Geneva Learning Foundation, 2024. World Malaria Day 2024: We need new ways to support health workers leading change with local communities. https://doi.org/10.59350/yrn1r-hpz62
- Thawer, S.G., Chacky, F., Runge, M. et al. Sub-national stratification of malaria risk in mainland Tanzania: a simplified assembly of survey and routine data. Malar J 19, 177 (2020). https://doi.org/10.1186/s12936-020-03250-4
- The Geneva Learning Foundation. Teach to Reach 11 – Malaria: Turning the tide. Listening and Learning report 19, 2025. The Geneva Learning Foundation, 2025. https://doi.org/10.5281/zenodo.15126588.
- Venkatesan, P., 2025. WHO world malaria report 2024. The Lancet Microbe 6, 101073. https://doi.org/10.1016/j.lanmic.2025.101073
- World Health Organization. Guiding principles for prioritizing malaria interventions in resource-constrained country contexts to achieve maximum impact. Geneva: World Health Organization; 2024. https://www.who.int/publications/i/item/B09044
- World Health Organization. Subnational tailoring of malaria strategies and interventions: reference manual. Geneva: World Health Organization; 2025. https://www.who.int/publications/i/item/9789240115712
- World Health Organization. World Malaria Report 2024. Geneva: World Health Organization; 2024.
#globalHealth #guideline #implementationGap #learningStrategy2 #malaria #peerLearning #snt #theGenevaLearningFoundation #worldHealthOrganization
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Subnational tailoring of malaria strategies and interventions: bridging the gap between planning and implementation
The global malaria response is currently navigating a convergence of crises. Epidemiologically, the reduction in mortality has plateaued. Biologically, threats from Anopheles stephensi and partial artemisinin resistance are accelerating. Financially, the 2025 landscape is defined by a severe contraction in foreign assistance, necessitating a radical optimization of resources. In this context, the World Health Organization’s (WHO) new guidance, Subnational tailoring of malaria strategies and interventions (2025), offers a necessary technical framework.
However, the manual relies on an implementation architecture that remains fragile. To succeed, the technical rigor of subnational tailoring (SNT) should be coupled with an operational mechanism capable of mobilizing the workforce in the current context. This article examines how digital peer learning-to-action networks offer a potential mechanism to address the operational deficits of conventional technical assistance and capacity building.
Subnational tailoring of malaria strategies: moving from blanket coverage to allocative efficiency
The rationale for SNT rests on the recognition that transmission heterogeneity – driven by ecology, urbanization, and human behaviour – renders national averages insufficient for operational planning. The WHO guidance codifies a ten-step “Data-to-Action Loop,” designed to be embedded within the National Malaria Strategic Plan (NMSP) cycle. This process moves beyond simple risk mapping to a rigorous cycle of optimization:
- Granular stratification: This involves using composite metrics (combining prevalence, incidence, and mortality) to segment operational units, rather than relying on broad national averages.
- Tailoring and prioritization: This requires developing “ideal scenarios” (what is epidemiologically required) versus “prioritized scenarios” (what is financially feasible). For example, this might involve restricting expensive indoor residual spraying (IRS) to high-burden zones while deploying next-generation nets solely in areas of confirmed pyrethroid resistance.
- Resource optimization: This entails using cost-effectiveness analysis (CEA) to scientifically justify trade-offs, such as cutting lower-impact interventions to preserve life-saving commodities in the face of budget shocks.
The implementation gap: systemic blind spots in subnational tailoring of malaria strategies
While the WHO framework is technically robust, its execution faces systemic “blind spots” that threaten to undermine the strategy:
- The private sector void: In high-burden nations such as Nigeria, the private sector acts as the primary entry point for febrile patients yet remains largely absent from national surveillance data. Without integrating these providers, SNT models risk being built on incomplete datasets, leading to flawed stratification.
- The incentive crisis: The operational culture of many national malaria programmes (NMPs) relies on donor-funded per diems to motivate training and data review. As funding from major donors contracts, this transactional motivation model is fracturing, threatening workforce retention and data quality.
- Centralization of analysis: There is a risk that SNT becomes an extractive process where districts feed data upwards to central planners without retaining analytical ownership. This centralization disempowers the district health teams (DHMTs) expected to execute the tailored strategies.
Operationalizing the subnational tailoring of malaria strategies: the role of digital peer networks
To operationalize SNT in a resource-constrained environment, national malaria programmes require a low-cost mechanism to drive district-level ownership and data quality that goes beyond traditional cascade training. The Geneva Learning Foundation (TGLF) has developed a digital peer-learning model that warrants examination by technical specialists as a complement to standard capacity-building approaches.
- Shifting from incentives to intrinsic motivation: Traditional training workshops often rely on per diems to ensure attendance. In contrast, the TGLF model connects health workers in digital cohorts to share problem-solving strategies without extrinsic financial incentives. Empirical data from recent cohorts involving 1,715 health workers indicate that participants report high levels of practice application (rated 5.13 on a 6-point scale) based purely on professional recognition and peer accountability. This suggests that intrinsic motivation can be sustained digitally, a critical finding as external funding for operational costs diminishes.
- Validating granular data through ground-level intelligence: SNT models depend entirely on the quality of input data. Digital peer networks can serve as a listening mechanism to surface “tacit knowledge” from the frontline that quantitative surveillance misses. For instance, during recent Teach to Reach sessions, health workers provided over 400 narrative accounts of specific local barriers – such as cultural resistance to bed nets due to associations with burial shrouds – that would not appear in DHIS2 reports. This qualitative intelligence provides a necessary layer of validation for stratification maps.
- Devolving analytical capacity to the district: True SNT requires districts to function as data users, not merely data collectors. The peer-learning platform employs a structured “Impact Accelerator” methodology, which guides frontline staff to conduct their own root-cause analyses (for example, using the “Five Whys” technique) rather than receiving top-down instruction. In Nigeria, working with UNICEF and NPHCDA, The Geneva Learning Foundation supported 4,300 health workers to identify and resolve local bottlenecks in a matter of weeks, effectively decentralizing the “tailoring” process to the community level.
- Cost-efficiency and sustainability: Traditional face-to-face training and supervision are resource-intensive. Comparative data suggests the peer-learning model delivers capacity building at approximately 90% lower cost than traditional technical assistance methods. This is primarily by virtue of scalability: costs very little whether there are 10 or 1,000 participants. Furthermore, in a country-specific study, 82% of a cohort reported using TGLF’s peer learning model for their own needs, and 78% said they needed no further assistance from TGLF. More than half of participants stay in touch because they want to. This aligns with both the value for money and sustainability mandates of malaria partners.
We need more than technical precision to overcome operational inertia
The WHO’s Subnational tailoring of malaria strategies and interventions guidance provides the necessary technical standards, stratification algorithms, and modeling tools for the next phase of malaria control. However, technical precision alone cannot overcome operational inertia.
TGLF’s peer-learning model demonstrates that it is possible to shift from top-down instruction to lateral learning, and from extrinsic financial incentives to intrinsic professional motivation. For technical partners and epidemiologists, integrating these two approaches – rigorous technical stratification coupled with broad-based workforce mobilization – could provide an innovative path to sustaining gains in a fragile funding landscape.
Image: “Contours of Local Knowledge”, The Geneva Learning Foundation Collection © 2025. This installation stretches organic planes across a web of taut, intersecting lines, echoing how malaria responses must adapt to the distinct shapes of local realities. The tension between each form –sometimes pulling apart, sometimes holding together – mirrors the work of tailoring strategies to varied terrains, communities, and transmission patterns. By revealing strength in flexibility and coherence in diversity, the piece evokes a central truth of subnational action: health systems become most effective when they align with the textures of the places and people they serve.
References
- Goodman, C., Tougher, S., Shang, T.J., Visser, T., 2024. Improving malaria case management with artemisinin-based combination therapies and malaria rapid diagnostic tests in private medicine retail outlets in sub-Saharan Africa: A systematic review. PLoS ONE 19, e0286718. https://doi.org/10.1371/journal.pone.0286718
- Sadki, R., 2024. Ahead of Teach to Reach 11, health leaders from 45 countries share malaria experiences in REACH network session. https://doi.org/10.59350/vhky9-fvf32
- The Geneva Learning Foundation, 2024. World Malaria Day 2024: We need new ways to support health workers leading change with local communities. https://doi.org/10.59350/yrn1r-hpz62
- Thawer, S.G., Chacky, F., Runge, M. et al. Sub-national stratification of malaria risk in mainland Tanzania: a simplified assembly of survey and routine data. Malar J 19, 177 (2020). https://doi.org/10.1186/s12936-020-03250-4
- The Geneva Learning Foundation. Teach to Reach 11 – Malaria: Turning the tide. Listening and Learning report 19, 2025. The Geneva Learning Foundation, 2025. https://doi.org/10.5281/zenodo.15126588.
- Venkatesan, P., 2025. WHO world malaria report 2024. The Lancet Microbe 6, 101073. https://doi.org/10.1016/j.lanmic.2025.101073
- World Health Organization. Guiding principles for prioritizing malaria interventions in resource-constrained country contexts to achieve maximum impact. Geneva: World Health Organization; 2024. https://www.who.int/publications/i/item/B09044
- World Health Organization. Subnational tailoring of malaria strategies and interventions: reference manual. Geneva: World Health Organization; 2025. https://www.who.int/publications/i/item/9789240115712
- World Health Organization. World Malaria Report 2024. Geneva: World Health Organization; 2024.
#globalHealth #guideline #implementationGap #learningStrategy2 #malaria #peerLearning #snt #theGenevaLearningFoundation #worldHealthOrganization
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Development is adaptation: Bill Gates’s shift is actually about linking climate change and health
Bill Gates’ latest public memo marks a significant shift in how the world’s most influential philanthropist frames the challenge of climate change. He sees a future in which responding to climate threats and promoting well-being become two sides of the same mission, declaring, “development is adaptation.”
Gates argues that the principal metric for climate action should not be global temperature or near-term emission reductions alone, but measured improvement in the lives of the world’s most vulnerable populations.
He argues that the focus of climate action should be on the “greatest possible impact for the most vulnerable people.”
The suffering of poor communities must take priority, since, in his view, “climate change, disease, and poverty are all major problems. We should deal with them in proportion to the suffering they cause.”
Climate change is about the health of the most vulnerable
This position resonates with a core message that has emerged across global health over the past several years: climate change is about health.
New data from the 2025 Lancet Countdown draw a stark picture:
- Heat-related mortality has risen 63 percent since the 1990s.
- Deaths from wildfire smoke and air pollution caused by fossil fuels continue to climb.
- Food insecurity, driven by erratic weather, is destabilizing health and economies at once.
- Thirteen out of twenty key health indicators linked to climate impacts now signal urgent action is needed.
Health professionals, policy coalitions, scientists, and patient advocates have succeeded in bringing this nexus between climate and health squarely to the global agenda, culminating in recent summits where health finally shared the main stage with energy and economics.
Yet just as the science and advocacy align, political attention risks fragmenting.
Despite sweeping reports, evidence, and high-level declarations, momentum can ebb.
There is now a risk that the transformative potential embedded in the climate-health linkage may not be fully realized.
Here, Gates’s pivot could actually be the inflection point that the field needs.
The case for health workforce-centered adaptation
For nearly a decade, The Geneva Learning Foundation (TGLF) has been advocating and demonstrating that meeting complex humanitarian, health, and development challenges requires strengthening not just technical capacities or disease programs, but the underlying connective tissue of the health system: its workforce.
TGLF’s digital peer-learning platform now connects over 70,000 health workers across more than 130 countries.
These practitioners – mostly in government service, often in low-resource or crisis-affected settings – are the first to observe, and often the first to respond to, the local impacts of climate change on health.
Their reports show that health impacts are immediate and multi-faceted: rising malnutrition from crop failures, increases in waterborne diseases following floods, new burdens from air pollution and heat, and psychological distress from repeated disasters.
What sets this approach apart is its systemic focus.
Climate change is not a threat that can be “verticalized”.
It demands responses that are adaptive, distributed, and coordinated across all levels of the health system.
TGLF’s innovation lies in harnessing a distributed network to surface and scale locally-grounded solutions:
- Peer learning accelerates uptake of proven local adaptations – health workers share and adapt practices in near real time.
- Digital networks enable early warning and rapid, cost-effective dissemination of context-appropriate strategies, even in remote settings.
- The workforce is not merely the channel for external solutions but is positioned as a community of problem-solvers and trusted communicators, leaders in building and sustaining resilience.
Data from these initiatives demonstrate that such networked learning delivers results at scale, often with return on investment superior to parallel vertical programs, and increases system resilience and flexibility.
Development is adaptation: the need for human capital investment
The urgency and logic of these approaches are reinforced by ongoing policy developments ahead of COP30:
- WHO’s Global Action Plan on Climate Change and Health, adopted at the World Health Assembly in May 2025, recognizes that without context-sensitive system strengthening, existing approaches are insufficient, and positions knowledge and workforce mobilization as strategic imperatives.
- The COP30 Belem Health Action Plan establishes adaptation of the health sector to climate change as an international priority, calling for holistic, cross-sectoral strategies, and “community engagement and participation as foundational to implementation.”
Without empowered and connected health workers, no global action plan will reach those most at risk or maintain public trust.
A strategic investment imperative: why the next breakthrough must be human-centered
The philanthropic search for cost-effective, scalable, and measurable impact has built immense legacies in reducing child mortality and combating infectious disease.
Gates’ own approach of pioneering “vertical” innovations, optimizing delivery through metrics, and prioritizing technical solutions has been transformative, especially at the intersection of science and delivery.
However, emerging science show the limits of technical “magic bullets” absent robust, interconnected local systems.
Trust, legitimacy, and action flow from the relationships health workers build in – and with – their communities.
If development is adaptation, what does this mean for the next phase in climate-health philanthropy?
If the measure of climate action’s value is the scale and speed at which lives are improved and disasters averted, investing in the human infrastructure of the health system is the most evidence-based, cost-effective, and legacy-ensuring play available.
- Investing in the health workforce is itself a breakthrough technology: It increases the absorptive capacity of low-resource health systems, making innovations stick and catalyzing uptake well beyond single-disease silos or narrow infrastructure projects.
- Long-term, system-wide resilience is built by equipping health workers – not simply with technology or training from above, but with platforms for peer learning, rapid response, and locally-driven adaptation coordinated through agile networks.
- The network effect is real: A million motivated and networked health practitioners is likely to surface, refine, and implement interventions at a scale and pace that outstrips most top-down models. Digitally-enabled peer learning, tested by TGLF, could link to AI systems to provide distributed AI-human intelligence that supports effective action.
Without these bridges, even the best technology or policies will fail to gain a durable footprint at community level, especially as climate impacts deepen.
Health is where climate change action matters most
The world is waking to the reality that technical solutions alone cannot future-proof health against climate risks.
We need to focus on the highest-value levers.
This starts with a distributed, networked workforce at the coalface of the crisis, empowered to adapt, share, and lead.
In a world of accelerating climate shocks and retreating political will, the boldest, most rational bet for sustained global impact is to go “horizontal” – to invest in the people and the systems that connect them.
By helping build adaptive, digitally connected networks of health professionals, philanthropy can reinforce the foundation upon which all high-impact innovation rests.
This is not a departure from the pursuit of technology-driven change, but rather the necessary evolution to ensure every breakthrough finds its mark – and that trust in science and public health stays strong under pressure.
If ever there was a time for rigorous, data-driven engagement that bridges technology, health, and community resilience, this is it.
Every indicator – scientific, economic, social – suggests that communities will confront more climate disruptions in the coming years.
Investing in the people who translate science into health, who stand with their communities in crisis, is the most robust, scalable, and sustainable bet that any philanthropist or society can make.
By focusing on these vital human connections, the world can ensure that innovation works where it matters most – and that the next chapter of climate action measures true success by the health, security, and opportunity it delivers for all.
History will honor those whose support creates not only tools and policies, but the living networks of trust and craft upon which community resilience depends.
That is the climate breakthrough waiting to happen.
References
- COP30 Belém Action Plan. (2025). The Belém Health Action Plan for the Adaptation of the Health Sector to Climate Change. https://www.who.int/teams/environment-climate-change-and-health/climate-change-and-health/advocacy-partnerships/talks/health-at-cop30
- Ebi, K.L., et al. (2025). The attribution of human health outcomes to climate change: transdisciplinary practical guidance. Climatic Change, 178, 143. https://doi.org/10.1007/s10584-025-03976-7
- Ebi, K.L., Haines, A. (2019). The imperative for climate action to protect health. The New England Journal of Medicine, 380, 263–273. https://doi.org/10.1056/NEJMra1807873
- Jacobson, J., Brooks, A., Mbuh, C., Sadki, R. (2023). Learning from frontline health workers in the climate change era. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7316466
- Jones, I., Mbuh, C., Sadki, R., Steed, I. (2024). Climate change and health: Health workers on climate, community, and the urgent need for action (Version 1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.11194918
- Romanello, M., et al. (2025). The 2025 report of the Lancet Countdown on health and climate change. The Lancet S0140673625019191. https://doi.org/10.1016/S0140-6736(25)01919-1
- Sadki, R. (2024). Health at COP29: Workforce crisis meets climate crisis. The Geneva Learning Foundation. https://doi.org/10.59350/sdmgt-ptt98
- Sadki, R. (2024). Strengthening primary health care in a changing climate. The Geneva Learning Foundation. https://doi.org/10.59350/5s2zf-s6879
- Sadki, R. (2024). The cost of inaction: Quantifying the impact of climate change on health. The Geneva Learning Foundation. https://doi.org/10.59350/gn95w-jpt34
- Sanchez, J.J., et al. (2025). The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(25)00003-8
- Storeng, K. T. (2014). The GAVI Alliance and the Gates approach to health system strengthening. Global Public Health, 9(8), 865–879. https://doi.org/10.1080/17441692.2014.940362
- World Health Organization. (2025). Draft Global Action Plan on Climate Change and Health. Seventy-eighth World Health Assembly. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_4Add2-en.pdf
#billGates #climateAndHealth #climateChangeAndHealth #development #humanCapitalInvestment #lancetCountdown #peerLearning #theGenevaLearningFoundation #workforce
-
Development is adaptation: Bill Gates’s shift is actually about linking climate change and health
Bill Gates’ latest public memo marks a significant shift in how the world’s most influential philanthropist frames the challenge of climate change. He sees a future in which responding to climate threats and promoting well-being become two sides of the same mission, declaring, “development is adaptation.”
Gates argues that the principal metric for climate action should not be global temperature or near-term emission reductions alone, but measured improvement in the lives of the world’s most vulnerable populations.
He argues that the focus of climate action should be on the “greatest possible impact for the most vulnerable people.”
The suffering of poor communities must take priority, since, in his view, “climate change, disease, and poverty are all major problems. We should deal with them in proportion to the suffering they cause.”
Climate change is about the health of the most vulnerable
This position resonates with a core message that has emerged across global health over the past several years: climate change is about health.
New data from the 2025 Lancet Countdown draw a stark picture:
- Heat-related mortality has risen 63 percent since the 1990s.
- Deaths from wildfire smoke and air pollution caused by fossil fuels continue to climb.
- Food insecurity, driven by erratic weather, is destabilizing health and economies at once.
- Thirteen out of twenty key health indicators linked to climate impacts now signal urgent action is needed.
Health professionals, policy coalitions, scientists, and patient advocates have succeeded in bringing this nexus between climate and health squarely to the global agenda, culminating in recent summits where health finally shared the main stage with energy and economics.
Yet just as the science and advocacy align, political attention risks fragmenting.
Despite sweeping reports, evidence, and high-level declarations, momentum can ebb.
There is now a risk that the transformative potential embedded in the climate-health linkage may not be fully realized.
Here, Gates’s pivot could actually be the inflection point that the field needs.
The case for health workforce-centered adaptation
For nearly a decade, The Geneva Learning Foundation (TGLF) has been advocating and demonstrating that meeting complex humanitarian, health, and development challenges requires strengthening not just technical capacities or disease programs, but the underlying connective tissue of the health system: its workforce.
TGLF’s digital peer-learning platform now connects over 70,000 health workers across more than 130 countries.
These practitioners – mostly in government service, often in low-resource or crisis-affected settings – are the first to observe, and often the first to respond to, the local impacts of climate change on health.
Their reports show that health impacts are immediate and multi-faceted: rising malnutrition from crop failures, increases in waterborne diseases following floods, new burdens from air pollution and heat, and psychological distress from repeated disasters.
What sets this approach apart is its systemic focus.
Climate change is not a threat that can be “verticalized”.
It demands responses that are adaptive, distributed, and coordinated across all levels of the health system.
TGLF’s innovation lies in harnessing a distributed network to surface and scale locally-grounded solutions:
- Peer learning accelerates uptake of proven local adaptations – health workers share and adapt practices in near real time.
- Digital networks enable early warning and rapid, cost-effective dissemination of context-appropriate strategies, even in remote settings.
- The workforce is not merely the channel for external solutions but is positioned as a community of problem-solvers and trusted communicators, leaders in building and sustaining resilience.
Data from these initiatives demonstrate that such networked learning delivers results at scale, often with return on investment superior to parallel vertical programs, and increases system resilience and flexibility.
Development is adaptation: the need for human capital investment
The urgency and logic of these approaches are reinforced by ongoing policy developments ahead of COP30:
- WHO’s Global Action Plan on Climate Change and Health, adopted at the World Health Assembly in May 2025, recognizes that without context-sensitive system strengthening, existing approaches are insufficient, and positions knowledge and workforce mobilization as strategic imperatives.
- The COP30 Belem Health Action Plan establishes adaptation of the health sector to climate change as an international priority, calling for holistic, cross-sectoral strategies, and “community engagement and participation as foundational to implementation.”
Without empowered and connected health workers, no global action plan will reach those most at risk or maintain public trust.
A strategic investment imperative: why the next breakthrough must be human-centered
The philanthropic search for cost-effective, scalable, and measurable impact has built immense legacies in reducing child mortality and combating infectious disease.
Gates’ own approach of pioneering “vertical” innovations, optimizing delivery through metrics, and prioritizing technical solutions has been transformative, especially at the intersection of science and delivery.
However, emerging science show the limits of technical “magic bullets” absent robust, interconnected local systems.
Trust, legitimacy, and action flow from the relationships health workers build in – and with – their communities.
If development is adaptation, what does this mean for the next phase in climate-health philanthropy?
If the measure of climate action’s value is the scale and speed at which lives are improved and disasters averted, investing in the human infrastructure of the health system is the most evidence-based, cost-effective, and legacy-ensuring play available.
- Investing in the health workforce is itself a breakthrough technology: It increases the absorptive capacity of low-resource health systems, making innovations stick and catalyzing uptake well beyond single-disease silos or narrow infrastructure projects.
- Long-term, system-wide resilience is built by equipping health workers – not simply with technology or training from above, but with platforms for peer learning, rapid response, and locally-driven adaptation coordinated through agile networks.
- The network effect is real: A million motivated and networked health practitioners is likely to surface, refine, and implement interventions at a scale and pace that outstrips most top-down models. Digitally-enabled peer learning, tested by TGLF, could link to AI systems to provide distributed AI-human intelligence that supports effective action.
Without these bridges, even the best technology or policies will fail to gain a durable footprint at community level, especially as climate impacts deepen.
Health is where climate change action matters most
The world is waking to the reality that technical solutions alone cannot future-proof health against climate risks.
We need to focus on the highest-value levers.
This starts with a distributed, networked workforce at the coalface of the crisis, empowered to adapt, share, and lead.
In a world of accelerating climate shocks and retreating political will, the boldest, most rational bet for sustained global impact is to go “horizontal” – to invest in the people and the systems that connect them.
By helping build adaptive, digitally connected networks of health professionals, philanthropy can reinforce the foundation upon which all high-impact innovation rests.
This is not a departure from the pursuit of technology-driven change, but rather the necessary evolution to ensure every breakthrough finds its mark – and that trust in science and public health stays strong under pressure.
If ever there was a time for rigorous, data-driven engagement that bridges technology, health, and community resilience, this is it.
Every indicator – scientific, economic, social – suggests that communities will confront more climate disruptions in the coming years.
Investing in the people who translate science into health, who stand with their communities in crisis, is the most robust, scalable, and sustainable bet that any philanthropist or society can make.
By focusing on these vital human connections, the world can ensure that innovation works where it matters most – and that the next chapter of climate action measures true success by the health, security, and opportunity it delivers for all.
History will honor those whose support creates not only tools and policies, but the living networks of trust and craft upon which community resilience depends.
That is the climate breakthrough waiting to happen.
References
- COP30 Belém Action Plan. (2025). The Belém Health Action Plan for the Adaptation of the Health Sector to Climate Change. https://www.who.int/teams/environment-climate-change-and-health/climate-change-and-health/advocacy-partnerships/talks/health-at-cop30
- Ebi, K.L., et al. (2025). The attribution of human health outcomes to climate change: transdisciplinary practical guidance. Climatic Change, 178, 143. https://doi.org/10.1007/s10584-025-03976-7
- Ebi, K.L., Haines, A. (2019). The imperative for climate action to protect health. The New England Journal of Medicine, 380, 263–273. https://doi.org/10.1056/NEJMra1807873
- Jacobson, J., Brooks, A., Mbuh, C., Sadki, R. (2023). Learning from frontline health workers in the climate change era. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.7316466
- Jones, I., Mbuh, C., Sadki, R., Steed, I. (2024). Climate change and health: Health workers on climate, community, and the urgent need for action (Version 1.0). The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.11194918
- Romanello, M., et al. (2025). The 2025 report of the Lancet Countdown on health and climate change. The Lancet S0140673625019191. https://doi.org/10.1016/S0140-6736(25)01919-1
- Sadki, R. (2024). Health at COP29: Workforce crisis meets climate crisis. The Geneva Learning Foundation. https://doi.org/10.59350/sdmgt-ptt98
- Sadki, R. (2024). Strengthening primary health care in a changing climate. The Geneva Learning Foundation. https://doi.org/10.59350/5s2zf-s6879
- Sadki, R. (2024). The cost of inaction: Quantifying the impact of climate change on health. The Geneva Learning Foundation. https://doi.org/10.59350/gn95w-jpt34
- Sanchez, J.J., et al. (2025). The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(25)00003-8
- Storeng, K. T. (2014). The GAVI Alliance and the Gates approach to health system strengthening. Global Public Health, 9(8), 865–879. https://doi.org/10.1080/17441692.2014.940362
- World Health Organization. (2025). Draft Global Action Plan on Climate Change and Health. Seventy-eighth World Health Assembly. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_4Add2-en.pdf
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