Topic 02
How Collaborative Learning supports locally-led development
Power imbalances in global development have resulted in the provision of technical assistance (TA) that is often one-directional, positioning experts from higher income countries as advisors to, or implementers for, leaders in low- and middle-income countries (LMICs). This stymies the leadership and voice of change agents in LMICs, who have tremendous, but often under-recognized, expertise and experience.
In addition, systems change is not a purely technical exercise — it is often highly political, context-specific, and replete with implementation challenges. Country leaders may have access to global guidance and evidence about solutions to their challenges, but often lack access to practical “how-to” knowledge that can translate ideas into action. They also lack opportunities to share their experiences and tap into contextually relevant implementation knowledge from peers in other countries.
To improve on traditional TA models, there is growing recognition that development funders and implementers must focus more on facilitating the sharing of knowledge among LMIC change agents, rather than serving as the providers of knowledge. Changing modes of TA need to foster practical and action-oriented learning among change agents rather than more passive modes of teaching and training. They also need to center the people familiar with the local context as the experts in the room (Ojiako, How not to become a global health expert – Speaking of Medicine and Health, plos.org, 2022)
Collaborative Learning’s bi-directional approach offers an immediate improvement to traditional TA provision by dissolving power imbalances, centering the expertise of local change agents, and utilizing tacit knowledge to advance systems change.
An alternative to traditional technical assistance
Collaborative Learning Networks (CLNs) have demonstrated that they can serve as an alternative, and complementary, form of TA in global development, recognizing network members as the experts and supporting them to learn from one another through effective technical facilitation. Collaborative Learning Networks have the potential to accelerate progress and systems strengthening in LMICs by harnessing the tacit knowledge of practitioners. The Joint Learning Network for Universal Health Coverage (JLN) is one such example — see the box below.
Collaborative Learning is particularly well-suited to bring together participants, such as peer organizations across countries, or peer groups within a country, that are pursuing similar goals and face common challenges. Frequently, the participants may be in different places along the implementation pathway, or focused on different components of the implementation effort, and are almost always in differing local contexts. When well designed, there is, however, sufficient commonality of purpose and pathways to ensure learning among the participants is of value to all.
Demand for collaborative learning often starts when there is a recognized common challenge and knowledge of what needs to be done, but uncertainty about how to implement.
The common challenge is almost always pursued in components, with the network establishing sub-groups or technical working groups around these components so that specialized personnel can meaningfully exchange questions and pursue targeted solutions related to their specific implementation stage.
Accelerating Progress toward Universal Health Coverage through the JLN
Since 2009, countries in the Joint Learning Network for Universal Health Coverage (JLN) have been working together to achieve and sustain universal health coverage (UHC) for nearly 3 billion people across the globe. JLN countries are expanding coverage to the poor and informal sector populations, reducing out-of-pocket health spending, increasing use of high-quality, essential health services such as primary care, and more sustainably financing health care.
- JLN membership has grown from teams of policymakers and practitioners from 6 countries in 2010 to more than 30 countries.
- The JLN platform currently houses 6 long-term technical initiatives under which more than 30 focused learning collaboratives and exchanges have brought together country change agents to learn from one another and jointly problem-solve.
- The JLN has produced over 60 knowledge products — of which over 30 were co-produced by JLN members themselves.
While remarkable progress toward UHC in the past decade is the result of many local and global efforts, the JLN has been a powerful resource for its members in helping them overcome technical and political roadblocks.
For example, after a parliamentarian from Ghana attended a joint learning workshop focused on how to ensure health services are reaching people living in poverty, he introduced an amendment, which quickly passed into law, requiring the Ghanaian National Health Insurance Authority to annually report on coverage of low-income populations.
An approach that strengthens the local and regional ecosystem of institutions and experts
Collaborative Learning can also be an effective and sustainable approach to integrating local, community, sub-national, and regional voices and developing strong ecosystems of actors to continuously drive systems change and strengthening. It can foster a community of local experts and institutions that can become trusted, “go-to” advisors to their government counterparts, ultimately becoming important agents in driving systems change. One recent example of how a CLN can facilitate local and regional ecosystem-strengthening is the Asia Health Policy and Systems Research Community that R4D began facilitating in 2021— see the box below.
Health Policy and Systems Research Ecosystem-Strengthening Community across Asia
- A community of domestic health policy and systems research institutions (HPSRIs) across Asia emerged in response to growing demand for country and regional learning on health systems strengthening as countries progress toward universal health coverage.
- The HPSRIs collaborated in 2021 to co-create a shared vision and action areas for a more robust health policy and systems research ecosystem across Asia by 2026.
- To move toward this vision, the community launched pilot activities in 2022 led by HPSRIs based in India, Indonesia, Nepal, the Philippines, South Korea, and Sri Lanka, alongside regional learning platforms and training partners.
- R4D, in partnership with the WHO Alliance for Health Policy and Systems Research, facilitated continuous experience-sharing and collaborative learning among ecosystem actors to improve pilot activities and capture the lessons as global public goods.
This work was supported by the Health Systems Strengthening (HSS) Accelerator with funding from the USAID/Asia Bureau
A powerful tool for partnership-building
CLNs can also be a powerful tool for partnership-building. Platforms like the Joint Learning Network for Universal Health Coverage (JLN) and the Accelerator’s Asia Health Policy and Systems Research Community bring change agents and funding partners together around a common, country-driven learning agenda. The JLN’s country-led global Steering Group provides a formal mechanism for country government officials and development partners to align around a shared learning agenda and funding priorities. These types of partnerships, when nurtured, last beyond a single project cycle, creating a sense of common purpose and shared commitment that can evolve into new, long-term models of global collaboration and co-funding.
