Bruno Meessen, Houcine El Akhnif, Joël Arthur Kiendrébéogo Workshop "Learning for UHC"

1. Learning for UHC
What collective learning for Universal Health Coverage?
International Workshop — October 15th-17th 2018
Bruno Meessen (ITM)
El Houcine Akhnif (ENSP, Rabat)
Joël Arthur Kiendrébéogo (University Ouaga 1 Pr Joseph Ki-Zerbo)

2. • Evidence-based policy
• Evidence-informed policy
• Getting research into policy and practice
➞ Knowledgetranslation.Gobeyondpapersinpeer-reviewed
journals: produce policy briefs (push approach), knowledge
brokers (pull approach)…
We believe that this is right, but too narrow. We have to embrace
a larger view. Cf. Kaelan Moat’s presentation in Liverpool.
Evidence to policy : a field in movement

3. • Work by anthropologists Etienne Wenger
and Jean Lave (1991).
• Professional learning is ‘situated’ and
‘social’. It is indeed also about transmitting
tacitknowledge(whatisunderstoodwithin
a group without the need to state it).
• Interaction with the peers is key.
• Ex: traditional birth attendants
A 1st source of inspiration

5. Lessons from four main CoPs (2010-today)

6. A 2nd source of inspiration: development of digital platforms

7. A 3rd source of inspiration: reading
Knowledge is inscribed, embodied and enacted
(Freeman Sturdy 2015)

8. • Knowledge is everywhere, with everyone ➞ be careful with a
too hierarchical approach, inclusiveness matters!
• “Knowledge” can take many different shapes. Evidence
has of course a special status; evaluation is crucial – but by
ignoring the attributes of other types of knowledge (e.g. their
stickiness, their appeal) and the limits of evidence itself, we
may lose some important battles for UHC.
• ➞ We need a broad understanding of knowledge and have
to move beyond a too narrow approach of its production,
sharing and enactement.
Implications (1)

9. 1. Bring all knowledge holders on a common platform.
➞ CoPs, district.team…
2. The more knowledge is co-produced, the more you achieve
its ‘embodiment’ (and therefore increase the likelihood of its
‘enactement’) ➞ Collectivity
3. Develop a research agenda on “learning for UHC”, be open
to external evaluation ➞ Houcine, Lara, Joël-Arthur…
Implications (2) – some of our own choices

10. The 3 key steps of learning

11. The three blocks of the learning organisation

12. Learning for UHC: a framework

13. Some results of the 6 country study

14. • Without supportive leadership at country level, knowledge
managers reach their limits
• Leaders:
- Allow and legimitate knowledge processes
- Allocate resources
- Take up lessons
Lessons

15. • There are more than 1 route for learning
• Comparison Burundi and Burkina Faso
Starting point

16. • Need to deep dive the concept of “learning for UHC”
• Our work so far highlighted the centrality
of “learning” to make progress towards
UHC in countries
• But questions remain...
There are significant needs

17. • How do ‘UHC systems’ learn in reality and how to achieve
optimized learning?
• Should we favor one type of learning in particular?
(e.g. Action learning? Cognitive learning? Behavioral learning?
Problem-based learning? Etc.)
• Where to start developing learning for UHC? (e.g. related
to the three blocks or levels of learning or other)
Is there an ideal entry point and/or ideal steps?
There are significant needs

18. • What learning actually entails (how does it work) and looks like
related to its nature (the learning types) and where it occurs ?
• What are the dynamics (actors and factors) that enable or
hinder learning processes (related to learning types and where
their occur) ?
• How to mitigate learning hindrances and how to create the
conditions for learning to sustainably support health policies ?
There are significant needs