The New Usual: Supporting Frontline Healthworkers as a goal, not a tool

"I wish I had known that my biggest source of learning would be my field colleagues. ...I believed in textbooks." Dr. Muhammad Musa reflects on 41 years of work in international development. His two biggest lessons are: learn from your frontline staff, and tell stories with impact. Some lessons he learned in the decades are to build a fearless climate--a climate of trust, where staff at all levels can learn from failure, and can take time to reflect. He also notes that moving from a project to a movement--one that changes a system--is the best way to create change. Technical solutions are not the only (or even the best) way to get the job done.

The Feed the Future Mali Sugu Yiriwa operates in the Delta Zone of Mali, aiming to strengthen the resilience of farming and business communities through market-driven, inclusive, nutrition-sensitive, and agriculture-driven economic growth. However, the complex nature of Mali’s political situation poses significant challenges to program implementation and participant outreach. In this episode of the Failing Forward Podcast, Laurore Antoine, Chief of Party for Sugu Yiriwa, shares valuable insights into how adaptive leadership, collaboration with local grassroots organizations, and strategic use of digital solutions, among other adaptive management approaches, have been instrumental in achieving program goals and positively impacting lives in Mali.

Christabell Makokha talks about always anchoring innovation to the success metric: have I solved the problem? Instead of focusing on the process, focus on the problem, and whether or not people's lives are getting better. She reflects on why innovation labs fail (inspired by this article from ICTworks). What's going wrong? We define innovation as "the next new thing" rather than leveraging creative problem solving. We struggle to find the balance between stand-alone innovation work and innovation integrated with existing programming We measure the wrong things--too much process measurement, and not enough problem-solving. Our risk appetite is too low, and our timelines are too short.  

You’ve done the desk literature reviews, collected and conducted field studies, crafted and deployed surveys, analyzed the data, written up the results, and released your study findings. Is it having any real influence or impact? How do you know? Laura Kim and Michelle LeMeur of the Canopy Lab wrestled with these questions when they attempted to trace uptake by stakeholders of their studies on COVID-19 and the international development workforce: https://www.marketlinks.org/blogs/beyond-downloads-views-and-likes-how-do-you-know-your-research-having-impact

Titukulane's progress was achieved by addressing the failures it faced in the years leading up to 2023. When the program was first implemented, the COVID-19 pandemic swept the world, making it extremely difficult to implement field-level activities. However, Titukulane was able to turn around its failures by starting from the roots and addressing every aspect of the program. They focused on team building and cross-functional teamwork, built the capacity of the M&E teams, made field engagement a regular task for everyone involved, and engaged participants in multiple activities to diversify their income while keeping sustainability in mind. This was no small feat. Listen to Daniel Abbott, the Chief of Party of Titukulane, as he speaks about how closely he worked with the team to address every detail and achieve where Titukulane stands today.

Maria Alemu and Gregory Makabila talk about the Ifaa project's Failure Summit, and what it took to create a culture where failure spurred reflection, learning and action. Lessons from Saint Yared, a learning from failure roadmap, pre-mortem exercises, and the 5 Whys of Failure were all key tools that helped the team learn, adapt, and improve. Check out their reflections, what they would do differently, and the diverse range of tools that helped the team embrace failing forward. Ifaa is a USAID-funded RFSA project that CRS leads in Ethiopia.

It's not easy or obvious to not only work with adolescent girls in crisis settings, but also to let them lead. But it is possible. AMAL currently operates in Syria, Nigeria, and Somalia, addressing the unique vulnerabilities of adolescent girls in crisis settings, such as early marriages and adolescent pregnancy. The program includes components like a Young Mother's Club, Community Dialogues, and a health provider curriculum to improve sexual and reproductive health service uptake and enhance participants' life skills. Our guest speaker, Pari Chowdhary, highlights the importance of relationship investments, continuous quality improvement mechanisms, and including adolescent girls in program design and evaluation. The final hope is for the program to be owned and run locally by the adolescent mothers themselves.

Katharine Nasielski, Pari Chowdhary, and Brittany Dernberger talk about Fast and Fair-- CARE's work trying to get COVID-19 vaccines out to the world to meet the global deadline for 80% vaccination rates by September 2022. Advocating for funding and policy change, running programs to support vaccine delivery around the world, and trying to measure global to local impact are all places where we've learned a lot about what we need to do next time. Because like it or not, we need to prepare for a next time. Consistent investments in innovative, nimble, and adaptable are our best shot for future pandemic preparedness.

If you looked at a problem and thought, "the answer is more capacity building and more guidelines" Florence Santos says you might need to think again. Based on her experience leading Monitoring and Evaluation at CARE, she's seen a proliferation of tools and resources that aren't really solving the underlying solution. If it's the recommendation you would always have made under any circumstances, you're probably not looking carefully enough at the solution. Florence reflects on how she would get to a solution with fewer tools and trainings, and more systematic follow through.

CARE implemented the Inspiring Married Adolescent Girls to Imagine New Empowered Futures (IMAGINE) project to design & test interventions aimed at delaying the timing of first birth among married adolescents in Niger (Zinder region) and Bangladesh (Kurigram district) between 2016 and 2022. Rachael Goba explains how the IMAGINE journey went on married adolescent girls envisioning, valuing and pursuing alternative life trajectories. For example, after 22 months of implementation, contraceptive use in Niger was significantly higher in the treatment group compared to the control group; and higher for those who have had a birth compared to those who have not.