Global health initiative reveals new insights on HPV vaccination through peer learning

Learn more: https://www.learning.foundation/teachtoreach

A new approach to implementing HPV vaccination programs is yielding unexpected insights by connecting thousands of health workers across the globe to share their frontline experiences. The Geneva Learning Foundation's "Teach to Reach" initiative has engaged over 16,000 health professionals to address implementation challenges in HPV vaccination programs.

"Evidence suggests that challenges in implementing and sustaining HPV vaccination in developing countries are significantly influenced by gaps between planning at national level and execution at local levels," says Rydda Sattky, Executive Director of the Geneva Learning Foundation.

Bridging the implementation gap

The initiative takes a different approach from traditional expert committees. Instead of relying solely on high-level expertise, it creates structured opportunities for health workers to share their direct experiences implementing HPV vaccination programs.

Through a five-step process, the program collects and analyzes experiences from frontline health workers, deepens understanding through case studies, and connects these insights to national-level planning.

The approach has revealed several unexpected findings. In some regions, tribal communities showed less vaccine hesitancy than urban populations. Teachers emerged as more influential than health workers in certain contexts, and personal stories proved more persuasive than statistical evidence.

"Success often proved independent of resource levels," notes Sattky, highlighting how informal networks and bottom-up strategies frequently outperformed more traditional approaches.

Practical solutions from the field

The initiative has documented numerous successful strategies emerging from local implementation:

- Using cancer survivors as advocates

- Creating WhatsApp groups for community health workers

- Engaging school children as messengers to families

- Integrating with existing women's groups

- Leveraging religious texts

- Using community theater for health communication

In January 2024, the program expanded to include national immunization program managers from 31 countries, creating direct connections between national planning and local implementation experiences.

Building sustainable programs

The findings point to several key factors for successful HPV vaccination programs. Multi-stakeholder engagement, sustained communication rather than one-time campaigns, and strong school system partnerships emerged as critical elements. The research also highlighted the importance of male community leaders as vaccination advocates, despite the program's focus on adolescent girls.

"Uniquely, Teach to Reach provides a way to link health professionals together so that they can share experiences about what works," said Dr. Kate O'Brien and Ephraim T. Lomango from WHO and UNICEF, who lead immunization efforts globally.

The initiative includes participation from both government and civil society organizations, with many participants working in challenging contexts such as remote rural areas, supporting nomadic populations, or facing armed conflict.

Measuring impact

The program has demonstrated measurable effects on participating health workers, showing:

- 45% stronger change in worldview

- 49% higher professional influence

- 41% greater impact on professional practice

These results suggest that peer learning networks can serve as valuable complements to traditional expert-led approaches in global health initiatives.

Looking ahead

The Geneva Learning Foundation continues to develop this approach, emphasizing continuous learning and improvement cycles. The initiative demonstrates how connecting frontline experiences to national policy can strengthen health systems and improve vaccination program outcomes.

The work forms part of broader efforts to achieve the goals of Immunization Agenda 2030, which aims to ensure all people benefit from recommended immunizations throughout their lives.

# PEN-H essential guidance for NCD care in humanitarian settings

13 April 2020

The Package of Essential NCD Interventions for Humanitarian Settings (PEN-H), published by the International Rescue Committee (IRC) in 2020, remains a valuable but underutilized resource for humanitarian health practitioners. This guide addresses specific challenges in delivering care for non-communicable diseases (NCDs) in crisis situations. It was launched during a lively special event hosted by The Geneva Learning Foundation (TGLF) on April 13, 2020, with PEN-H’s leader author and TGLF co-founder Dr. Shanthi Mendis and IRC’s Dr. Laura Miller responding to questions from 754 health workers, primarily from developing countries.

Dr. Shanthi Mendis, who is also the principal author of the original WHO Package of Essential NCD Interventions (WHO-PEN), explains why this guidance remains relevant: “When humanitarian emergencies occur in any part of the world, people caught in these situations will include many with NCDs, some diagnosed and some undiagnosed. The stressful situation itself will make people develop acute exacerbations.”

Current data shows hypertension affects approximately 25% of populations globally, while diabetes prevalence ranges from 6% to 15%. These conditions become particularly challenging in crisis situations where healthcare systems are disrupted and resources are limited.

## Specific challenges in humanitarian settings

Laura Miller from IRC identified three persistent challenges that make the PEN-H guidance essential:

“Several countries affected by conflict have had a higher burden of NCDs. Specifically Syria, Libya, Yemen – these conflicts have continued for many years, meaning that there have been many more people who have died unnecessarily due to NCDs.”

She highlighted particular concerns in refugee settings: “In refugee camp settings, such as in Kenya and Thailand, where refugees have been living for two to three decades, we have seen increasing rates of NCDs due to exposure to unhealthy risk factors – inability to access healthy foods, lack of space to be physically active, and increased stress resulting in use of tobacco and alcohol.”

The third challenge involves healthcare delivery systems. Miller noted: “The clinical guidelines and standards really vary in countries and contexts. In some places where we work, there are Ministry of Health clinical guidelines. In other places, clinicians use MSF guidelines. But in many countries where you have extremely weak health systems or failed states, the clinical guidelines have not been updated in many years.”

## Practical guidance for critical care

PEN-H provides specific protocols for managing NCD emergencies in resource-limited settings. Dr. Mendis detailed the most critical scenarios: “When you take non-communicable diseases, there are certain emergencies that are likely to occur, particularly in the acute response stage in the first week or so. People will die from NCDs within the acute phase from conditions like acute coronary syndrome, acute heart failure, stroke, hypertension emergency, diabetic ketoacidosis, acute asthma exacerbation, and status epilepticus.”

The guide includes practical interventions for situations where hospital referral is impossible: “If the patient is breathless, you could sit the patient up. You can give oxygen if available. If the blood pressure is very low, you can raise the foot end of the bed. An intravenous line is set up for most acutely ill patients, ensuring they receive intravenous fluids when unable to take anything orally.”

## Supporting community health workers

PEN-H includes eight specific protocols for community health workers, recognizing their essential role in crisis response. These protocols cover patient counseling, advice on tobacco cessation, guidance on harmful use of alcohol, diet, physical activity, and medicine use.

## Development implications

The guide addresses broader societal impacts of NCDs in humanitarian settings. “If you let people die prematurely under the age of 70, you are losing breadwinners of families,” Dr. Mendis explained. “This affects family income and creates long-term healthcare costs. By prevention, you save money, and this is a major development issue for countries.”

## Accessing the guidance

The PEN-H guide remains available in English, French, and Arabic. The 2020 launch event provides additional context and implementation insights from humanitarian health practitioners.

IRC developed this resource to address a critical gap in humanitarian healthcare delivery. As Miller stated: “We had to prioritize this as part of our mission of ensuring people remain healthy within humanitarian contexts.”

# Europe-wide Network supporting Ukrainian Children through Psychological First Aid (PFA) announces first 34 Focal points

A Europe-wide initiative to support Ukrainian children through psychological first aid (PFA) marked several key developments during its February 11, 2025, Leaders and Partners meeting. The Certificate peer learning programme on Psychological First Aid (PFA) in support of children affected by the humanitarian crisis in Ukraine provides innovative opportunities to strengthen immediate mental health support to children in crisis, is rapidly scaling up into a comprehensive network spanning 27 countries.

## First wave of PFA Focal Points

The initiative announced its first 34 PFA focal points - volunteer representatives who will coordinate support within their organizations and regions. While most focal points are based in Ukraine working directly in fragile contexts, the network includes practitioners from Poland, Romania, and Iceland, creating a bridge between local needs and international support.

## Building local capacity

“We work with children in Kyiv region, Ivano-Frankivsk region, Chernihiv region, and Sumy region. We travel to locations and conduct psychosocial sessions with children,” explained I. from Yellow-Blue Wings, describing their direct work with affected communities.

“When I went through this training that lasted several weeks, it was both learning and active participation... you felt like you leveled up a bit,” shared A. from Platform of Unity, a Ukrainian humanitarian organization working in the Kharkiv region.

## Practical peer learning approach

The program combines several key elements:

- Certificate-based peer learning exercises providing structured training

- Bi-weekly “PFA Connect” sessions for rapid knowledge exchange

- New courses based on practitioners’ real-world experiences

- An Impact Accelerator to support practical implementation

## Measuring impact on children

A new measurement tool is being developed by this network to evaluate effectiveness of support to children at the local level. The tool examines children’s functioning, well-being, distress levels, coping ability, social behavior, and connectedness.

## Cross-border collaboration

“This is just a wonderful way of connecting with others across the world who are dealing with the same challenges and issues and concerns and learning from each other,” noted W. from a National Red Cross.

## Looking ahead

The program aims to reach 4,100 professionals by June 2025. The next “PFA Connect” peer learning session on February 12 will address three critical topics: recognizing severe reactions in children, managing multiple children in crisis, and providing remote psychological support.

The initiative, funded through the EU4Health program, represents a shift from traditional training approaches by emphasizing peer learning and practical implementation while maintaining professional standards through certification. These regular Leaders and Partners meetings ensure the program continues to evolve based on practitioners’ needs and experiences in supporting children affected by the ongoing crisis.

# Health workers share measles outbreak experiences in global learning exchange

During the October 13, 2023 session of Teach to Reach 9, immunization professionals from India, Nigeria, Pakistan, and Uganda exchanged specific experiences responding to measles outbreaks. The session focused not on technical guidelines, which participants already implement through their national programs, but on the practical challenges and solutions they have developed in their local contexts.

## Field experiences and local innovations

Dr. Isha Goyal, WHO surveillance officer in India, described analyzing outbreak data that revealed 90% of cases concentrated in a single community. Despite engaging religious and community leaders, vaccination coverage remained at 60-70% post-outbreak. She noted that the same community consistently refused vaccines across different immunization programs, raising questions about current engagement approaches.

In Nigeria, Mudassir Abdullahi from Skano State Hospital outlined how response teams mapped affected settlements and conducted household assessments that revealed missed vaccinations. The team combined awareness activities with vaccination services, leading to reduced cases in previously affected areas.

Dr. Bala Ganesh Kumar, WHO medical officer in South India, shared a systematic response protocol initiated by a hospital case notification:

- Sample collection for laboratory confirmation

- Formation of epidemic response teams at district and block levels

- House-to-house surveys in affected areas and schools

- Line listing of fever/rash cases from previous 90 days

- Catch-up vaccination for children with immunity gaps

Dr. Kamran Khan described Pakistan's 2021 nationwide campaign strategies that achieved 95% coverage:

- Public vaccination of policymakers' children

- School-based outreach covering 70% of target population

- Direct engagement with hesitant parents through schools

- Coordinated media management for adverse events

## Implementation challenges identified

Participants shared several common challenges:

1. Data and tracking:

- Mobile population movement during investigations

- Incomplete vaccination records for second doses

- Limited data sharing between facilities

2. Vaccine delivery:

- Supply chain disruptions

- Reluctance to open multi-dose vials

- Geographic access barriers

3. Community engagement:

- Persistent vaccine hesitancy in specific groups

- Limited success with traditional approaches

- Need for new strategies for consistently refusing communities

## Analysis and recommendations

Lora Shimp synthesized three key approaches from the shared experiences:

1. Data utilization:

"Using data to really help us identify where we have missed infants or younger children who may have received one dose of measles, but not two doses."

2. Health system operations:

"Working with the health system to address these problems, to better communicate how to get, not to turn people away, what are the best ways to organize these services."

3. Campaign duration:

"That campaign shouldn't just stop the day we're doing vaccination... planning for four weeks so that you also follow up with those communities that have been missed."

## Next steps

The session highlighted several areas requiring further examination:

- Analysis of patterns in vaccine refusal across programs

- Development of new approaches for consistently refusing communities

- Improved systems for vaccination record keeping

- Strengthened preparedness planning

Participants continued discussions through networking sessions to explore specific challenges in more detail.

Note: Names have been transcribed from the session recording. Their spelling therefore may be inaccurate.

# Field workers share innovative approaches to HPV vaccination acceptance at Teach to Reach 9

Healthcare workers and community leaders from multiple countries shared their frontline experiences with HPV vaccination programs during a special session at Teach to Reach 9, highlighting successful strategies for building vaccine confidence and overcoming hesitancy.

The session, which followed up on discussions from Teach to Reach 8, focused on the critical question "How have you made HPV vaccination work for girls and women?" Against the backdrop of concerning statistics - 600,000 new cervical cancer cases and 340,000 deaths annually, with vaccination coverage declining since the COVID-19 pandemic - participants shared concrete examples of local solutions.

## Nigeria launches nationwide campaign

Boma Otobo, an adolescent health and HPV vaccine introduction consultant to Lagos state, described Nigeria's preparations for a major HPV vaccination campaign launching October 24, 2023. The initiative targets girls aged 9-14 years through both school-based and community outreach approaches.

"We have done the micro plan in Nigeria. We have been able to get our HR requirements sorted. Logistics have moved," Otobo explained. The program conducted rapid community assessments and extensive engagement with schools, religious groups, and traditional leaders to address concerns and build support.

## Community-level innovation

Several speakers highlighted the critical importance of direct community engagement:

Zuhura Gaki Ahmed, a community health worker from Meru, Kenya, described her successful approach to addressing vaccine hesitancy: "I talked to both the mother and the girls...I gave them an example of a certain lady who had this problem. When she was asked whether she had ever been vaccinated, she said she had never been vaccinated."

In Uganda, Rebecca Akelo, a public health nurse, leveraged concerning data on teenage pregnancies to build support for HPV vaccination. She engaged education officials and school leaders, using parent-teacher meetings to explain the science behind the vaccine. "I had to draw for them the uterus and locate where the cervix is and how the vaccine will prevent cervical cancer. They really appreciated the science behind that," Akelo shared.

## Integration and partnership approaches

Michael Jones from Sierra Leone described an innovative approach of integrating HPV vaccination with COVID-19 vaccination, which helped overcome resource constraints while achieving higher than expected coverage. The program vaccinated girls at age 10 for HPV and both boys and girls at age 12 for COVID-19.

In India, Dr. O.P. Kansal highlighted a new initiative to address hesitancy among medical professionals themselves. The American Cancer Society, working with the Indian Academy of Pediatrics and Federation of Obstetrics and Gynecologists Society of India, launched virtual training programs to build healthcare provider confidence in recommending HPV vaccination.

## Key success factors

Laura Shimp, director of the Immunization Center at JSI, identified three critical elements for successful HPV vaccination programs:

1. Leveraging girl advocates and peer-to-peer learning

2. Partnering with cancer prevention groups to emphasize the vaccine's role in cancer prevention

3. Building strong partnerships with education ministries and religious groups

Deepa Pokhrel from UNICEF headquarters emphasized the importance of:

- Conducting rapid community assessments to understand local concerns

- Engaging young people directly in program design

- Addressing misinformation quickly through trusted community channels

- Moving beyond mass media to focus on sustained community engagement

The session demonstrated how local innovation and adaptation, combined with strong partnerships and community engagement, can help overcome hesitancy and build acceptance of HPV vaccination. These insights will be particularly valuable as more countries launch or expand their HPV vaccination programs.

## About Teach to Reach

Teach to Reach is a global forum where healthcare workers, community leaders, and public health professionals share field experiences and practical solutions. The format combines plenary sessions with networking opportunities, allowing participants to learn both from formal presentations and direct peer-to-peer exchanges. This session was part of Teach to Reach 9, building on discussions from previous events while incorporating new experiences and innovations from the field.

# Global Climate and Health Survey Partners Mobilize for Community Impact

Health professionals and community leaders gathered on February 5, 2025, to advance a groundbreaking global climate and health survey initiative. The virtual check-in session brought together participants from multiple continents to discuss dissemination strategies for reaching frontline health workers and communities most affected by climate change.

## Survey to Guide Major New Funding Program

Joanna Sanchez from Grand Challenges Canada revealed that the survey will inform a significant new climate and health funding program. "This is going to be a very exciting year for us," Sanchez explained. "The survey will guide us as we develop this new funding program, expected to launch between January and March of 2026."

The initiative represents an unprecedented approach to program development. "We are here to learn, listen, and take inputs from local communities," Sanchez emphasized. "We have never done quite like this before, taking experiences from those at the frontlines of the climate and health crisis to guide funding priorities."

## Global Partners Unite for Grassroots Engagement

The survey has rapidly gained support from major global organizations. Originally launched as a partnership between Grand Challenges Canada and the Geneva Learning Foundation, it has expanded to include multilateral organizations, NGOs, and international funders. The initiative was recently featured in The Lancet Global Health, accompanied by an expert panel representing every continent.

## Community Health Workers Share Climate Impact Experiences

Participants described stark realities of climate change effects on healthcare delivery. Alaouiatu from the Nanani Women and Youth Development Foundation highlighted specific challenges: "We have a lot of rivers and streams, and it is a barrier to our health professionals in crossing those streams to reach settlements to deliver vaccines or medications."

## Strategic Dissemination Plans Emerge

Health leaders outlined concrete plans for sharing the survey. Kingsley Kofi Nignere, from Ghana's Community Youth Development Foundation, detailed his organization's approach: "I will share with Ghana Coalition of NGOs in Health, which is made up of 150 members, and Ghana Coalition of NGOs in Climate Change, with 100 members."

Paul Oche, working with Malaria Consortium in Nigeria, emphasized reaching diverse sectors: "I will be sharing with my professional colleagues and coursemates in health economics, as well as those in energy and gas and green energy sectors for their perspectives."

## Looking Ahead

The survey results will be presented publicly between September and October 2025. Partners are encouraged to complete organizational applications and document their dissemination efforts through a structured process that includes sharing across multiple platforms and tracking reach.

The initiative emphasizes three primary areas of investigation:

- Observable climate changes in local communities

- Health impacts of these changes

- Barriers to protecting community health

As Mario Chazidamianos noted during the session, "Teach to Reach is turning into something more - a network of proactive professionals looking to take care of the world."

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🎧 Supporting Ukrainian children? “Sometimes the simplest solutions are the most powerful”…

This AI podcast explores PFA Connect, a new peer learning platform from The Geneva Learning Foundation.

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# Getting started with PFA Connect: A step-by-step guide

Request your invitation: https://www.learning.foundation/ukraine

## What is PFA Connect?

PFA Connect helps professionals who support Ukrainian children to:

- Share challenges and find solutions

- Learn from other professionals' experiences

- Build trusted relationships with colleagues

- Connect with over 2,000 professionals across Europe

Sessions are only 30 minutes long, designed for busy professionals.

## Who can participate?

Anyone who supports Ukrainian children:

- Teachers and education professionals

- Social workers and community support staff

- Mental health specialists

- Healthcare professionals

- Red Cross staff and volunteers

You do not need previous training in Psychological First Aid (PFA) to participate.

## How to register for a session

### Step 1: Quick registration

1. Go to the PFA Connect landing page

[PFA Connect](https://www.learning.foundation/ukraine)

1. Enter your name and email address in the registration form

2. Click the registration button

3. Check your email - you will receive three messages:

- Registration confirmation

- Instructions to prepare for PFA Connect

- Pre-registration from Zoom Eevent, to access the PFA Connect platform

### Step 2: Set up your Zoom Events access

1. Open the registration confirmation email

2. Click the "Register now" button

3. Choose how to register:

- Recommended: Sign in with your Zoom account (enables networking features)

- Alternative: Register with email

4. Select your language (English or Ukrainian)

5. Fill in your information:

- Your name

- Location

- Organization type

- Role/profession

- Number of staff in your organization

- Number of Ukrainian children you support

6. Click "Confirm registration"

7. Add the event to your calendar

### Step 3: Reserve your spot

1. Go to the Zoom Events platform using the link in your email

2. Click on "Sessions"

3. Find the upcoming session

4. Click "Reserve spot"

5. Make sure you see "Spot reserved" confirmation

## Before the session

### Share your experience (optional)

1. Open the "Prepare for PFA Connect" email

2. Click the link to share your experience

3. Choose what you want to share:

- A specific challenge you need help with

- A success story or lesson learned

- A tool or resource

- A topic for discussion

- An upcoming event

4. Fill in the short form describing what you want to share

5. Submit your contribution

### Invite colleagues (recommended)

- Share the PFA Connect invitation with trusted colleagues

- Use the sharing buttons for WhatsApp or Telegram

- Forward the registration link to your professional network

## During the session

1. Join at the scheduled time using your Zoom Events link

2. You will work in small groups to:

- Discuss real challenges

- Share practical solutions

- Exchange resources and tools

3. Sessions are initially 30 minutes

4. Groups can choose to extend discussions if desired

## After the session

1. Complete the 5-question feedback form to:

- Help improve future sessions

- Receive your certificate of participation

2. You will receive:

- A summary of insights based on what participants shared in their feedback

- Links to useful resources

- Ways to stay connected with colleagues

## Languages

- All activities are available in English and Ukrainian

- You will be grouped with others who speak your selected language

- You must choose your language during registration

## Need help?

If you have technical difficulties:

- Check your spam folder for registration emails

- Make sure to mark our emails as "not spam"

- Follow all registration steps in order

- Reserve your spot after registering

🎧 In the topography of global health, theory and practice often inhabit separate worlds. Our new AI-generated Deep Dive podcast examines Donald Schön's seminal framework on this divide - and why it matters for health systems transformation.

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