Conversation: a powerful tool for sharing innovations

Delphina Ntangeki

Improvement Advisor, KM and Communications, Tanzania, USAID ASSIST Project/URC

Often, learning events are didactic in nature, and the assumption is that there are learners and trainers. Such sessions are characterized by numerous PowerPoint presentations and a lot of take-home notes and assignments.  However, during the recent Knowledge Harvesting Session organized by the USAID ASSIST Project in Lindi, we arranged the room in a u-shape instead of a common classroom style seating arrangement. The first reaction from participants was excitement; over the course of the two-day meeting, the deep, frank, rich conversation and engagement that were created proved fulfilling.

The District Health Management Performance (DHMP) improvement activity was initiated to address district-level challenges that hinder the improvement of ART/PMTCT services in Lindi region, despite collaborative improvement activities that showed improvement in the outcome of services delivered in this area. A situational analysis conducted in January 2012 revealed challenges in several functional domains which included Human Resources for Health, Council Health Planning, District Health Information Systems and Supplies and Logistics.

In the end of March 2014, the USAID ASSIST project in Tanzania convened a knowledge harvest meeting to identify key learning from implementation of the DHMP initiative, implemented in six districts of Lindi region from February 2012 to March 2014.

Dr. Davis Rumisha, ASSIST Tanzania COP summarizing responses

Dr. Davis Rumisha, ASSIST Tanzania COP summarizing responses of one of the functional domains during the DHMP initiative harvest meeting.

The two-day harvest meeting brought together participants from all six districts implementing the initiative that consisted of 12 Council Health Management Team (CHMT) members, 2 health care workers and 3 members of the Lindi Regional Health Management Team. The meeting was facilitated by the ASSIST Chiefs of Party from Tanzania and Uganda, Drs. Davis Rumisha and Humphrey Megere. What interested me about the meeting were the knowledge management techniques used to collect information from participants.

After introductions and an opening speech from Dr. Humphrey Megere, we asked participants to sit in small groups to discuss the functional domains they implemented. We mixed participants from different districts, so as to get more information and different experiences. We distributed participants into three small groups. Each group discussed one domain and then switched to another table after 30 minutes. Two ASSIST facilitators were permanently placed at each table to probe questions to the groups so as to extract information on each functional domain and promote knowledge sharing among teams.

After all three groups had rotated through each table and discussed all three functional domains, we re-divided the three groups to form two groups to discuss the remained two functional domains.  Each group discussed one domain switched to another table after 30 minutes. At the end, every participant had opportunity to contribute on each domain. This was a very effective way to get every participant to share their knowledge and experiences.

At the end of the first day, we gave participants homework whereby each district was assigned to brainstorm and come up with a maximum of three sustainability strategies and also reflect on how the initiative had changed their team in terms of overall team performance and the way they communicate internally. The following day, we asked the teams to write their responses on a flip chart and stick them on the walls for presentation. Each team selected a presenter who presented their work to other participants and facilitators and clarified issues raised by other participants.

Dr. Humphrey Megere supports discussion in harvest meeting

Dr. Humphrey Megere COP ASSIST in Uganda supports participants discussing one of the functional domains during the DHMP initiative harvest meeting.

The rapid fire session was another interesting part of the meeting. During this session, participants sat in u-shaped arrangement and one facilitator asked quick questions whereby every participant, including ASSIST facilitators, was supposed to answer. The questions required participants to mention ‘what were their feelings about QI’ and the second question was about ‘what was the worst part of their job.’ Although the questions did not specifically seek to provide answers relevant to information the meeting intended to collect, they helped to keep participants active.

The participants enjoyed this session as they got opportunity to say what they wished to speak out but they had no place to speak. For example one participant responded “QI has helped to change attitude and has increased commitment” and another said “I work hard, but my work is not recognized.”

One thing I noticed during this meeting is that participants remained active throughout the meeting. I also think that not using many PowerPoint presentations helped to make participants active (there was only one formal presentation in the entire meeting). Also the small group discussions, plenary discussions, seating arrangements as well as room visit techniques made participants excited to see what would happen next as every session was different from the previous session.

From my point of view, this meeting was excellent, as participants were engaged but they remained active all the time. I would recommend this approach to conduct not only harvest meetings, but also learning sessions and other trainings for it is the best- engaging meeting I have seen.

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