Chair 2

Prof Mark Dybul

Professor in the Department of Medicine at the Medical Center and the co-director of the Center for Global Health Practice and Impact at Georgetown University

Professor Mark Dybul will address the role of ‘communities of practice’ in creating efficiencies in health and healthcare provision with an emphasis on the lessons that can be learnt from HIV.

Timeline of engagement

Prof Mark Dybul was appointed Joep Lange Chair on 1 July 2017, when he left his position as Director of the Global Fund to fight AIDS, malaria and tuberculosis.

Research focus within the Joep Lange Chair & Fellows Program

The Local Innovation Scaled Through Enterprise Networks (LISTEN), formerly Business Process for Impact (BPI) approach, leverages communities of practice (CP), human-centered design (HCD) and data-driven decision-making to catalyze, capture and scale locally driven innovations for greater impact to accelerate the uptake of new technologies and solutions in the fight against HIV and TB/HIV. Funded by the Bill and Melinda Gates foundation, and launched in April 2018, the grant supports activities in two counties in Kenya (Homa Bay and Kiambu), the Kingdom of Eswatini, and Malawi. The Joep Lange Chair and Fellows program supports Mark Dybul (as principal investigator of the grant), Janneke Verheijen (fellow engaged on the project), and Prof Eileen Moyer’s activities under LISTEN.

LISTEN begins by identifying and mapping existing communities of practice based on level of service delivery, starting at the community level. Using human-centered design, the CP are then supported to get to the root causes of stubborn challenges and innovate and test solutions against them. Existing innovations and ideas for new approaches are assessed, revised, and improved upon by members of the CPs, the results of which are then “looped” back through to the community, where the process continuously repeats and reinforces itself. The CPs are also supported to establish linkages both vertically (such as a community level CP gaining access to policy makers), and horizontally (such as linking two communities of practice that are addressing similar challenges). Through-out the process, relevant existing data is optimized and adapted for each CP, so that it is accessible and used routinely to inform decision making. Data adaptations are few and impactful for innovation and decision-making, (i.e., heads of state/government, communities) while adaptations for technical levels would be extensive and comprehensive.

To date, eight communities of practice have been established in Kenya (4) and Eswatini (4) and supported to use data and an HCD approach to problem solve and use existing local resources to address their priorities, which include both HIV and non-HIV related issues. Results have been promising – in Kenya for example, one of the CP is boda boda (motor cycle taxi) drivers, and their engagement in the process has led to successes such as the distribution of 75,358 condoms by chairmen of local boda boda sub-groupings and male champions, and a new collaborative engagement between boda boda drivers and the National Ministry of Transportation, resulting in an increase of Ksh 50 Million ($50,000) to fund road repairs. Similarly, in Eswatini, a community health semi-annual review platform (the COHSAR) has been developed as part of the already well-functioning national, regional, and facility-level semi-annual review structure, to monitor progress of health outcomes at the community level and serve as an accountability mechanism, and access to clean water has been provided to 450 households. A nurse wellness program that has provided health provider wellness screening to over a 1/3 of Eswatini’s health workforce has also been established as a ‘spill-over’ from the LISTEN implementation. Similar accomplishments have been made across all the CPs supported in both countries.