Wrapping up 2023: Progress and Next Steps

Progress

It’s been a busy year at HealthLearn, with some important goals met and a lot of work left to do. Here are some of the key milestones we reached this year:

• In May, we received our seed funding and officially launched HealthLearn as an independent organization,

• In August, we signed agreements with a major iNGO to develop and host courses, which we see as a first step towards building a sustainable funding model,

• In October, we completed a feasibility pilot of our newborn care course, with encouraging pilot results (high uptake, strong learning gains, and positive learner feedback), and

• As of December, our new, custom platform, tailored to the learning needs of our audience, is almost complete.

Much of our work in 2024 will be oriented towards evidence generation, especially assessing the impact of our courses on health workers’ clinical practice and finding efficient models for scaling up.

Programs and impact

Our theory of change is that better health worker training leads to improved clinical care, which in turn improves health outcomes. The theory of change hinges on four key uncertainties, summarized in the figure below.

HealthLearn's theory of change.

This year, we ran a feasibility pilot to gather data that gives us more clarity on the first two uncertainties, namely:

1. a high percentage of eligible health workers did take the course, and

2. there were large and significant learning gains among health workers who took the course.

From interviews and surveys of pilot participants, we have early indications that the course led participants to update their clinical practices. However, we know the limitations of self-reported behavior change. 

In 2024, we aim to address the biggest uncertainty, which is whether health workers’ clinical practice improves when they take our courses. It’s likely that this evaluation will involve directly observing health workers in their day-to-day clinical practice before and after they take the HealthLearn newborn care course.

The impact of our courses may be relatively small on a per-health-worker basis. If that is the case, it will be critical for us to find efficient models for scaling up to reach many thousands of health workers. Therefore, another key program objective for 2024 is to explore different “implementation models” and find the approaches that will allow us to most efficiently scale up while still reaching the health workers who can benefit the most from our courses.

A new and improved learning platform

We’ve known for a long time that existing learning management systems are not optimized to meet the technology and learning needs of our audience. Some of the challenges with existing platforms include:

• a lack of backwards compatibility with the older phones and browsers that are commonly used by our audience,

• poor performance on low bandwidth cellular internet connections that are widespread in our context, and

• complex navigation and user experiences that are not optimized for mobile devices.

While we have been able to surmount those challenges at the pilot stage, they could become major impediments to scaling up. We’ve been extremely fortunate to have the support of four volunteer software engineers (Karl Keefer, Jonas Wagner, Ben Hamilton-Olsen, and Steve Avery) who built an entirely new, custom HealthLearn platform. This platform ameliorates the challenges we’ve encountered in the past and also enables more rapid and iterative improvement as we move forward. The demo below shows the new platform in action. 

A brief demo of our new platform.

We’re currently integrating feedback from user testing and we plan to launch the new platform along with a few courses in early 2024.

Sustainability

We have a vision of high-quality online health worker training as a systemic intervention that improves quality of care across the entire health system, not just in a single program area such as newborn health. This is linked to our vision for financial sustainability — we aim to partner with governments and NGOs to offer courses that cover the most important topics in primary care. Earlier this year, we took a major step forward by signing agreements with Resolve to Save Lives (RTSL), which focuses on preventing pandemics and averting deaths from non-communicable diseases. We’re currently working with RTSL to develop and host courses on hypertension and epidemic preparedness. In alignment with our work on newborn care, the RTSL courses also focus on an audience of Nigerian health workers who staff primary health centers. 

The revenue we’re earning from this work hints at a pathway to a financially sustainable business model. We’ve also been fortunate to receive support from donors who invest in innovative solutions with potential to be highly impactful and cost-effective. We aim to grow both streams of revenue by gathering more evidence of our impact, continuing to improve our product, demonstrating our capacity to implement, and improving our programs (as described above). 

2024 goals and risks

Our goals for 2024 are to:

• assess the impact of our courses on health workers’ clinical practices,

• find the most simple and efficient implementation models that will work at scale,

• release our new learning platform under an open-source license,

• continue to build a sustainable business model, and

• build our team to be well-positioned to scale up in 2025 and beyond.

We’re a lean organization and we aim to move quickly to be good stewards of our resources, so one of the biggest challenges we may face is that governments and regulators move at a different pace. Moreover, we will continue to have substantial uncertainties about the impact of our program until we complete the clinical practice evaluation.

2024 funding needs

We aim to raise $134,500 to achieve our ambitious targets for 2024. Most of what we fundraise will go towards implementing partners and hiring key staff members in Nigeria and on our technology team. This will maintain our runway while putting our organization in a much stronger position to deliver these goals and be competitive for larger grants moving forward. 

Interested in learning more? Reach out to us at contact@healthlearn.org