ACCESS Health International’s vision is that all people, no matter where they live, have a right to access quality and affordable healthcare. ACCESS identifies good practices in high quality, low cost healthcare, supports the scale up of good practices in close collaboration with governments and the private sector, and strengthens health financing systems to improve the quality of healthcare services.
Building on this work, ACCESS Health has worked in close collaboration with Results for Development Institute (R4D) to develop R4D’s broader innovation, learning and knowledge sharing initiatives -including the Joint Learning Network for Universal Health Coverage and the Center for Health Market Innovations (CHMI). As a CHMI country partner, ACCESS has spearheaded implementation of the CHMI Learning Exchange, a fund designed to enable the scale up, replication or improvement of program models by facilitating the engagement of programs in a strategic learning activity with a pre-defined partner. Our work builds on the principles of the Adaptation Framework – fostering joint learning and promoting the adaptation and uptake of practices to new contexts.
The Learning Exchange was developed in response to an emerging need within the CHMI network. There has been rapid growth in the number of innovative health programs serving the poor, but many reach a point where growth stalls. Successful models require iteration to learn from mistakes, improve upon best practices, and adapt models to prepare for scale up. The CHMI database documents a wealth of innovative programs, but funding and knowledge gaps prevent programs from learning from their peers, requiring them to “re-invent the wheel” in siloes.
The Adaptation Framework speaks to the theory of change underlying the Learning Exchange—that components, or ‘active ingredients’ of successful models are adaptable across geographies, and that programs desire opportunities to test this approach on the ground. By focusing on the “active ingredient” as the unit of analysis, the learning exchange has developed a structured environment for solutions to be iteratively field tested and implemented within a peer learning partnership. Programs apply jointly with the aim of addressing a specific need using their partner’s identified strengths and drawing upon potential active ingredients that could be adapted to their own context. During the process, organizations are encouraged to define their own learning agenda and share their learnings with other programs in the learning exchange cohort.
The adaptation framework is a tool that enables the success of peer learning partnerships by helping program managers identify the active ingredient to be adapted (i.e. Aravind Eye Care’s specific operational processes in India, which are being adapted by SalaUno Eye Care in Mexico) as well as the contextual factors that enable that success (i.e. higher patient volumes in India than Mexico). After the individual partnerships have concluded, the framework will provide a framework for ACCESS and R4D to disseminate the learnings from this process.