I had the opportunity to chair a panel presentation on the role of social networks in global health at Medicine 2.0, the fifth annual international conference on social media, mobile apps, and Internet/Web 2.0 in health and medicine held at Harvard Medical School in Boston on September 15-16.  I joined Bruno Meessen, an economist based at the Institute of Tropical Medicine in Antwerp, Belgium who leads a performance-based financing online community with Harmonization for Health in Africa (HHA) and former colleague Sophie Beauvais, with the Global Health Delivery Project at Harvard University in Boston.  

Bruno shared his experience with online Communities of Practice (CoPs) for HHA, an interagency coordinating body supported by UNICEF, World Bank, WHO, and USAID.  HHA launched online CoPs as a way to coordinate capacity-building support among these agencies.  The first of its kind at the global level, the performance-based financing community has over 650 English and French speaking members and blends online activities including discussion forums, seminars, and blogs with face-to-face workshops.  In Bruno’s experience, the CoP can enhance the expertise of experts based in Africa working to solve problems as well as provide access to knowledge.

Sophie discussed the Global Health Delivery (GHD) project, put together by Dr. Jim Kim, currently President of the World Bank, who contrasted Coca-Cola’s distribution to delivering health services in resource-constrained settings and asked the important question, “Why can you find a bottle of Coke anywhere in the world, but not essential information?”  The GHD project consists of expert-led online CoPs and an educational model using teaching case studies based on the Harvard Business School method.  These case studies offer blueprints as to what works and what doesn’t in implementing solutions to address global health challenges.

I shared our experience convening virtual discussion forums on the IBP Knowledge Gateway, founded by USAID and WHO along with partner organizations including JHU∙CCP, to exchange knowledge in order to advance global reproductive health.  The Knowledge Gateway features, which include low-bandwidth technology and asynchronous discussions, are uniquely suited to meet the needs of users who do not have consistent and reliable Internet access.  Our forums serve to develop and guide policy on reproductive health.  I highlighted the Road to Dakar conversation series, which especially enabled those who could not attend the Senegal conference to contribute to shaping the global family planning agenda.

Online CoPs play an important role in transferring evidence to practice, particularly among healthcare practitioners and program managers in developing countries.  We agreed that for online CoPs to be successful, you need experienced and motivated facilitators to guide discussion as well as active participation of a core group of participants in order to sustain a sense of community.  However, important questions remain. 

The Knowledge Gateway and GHD use custom-built platforms, whereas HHA incorporates freely available technologies, including Google Groups.  Free technology provides us with opportunities to connect, however it may only be able to go so far in meeting user needs.  As a result, HHA is considering using the Knowledge Gateway.  Sophie also noted challenges with engaging the private sector in CoPs.  We should actively look for opportunities to involve and pique the interest of private sector participation.  Funding constitutes another issue.  Money and staffing is required to manage and maintain systems to foster and create knowledge and application.  While there is literature to support the effectiveness of online CoPs, we still need to continually provide funders with appropriate justification.  Bruno encouraged increased advocacy through op-eds and other ways to enhance awareness on the benefits of CoPs.  Sophie discussed the idea of core champions to promote CoPs.  Compelling case studies of knowledge exchange and application in developing countries can help tell the story.   

Monitoring and evaluation is needed to show that these efforts are working.  Measuring and evaluating the impact of online CoPs in global health is a challenging task.  Existing studies are primarily theoretical.  Few empirical studies specific to global health and international development exist, and there is a need for a conceptual framework for impact evaluation of CoPs.  K4Health has added to this literature with Six Years of Lessons Learned in Monitoring and Evaluating Online Discussion Forums, and will continue to work on assessing the impact of online CoPs in advancing global health.