Managing information and knowledge: a conceptual framework
The exercise helped participants understand how KM could support their activities and program goals. No statistical tests were conducted. The endline post-assessments found that staff knowledge of how to design and implement SBCC activities had improved, and they increasingly used a strategic process for developing messages and materials.
Staff also demonstrated greater ability to manage data, more appreciation for monitoring and evaluation, and improved leadership skills. Although the units recognized the need, KM processes were not prioritized. Barriers included competing demands and limited information sharing. BKMI advocated improved KM with the line directors and at higher levels, including the Secretary of Health, specifically to develop processes and use tools that could help improve organizational effectiveness, knowledge sharing, and on-the-job skills.
Knowledge management in support of SBCC programs requires time and space to share knowledge in order to harmonize plans and align messages and activities within and across health sectors and among varying SBCC stakeholders.
Coordination allows SBCC stakeholders opportunities to collaborate, share, and validate good practices and lessons learned, pool resources, avoid duplication of effort, and create and implement activities according to common quality standards. By establishing a systematic process for exchanging knowledge around SBCC programs and materials and institutionalizing a process through the working group and its members, BKMI sought to create a sustainable solution to chronic coordination issues.
In addition, coordination objectives and activities must be clear and inclusive of all who want to be involved. The BKMI team found that inclusiveness helped address common challenges from different angles and ensured that those implicated in SBCC activities in Bangladesh could have a voice and contribute to the national conversations occurring within the health system.
Furthermore, for the effort to be sustainable, the MoHFW must take ownership of the group and drive the agenda. The eHealth pilot presented an opportunity to use new technology to deliver effective HPN counseling to the community and improve knowledge in a standardized manner. While the BKMI team had concerns about using the netbooks with field workers, they quickly learned how to access the digital resources, demonstrating that technology can be a useful tool for facilitating SBCC and strengthening counseling skills.
While not its original intention, field workers used the eLearning courses as counseling tools because clients found the courses entertaining and easy to understand. The BKMI team learned that providing field workers with digital resources on netbooks empowered them, increased their confidence on the job, and heightened their credibility in the community. The team also learned that the field workers would have benefitted from a more in-depth, in-person interpersonal communication and counseling training on how to use the netbook and its resources during counseling sessions.
In addition, field workers would have been better supported if their supervisors had been part of the pilot and had been available to answer content-related questions and to help navigate the resources in the netbook to find those most appropriate for a particular counseling session. Finally, the project team learned that any activity involving technology requires ongoing IT and monitoring support. Field workers used the eLearning courses as counseling tools—not by design but because clients found the courses entertaining and easy to understand.
The major activities of the BKMI project mutually reinforced each other. All 3 units were involved in every stage of Toolkit and eLearning course development for the eHealth pilot that took place at the community level. The eHealth pilot was an important activity to link national coordination and community needs. Given the high staff turnover within the MoHFW, it is important to go beyond strengthening the capacity of individuals to focus on strengthening the capacity of the whole organization by setting up strong processes and employing state-of-the-art tools to ensure sustainability.
Furthermore, organizations need to take responsibility for their own capacity strengthening initiatives by recognizing their importance and helping identify areas for improvement. Also, given competing time pressures, capacity strengthening plans should support and help meet the objectives and deliverables of operational plans. To be most effective, capacity strengthening efforts must include the full team of SBCC staff members to achieve a common level of SBCC ability throughout the organization.
Integrating new technology as part of capacity strengthening can motivate staff and enable them to achieve deliverables more efficiently. In addition, the project continues to update and expand the HPN Toolkit and 8 eLearning courses through a local organization called the Bangladesh Center for Communication Programs. The netbooks used for the eHealth pilot were deemed to not be scalable because of the cost associated with the netbook itself, as well as ongoing needs for IT and monitoring support.
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Rather than pursuing scale-up through netbooks, the project is now exploring how it can scale-up use of the Toolkit and the eLearning courses to more health service providers in Bangladesh through the existing infrastructure, which includes mostly desktop computers in clinics and tablets among the health assistants. Many global health programs are grappling with issues related to coordination, learning and application, and capacity strengthening.
Addressing these issues is critical across technical topics and sectors, as these foundational factors, if properly achieved, can increase efficiency, maximize resources, and contribute to both short- and long-term health goals. The case study from Bangladesh illustrates how KM can improve coordination by creating and implementing a systematic process to exchange knowledge on a particular technical topic—in this case, SBCC programs and materials—as well as institutionalizing such a process to ensure sustainability.
These changes are hypothesized to improve service delivery quality. From a health systems strengthening perspective, this example illustrates that ensuring coordination among different actors, such as those working cross-sectorally in SBCC, supporting learning, and investing in capacity building, can contribute to improving health and development outcomes. Further research would be beneficial in understanding the application of KM within the health sector.
At a minimum, more rigorous studies that isolate KM activities and compare them to the absence of KM activities would provide stronger evidence of its effectiveness on health outcomes. Having a deeper understanding of how health care organizations use KM and further testing of various KM interventions within the health care context would be helpful in demonstrating the potential impact. Because knowledge management has been informed by and used within disciplines outside public health, there is a crucial need to consider how to apply KM tools and processes from other fields to global health.
The management of that knowledge is paramount but has yet to be viewed as such. The views expressed in this document do not necessarily reflect those of the US Agency for International Development or of the US government.
Becoming virtual: Knowledge management and transformation in the distributed organization
Leveraging the power of knowledge management to transform global health and development. Glob Health Sci Pract.
National Center for Biotechnology Information , U. Published online Apr Author information Article notes Copyright and License information Disclaimer. Correspondence to Tara M Sullivan ude. Received Dec 7; Accepted Feb This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited.
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Knowledge Management Tools. Lack of coordination between organizations led to duplication of effort. Competing demands and limited information sharing impeded the use of KM processes.
Strengthening KM and SBCC Capacity Given the high staff turnover within the MoHFW, it is important to go beyond strengthening the capacity of individuals to focus on strengthening the capacity of the whole organization by setting up strong processes and employing state-of-the-art tools to ensure sustainability. Notes Competing Interests: None declared.
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