Five things public health can learn from education
Cross-sector perspectives for stronger programs.
Noora Health’s Care Companion Program (CCP) provides high-impact, culturally contextualized, and tailored health skills training that equips families to provide care for their loved ones in health facilities and at home. Our CCP has often been viewed through the lens of public health but can also benefit from deeper investigations of other fields. As we train nurses to become trainers and families to become caregivers, we embody the role of a teacher or an educator.
This shift in understanding our program from an education lens led us to undertake an analogous inspiration exercise to draw on perspectives from the education sector. According to global design firm, IDEO, analogous inspiration projects are “a form of exploration that takes a team outside of its industry to find inspiration in the ways others have tackled similar challenges”. With a fresh perspective, we can develop creative solutions to the challenges we face. Through this project, the ultimate aim was to apply our learnings and findings to the CCP context.
Through interviews with 12 experts in the education space, we gained insight into how we might strengthen our programs, with a particular focus on increasing our effectiveness as trainers and educators in the health sector. The project also revealed the larger need for the health sector to learn from the education sector. This article captures five learnings, highlighting what public health can learn from the education sector.
Learning #1: Staying motivated
Motivation is why we do what we do. Teachers and nurses often do what they do because their work gives them purpose and the joy of contributing to their communities. Without motivation, teaching or medicine can be very emotionally and physically demanding fields to cope with.
From our interviews, we noted that motivation can be broken down into two types: financial and non-financial motivators. When asked about methods of non-financial (or intrinsic) motivation, participants expressed that the key motivator for teachers was a sense of ownership in their work. There are multiple ways of achieving this, such as involving teachers as co-designers of curriculum, increasing their participation in decision-making, or adopting a democratic leadership style.
STIR Education, an international NGO that supports education systems to increase intrinsic motivation in teachers, shared that this form of intrinsic motivation is only possible when teachers can understand their purpose and have the space to succeed and to fail. This leads them on the path to continuous improvement and “continual improvement leads to mastery”. The Citizens Foundation (TCF), one of Pakistan’s leading organizations in the field of education for the less privileged, was able to successfully maintain the motivation of local teachers by drawing on their sentiment to give back to their own communities — an idea known as ‘purpose-driven motivation’.
On the other hand, an example of a financial motivator is TCF’s performance-based pay approach. TCF administers competency tests for teachers on a yearly basis. The teachers who score well on these tests are rewarded with an increase in salary, thereby incentivizing their performance.
However, Maansa, an educator and PhD student at the University of Canterbury, argues that extrinsic motivation has many negative effects. This is because if a person gets used to external rewards, intrinsic motivation starts to decline. At that point, she notes, “It’s problematic to keep that spark alive, and that’s (the spark) why teachers are in it”.
It is important to note that for both nurses and teachers from underserved backgrounds, the extra financial incentive can have a lasting effect and impact on their lives. However, such financial motivation techniques should always be coupled with non-financial or intrinsic motivation. This can take the form of appreciation — through a nurse of the month program, for example — or increased autonomy and involvement in decision making. As healthcare organizations work towards building the motivation of their nurses into the core of their organizational goals, they must prioritize the maintenance of the ‘spark’ with which nurses enter their field of work.
Learning #2: Increasing the role and relevance of technology
Our participants shared three benefits of incorporating technology into their classrooms: teacher aids, personalization of education, and accessibility of education.
For low-resourced areas, technology can support in-class instruction or help teachers prepare for lessons beforehand. This is a model utilized by Meghshala, an organization that developed a teacher preparation program on an app which allowed teachers to prepare for lessons without feeling overwhelmed or overburdened. STIR Education recommends that in such scenarios where technology serves as a teaching aid, it must be flexible enough to adjust the model for each context. This is what TagHive, a Samsung-funded education technology company, aims to do at the school level, where content is tailored to each school’s curriculum and needs. Artificial Intelligence assesses the child’s learning level, and content is then tailored appropriately without the teacher’s assistance. The child, therefore, is never asked a question they are ill-equipped to answer. Finally, as the pandemic has revealed, technology enables remote learning opportunities, reaching students that may otherwise not have had access to education.
Drawing parallels between technology as an educational aid and as a tool to improve health outcomes, we identified multiple ways in which technology can be used to strengthen Noora Health’s work. These include improving the ability of patients to remotely access information about their health, as well as reaching out to healthcare professionals when they have personal questions or concerns about their health. Similarly, technology also provides nurses with an informational aid that can be accessed on their personal devices on the go.
Learning #3: Understanding the importance of context, community, and collaboration
Collaboration across parents, teachers, school administrators, governments, and the larger community is central for quality education. Sridhar, a former Teach for India fellow and current senior associate at IDFC Institute, mentions how feedback from family members on their children’s education provides a more holistic picture of student learning.
Similarly, before building their educational app, the Upepo team spoke with parents to ensure the app was in line with parent aspirations. Additionally, whether an education intervention is discussed in community gatherings can be an indicator for success. Sridhar notes, “There are folks who are not in the traditional loop who can give you an idea about the quality of your programs, for example, the shopkeeper who sells the children snacks.” Given their role as trusted community insiders, these individuals are able to gather authentic and informal feedback about various community interventions — in education and health alike — that may be able to help practitioners identify the strengths and weaknesses of their programmes.
It is also important for educators to collaborate internally. Maansa shares how, in her experience as a teacher, the teachers would meet regularly to discuss strategies and challenges. Similarly, others note how helpful it has been for them to connect with those who have taught at the same school to be able to identify where the issues are arising and how to address them.
Alini Singh, an English teacher at Ingraham Institute Ghaziabad, notes that “who you’re teaching is very important; the students and their diverse backgrounds matter”.
Without a full understanding of how diverse backgrounds impact their experience, the organization may fail to sufficiently address the needs of their communities.
Moreover, Maamta, an educator at the Milaan Foundation, notes that “educators must know each child very well otherwise many times the problems cannot be dealt with”.
Education relies heavily on community, context, and collaboration. A child is not isolated in their educational experience, nor is a patient in their journey to health. Any intervention affects the community at large, be it family, friends, or other community members. This understanding of context and community allows us to better tailor our programming to accommodate for the diverse experiences of health and treatment with our patients and patient families. To ensure that we provide the optimal care and support for every patient, our health recommendations must be modified according to the culture, customs, and context of our patients. For example, any recommendations on diet for maternal health must take into account the availability of local ingredients, the cost of purchasing various food items, the religious and cultural dietary restrictions, and so on.
Learning #4: Investing in people
Investing in the growth and development of the team is the best way to ensure that organizational goals are continually met.
Participants shared that they found training helped reduce stagnation and ensure improvement. Maansa shares that administrators and trainers must “challenge (teachers) from a genuine space instead of from intimidation”, emphasizing the importance of adopting kindness as part of the training and mentoring process. The training provided should be jargon-free to make it as accessible as possible. The sessions should be actionable (and not limited to theory) to ensure that the learnings from training can be easily applied to the classroom context. Reflecting on her time as a trainer and teacher, Maansa noted that there is a need to mindfully develop training sessions that have significant break time. This is because teachers come into these training sessions — which are often at the end of the day — feeling exhausted and burned out. She recommends that the trainings are not cognitively overloaded and that every session should end with a reflection and an actionable takeaway. “Adopt a human-centered learning approach,” emphasizes Maansa.
Jump Design India, a design studio for education products, curriculum, and design research, further highlights the need to be mindful of teacher burnout: “Any additional intervention or training for teachers beyond work hours should be well thought out and well scheduled.” Make a Difference, an NGO that works with children in orphanages and shelters across India, echoes Maansa and Jump Design India’s sentiments. They highlight how “lecture-y sessions” should be avoided and instead trainings should involve interactive and action-based activities. When designing their sessions, Make a Difference assumes that no one has previous experience as an educator. The designers of teacher trainings ask themselves: What are the most basic things an individual requires to be successful in a classroom? Additionally, the trainings should also have a sense of growth where trainees can ‘level up’ if they’ve been through the early modules of training. The content should also be revised every year to ensure that it contains only the best and most relevant practices and information.
These experiences shine light on the importance of investing in people and the impact it can have on the organization and its mission. Within Noora Health’s context, we understood why nurses should be able to request training on particular topics or serve as co-creators for their own training sessions, should they be inclined to do so. It would also be of great benefit to healthcare workers if they are provided with additional training to prepare themselves to take on the role of a facilitator, teacher, or trainer — roles that they may often find themselves in during their time as healthcare professionals.
Learning #5: Recognizing the need for organizational support
Organizations can play an important role in ensuring the success of the teaching staff. To build a sense of community among the staff, organizations must provide high levels of continued support. Maamta expands that this is only possible when there is trust between the educators and administrators. She shares: “Quality requires trust. They must trust that the organization is doing the right thing”.
For this to happen, the relationship should be ongoing between teachers and administrators. Teachers should feel free to share their dissent, receive personalized feedback and have opportunities to seek mentorship.
In addition, administrators must meet the needs of the staff. For example, at Protsahan, an organization working on education for girls, anganwadi workers often approach administrators, asking for training for themselves and their community. Another example is the Akanksha Foundation where the organization makes sure that each school gets its own social workers. Successful organizations meet the needs of the community and educators as needs arise.
TCF also remains deeply connected with their teachers through training. Their training team organizes regular school visits so that they don’t become too divorced from the teachers and ground reality. Sridhar agrees with this approach, noting that the organization must “become an ‘insider’ in the life of (their) teachers to ensure there is no disconnect”.
Maansa thinks back to the time her mother was a teacher, and shares: “Be involved with your team of teachers. Be there every morning to say good morning. Be around and available; teachers should feel your presence. Develop a true democratic environment where teachers feel like they belong. Teachers are happiest when they have a strong relationship with the management — don’t let them feel alone.”
In the healthcare context, we must consider how we can provide nurses with the platform to voice dissent, communicate freely with administrators about their concerns and ideas, and feel like an integral part of the hospital and patient education environment. Ways to provide sufficient organizational support include having frequent and open communication between nurses who are on the ground and administrators working behind the scenes and to involve nurses in decision making whenever possible. This is particularly important when decisions are being made that may impact their day-to-day work.
In sum, analogous projects allow us to step outside ourselves. In doing so, they have the potential to inspire us to see our world from a different lens, collaborate with new and diverse industries and individuals, and allow us to creatively identify solutions to problems. Public health and education overlap in a shared mission to benefit the communities they work in. Learning from each other opens the door to limitless possibilities of becoming better educators, better healthcare workers, and, most importantly, better caregivers.
This article was originally published on Apr 29, 2022 and edited and updated in June 2023.
Minha Khan
Noora Health Alumni
