At a symposium of the American Society for Tropical Medicine and Hygiene (ASTMH) Annual Meeting, I explored how peer learning could help us tackle five critical challenges that limit effectiveness in global health. Performance : How do we move beyond knowledge gains to measurable improvements in health outcomes? Scale and access : How do we reach and include tens of thousands of health workers, not just dozens?

A formula for calculating learning efficacy, (E), considering the importance of each criterion and the specific ratings for peer learning, is: This abstract formula provides a way to quantify learning efficacy, considering various educational criteria and their relative importance (weights) for effective learning. Weights for each variables are derived from empirical data and expert consensus.

Cascade training remains widely used in global health. Cascade training can look great on paper: an expert trains a small group who, in turn, train others, thereby theoretically scaling the knowledge across an organization. It attempts to combine the advantages of expert coaching and peer learning by passing knowledge down a hierarchy.