Highlights from the closed-door briefing: Local solutions to funding cuts (26 June 2025)

# Local solutions to funding cuts highlights After nearly a decade of research and implementation, significant breakthroughs have emerged in the last three years around supporting locally-led change in health systems. The key discovery centers on a simple yet transformative approach: facilitating health workers to help each other solve problems. ## The power of asking the right questions Many health workers report that no one has ever asked them what they think should happen or sought their input on solutions. This represents a fundamental shift from traditional top-down approaches to one that recognizes frontline expertise. The model works because it taps into learning science principles. Knowledge acquisition alone does not drive change—learning happens when people actively apply knowledge to real problems. During the COVID pandemic, this approach proved particularly effective when health workers at facilities were asked directly: "You have this problem. What is your suggestion? What is your solution?" The solutions came from the workers themselves. ## Scalable and sustainable impact This collaborative approach has demonstrated success across different contexts, thematic areas, countries, and regions when deployed correctly. The model works at scale while maintaining lower costs than traditional interventions. The Nigeria collaborative provides compelling evidence of the approach's momentum-building potential. Government staff initially viewed the initiative with skepticism. One official explained: "Initially, I heard about this. I thought this was just another CSO initiative. Two weeks in, I realized how exciting and useful this could be, and so I joined and participated fully." ## Mission-driven participation The model operates without per diems, travel allowances, or hotel accommodations. This structure naturally attracts exceptional participants who possess a genuine sense of mission and purpose. The theory of change assumes these committed individuals will influence broader adoption when they receive proper support and recognition within their health systems. Results from a Gavi-supported project reinforce this approach's potential for replication. Among participants, 82 percent reported they could implement the methodology independently, suggesting strong capacity for organic spread and sustainability.