Nov. 23, 2020

Knowledge clinics offer a virtual method for synthesising best practice in MSD

Tackling complex challenges, virtually, with facilitated knowledge clinics

‘Knowledge clinics’ are carefully facilitated virtual learning spaces organised around small groups meeting frequently over a period of several months. They capture tacit knowledge from a diverse range of organisations. In 2020, knowledge clinics were used to generate new understanding around MSD procurement. The results were published as four papers in the MSD Procurement Series.

Focusing on the process of running the clinics, this blog accompanies our short paper on the clinics' methodology.

At the best of times, organisations struggle to find the time and resources to share experiences and jointly develop best practices. The COVID-19 pandemic has exacerbated the situation: face-to-face conferences cancelled, professional development budgets slashed, and competition for funding has intensified. Against this backdrop, knowledge clinics offer a clear process to bring together diverse groups of practitioners to address practical challenges and chart new approaches.

In 2020, the BEAM Exchange ran knowledge clinics to tackle the complex challenges of procurement and contracting in MSD. I was the facilitator of the process, meeting 1-on-1 with all 19 participants (donors, implementers and consultants) before I split them into four groups, with each meeting six times over a 3-month period.

A reasonable person might say: “that’s a lot of meetings, especially on procurement, of all topics!” And yet, the meeting participation rate was over 85 per cent, with many taking calls earlier than 8am or after 7pm because of time zones.

I think participation was high because people in senior roles were suddenly given a space to reflect, connect and experience that rare feeling of being in totally different ‘worlds’ but facing the same challenges from different perspectives. There was enough focus and structure to keep people on topic, with a facilitator to handle the mundane distractions- logistics, scheduling, note-taking. There was also enough freedom and flexibility to explore tangential ideas and questions. When one group asked: “what if we analysed the incentives of every player in an MSD consortium?”, this led to a new way of thinking about consortium dynamics, which is described in the procurement paper Decisive structures. Similarly, another group decided: “let’s focus on the procurement challenges in programme start-up”, which provided the framing for the paper Getting off the ground.

Because there was repeated interactions amongst the same small group of four to six people, ideas could be deepened and connected over a period of several weeks. This helped to synthesise key principles and important ways of framing issues. For example, it took several meetings to recognise that operations and procurement staff can sometimes be forgotten in MSD training. Operations staff need to be valued and recognised as equal to their technical counterparts, a point made clearly in the paper Fit for business.

While every participant had their own experience of procurement, nobody had the complete picture of the full web of actors involving donors, implementers and consultancies.

These broader structural aspects of procurement required the knowledge clinics to go beyond immediate experiences to offer new ways of thinking about, and framing, issues. Ultimately, this led to the publication of four papers in the Procurement Series:

#1 Decisive structures: procurement format options for MSD programmes and their different implications

#2 Deepening the relationship: a stage-by-stage guide to strengthening partnerships between donors and implementers in MSD programmes

#3 Getting off the ground: practical lessons for the launch phase of MSD programmes

#4 Fit for Business: modifying internal procurement processes to suit adaptive MSD programmes

More important than the specific findings is the applicability of the methodology. The facilitation process has matured from its initial how-to manual from 2016 and is more relevant today given constraints on mobility and in-person gatherings. In a new summary note, we have documented evolutions in the methodology and some new lessons for prospective facilitators:

  • How to develop relationships between people who have never met in-person
  • How to drive engagement
  • How to build continuity across sessions

There are other signs that adoption is spreading. In June and July 2020, the DCED Secretariat hosted two sought-after clinics on remote monitoring for market systems programmes. These sessions show that clinics can address timely topics (i.e. new realities brought on by the pandemic) with a process methodology that maximises engagement.


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