In 2017, an external evaluation of SNI identified that knowledge exchange between the four country hubs was limited and suggested that SNI should actively facilitate this exchange. SNI country hubs supported this idea and indicated a particular interest in focusing on translating knowledge into products for use in changing policy and practice. In light of these developments, the Share-Net International Rapid Improvement Model (SHIRIM) was established in 2017.
SHIRIM aims to:
SHIRIM was built on a method called the Collaborative Approach. It was used previously for improving specific health care practices and reducing costs in specific countries. SHIRIM now uses the Collaborative Approach concept for the first time for knowledge management purposes across different country contexts.
The Collaborative Approach forms part of the Breakthrough Series developed by the Institute for Healthcare Improvement (IHI), an independent not-for-profit organization based in the US. The approach was initially developed to further our mission of improving the quality and value of health care. However, it is applicable to everything, as the approach helps organisations close the gap between what we know and what we do by creating a structure in which interested organisations can easily learn from each other and from recognised experts in topic areas where they want to make improvements.
SHIRIM is implemented as a short-term learning system of 18 months during which the country hubs can develop and try out new strategies and interventions to translate knowledge into products for use in changing policy and practice. The country hubs each selected a theme for breakthrough improvement. Share-Net Bangladesh and Share-Net Jordan both chose child marriage, while Share-Net Burundi chose teenage pregnancy. Share-Net Netherlands adopted a slightly different focus by partnering with Rutgers Indonesia to target child marriage in Indonesia. A facilitation team that includes knowledge experts and subject matter experts in the specific focus areas assist the representatives in selecting, testing and implementing changes.
The Collaborative Approach is implemented in a cyclical manner, alternating between learning sessions and action periods:
1. During the first learning session participants learned how to implement the Collaborative Approach in their own context, and got topic updates from subject matter experts. The country hubs also developed a change package which encompassed strategies for knowledge translation to tackle their chosen issue.
2. The country hubs then returned to their country and set up a local collaborative with their own stakeholders. Here, they replicated the first learning session and adapted their change package with the input of these stakeholders.
3. The strategies for knowledge translation were then implemented during the local action period.
Examples of change packages developed and adjusted jointly with local stakeholders include:
Established in 2017, SHIRIM is still a relatively new model for SNI. Adapting this model has resulted in a lot of enthusiasm between the hubs and the sessions inspire and foster collaboration and sense of togetherness. SNI aims to replicate the approach to two additional topics over the next 5 years. Topics may include unsafe abortion, gender-based violence, and adolescent sexual health depending on which topics have the potential to elicit change.