{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:15:36Z","timestamp":1790644536411,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Processes of self\u2010reflection and the learning they allow are crucial before, during, and after acute emergencies, including infectious disease outbreaks. Tools\u2014such as Action Reviews\u2014offer World Health Organization (WHO) member states a platform to enhance learning. We sought to better understand the value of these tools and how they may be further refined and better used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the publicly available WHO Strategic Partnership for Health Security website for paired reports of Action Reviews, that is, reports with a comparable follow\u2010up report. We complemented the paired action reviews, with a literature search, including the gray literature. The paired action reviews were analyzed using the \u201cLearning Health Systems\u201d framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified three paired action reviews: Lassa Fever After Action Reviews (AARs) in Nigeria (2017 and 2018), COVID\u201019 Intra\u2010Action Reviews (IARs) in Botswana (2020 and 2021), and COVID\u201019 IARs in South Sudan (2020 and 2021). Action Reviews allowed for surfacing relevant knowledge and, by engaging the right (in different contexts) actors, asking \u201care we doing things right?\u201d (single loop learning) was evident in all the reports. Single loop learning is often embedded within examples of double loop learning (\u201care we doing the right things?\u201d), providing a more transformative basis for policy change. Triple loop learning (\u201care we learning right\u201d?) was evident in AARs, and less in IARs. The range of participants involved, the level of concentrated focus on specific issues, the duration available for follow through, and the pressures on the health system to respond influenced the type (i.e., loop) and the effectiveness of learning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Action Reviews, by design, surface knowledge. With favorable contextual conditions, this knowledge can then be applied and lead to corrective and innovative actions to improve health system performance, and in exceptional cases, continuous learning.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lrh2.10447","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T03:39:46Z","timestamp":1724989186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A conceptual learning analysis of paired after action and intra action reviews for health emergencies"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4156-4297","authenticated-orcid":false,"given":"Elliot","family":"Brennan","sequence":"first","affiliation":[{"name":"Sydney School of Public Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seye","family":"Abimbola","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijinfomgt.2020.102180"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czs132"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031\u2010023\u201000528\u20107"},{"key":"e_1_2_9_5_1","unstructured":"SheikhK AbimbolaS.Learning Health Systems: Pathways to Progress. Flagship Report of the Alliance for Health Policy and Systems Research.2021https:\/\/ahpsr.who.int\/publications\/i\/item\/learning-health-systems-pathways-to-progress."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)33134-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102022\u2010010572"},{"key":"e_1_2_9_8_1","unstructured":"World Health Organization.A Global Analysis of COVID\u201019 Intra\u2010Action Reviews: Reflecting on Adjusting and Improving Country Emergency Preparedness and Response during a Pandemic. Geneva.2022https:\/\/apps.who.int\/iris\/handle\/10665\/365488."},{"key":"e_1_2_9_9_1","volume-title":"After Action Reviews and Simulation Exercises under the International Health Regulations 2005 M&E Framework (IHR MEF)","author":"World Health Organization","year":"2018"},{"key":"e_1_2_9_10_1","volume-title":"Guidance for Conducting a Country COVID\u201019 Intra\u2010Action Review (IAR)","author":"World Health Organization","year":"2020"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(23)00167\u20105"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.62454\/KA112E"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978\u20100\u201012\u2010820204\u20103.00004\u20108"},{"key":"e_1_2_9_14_1","volume-title":"The Global Practice of after Action Review: A Systematic Review of Literature","author":"World Health Organization","year":"2019"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-019-0500-z"},{"key":"e_1_2_9_16_1","volume-title":"Guidance for Conducting a Country Early Action Review (EAR): Rapid Performance Improvement for Outbreak Detection and Response, 31 August 2023","author":"World Health Organization","year":"2023"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102021\u2010007993"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.onehlt.2021.100346"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102022\u2010010996"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-022-02367-4"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/08901171211070955"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2022.34.4.325"},{"key":"e_1_2_9_23_1","unstructured":"Nigeria Centre for Disease Control.AAR Lassa Fever Nigeria. August 2017.https:\/\/extranet.who.int\/sph\/sites\/default\/files\/document-library\/document\/AAR%20Lassa%20Fever%20Nigeria%20%2821-22%20Aug%202017%29.pdf2017."},{"key":"e_1_2_9_24_1","unstructured":"Nigeria Centre for Disease Control.AAR Lassa Fever Nigeria. June 2018.https:\/\/extranet.who.int\/sph\/sites\/default\/files\/document-library\/document\/AAR%20Lassa%20Fever%20Nigeria%20%285-7%20June%202018%29.pdf2018."},{"key":"e_1_2_9_25_1","volume-title":"Fragile States Index 2022 \u2013 Annual Report","year":"2022"},{"key":"e_1_2_9_26_1","unstructured":"Ministry of Health South Sudan.Country COVID\u201019 Intra\u2010Action Review Report November.https:\/\/cdn.who.int\/media\/docs\/default\u2010source\/health\u2010security\u2010preparedness\/cer\/iar\/south\u2010sudan\u2010\u2010\u2010covid\u201019\u2010intra\u2010action\u2010review.pdf?sfvrsn=de995e23_3&download=true2020."},{"key":"e_1_2_9_27_1","unstructured":"Ministry of Health South Sudan.Country COVID\u201019 Intra\u2010Action Review Report August.https:\/\/extranet.who.int\/sph\/sites\/default\/files\/document\u2010library\/document\/IAR%20COVID\u201019%20South%20Sudan%20%2805\u201006%20Aug%202021%29.pdf2021."},{"key":"e_1_2_9_28_1","unstructured":"Ministry of Health and Wellness Botswana.Country COVID\u201019 Intra\u2010Action Review Report. Novemberhttps:\/\/extranet.who.int\/sph\/sites\/default\/files\/document\u2010library\/document\/IAR%20COVID\u201019%20Botswana%20%2809\u201012%20Nov%202020%29.pdf; 2020."},{"key":"e_1_2_9_29_1","unstructured":"Ministry of Health and Wellness Botswana.Country COVID\u201019 Intra\u2010Action Review COVID 19 Vaccination Report April.https:\/\/extranet.who.int\/sph\/iar-details\/31493; 2021."},{"key":"e_1_2_9_30_1","unstructured":"Nigeria Centre for Disease Control and Prevention.Nigeria Centre for Disease Control and Prevention (Establishment) Act 2018 Act No. 18 Federal Nigeria Official Gazette 145(105) (November 12 2018).https:\/\/faolex.fao.org\/docs\/pdf\/nig195227.pdf2018."},{"key":"e_1_2_9_31_1","volume-title":"Guidance for Conducting a Country COVID\u201019 after Action Review (AAR), 31 August 2023","author":"World Health Organization","year":"2023"},{"key":"e_1_2_9_32_1","first-page":"xliii","article-title":"Operationalizing COVID\u201019 intra\u2010action reviews \u2013 preliminary findings","volume":"96","author":"Mayigane LN","year":"2021","journal-title":"Wkly Epidemiol Rec"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(20)30414\u20109"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2022.48"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010056896"}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.10447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T03:42:08Z","timestamp":1729568528000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.10447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/lrh2.10447"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.10447","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]},"assertion":[{"value":"2024-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e10447"}}