Tracing the Ripple: How JBI’s Audit &Feedback Model Is Driving Cross-Sector Change with eBASE Africa

By Thelma Akah, Health Research Fellow, eBASE Africa

It started in healthcare, with clinicians using structured audits and feedback loops to improve diagnosis, communication, and resilience. But today, that same approach is making waves far beyond hospitals.

Through its partnership with the Joanna Briggs Institute (JBI), eBASE Africa first adapted the Audit and Feedback (A&F) model to strengthen healthcare systems in Cameroon. Since then, we’ve expanded its reach, applying it in classrooms to improve teaching, and now exploring how it might shape peacebuilding efforts in some of the country’s most fragile regions.

On April 15, 2025, I joined colleagues across sectors for the first webinar in our Bridging Evidence and Action series to reflect on this journey. Together, we explored how a simple, evidence-based tool is driving practical, people-centered change across health, education, and peace.

What Is Audit & Feedback—and Why Should We Care?

Audit and Feedback is a structured, cyclical process that helps teams identify problems, track progress, and act on evidence. It involves:

Identifying gaps in current practice
Measuring baseline performance
Providing constructive feedback
Co-creating improvement strategies
Re-auditing to assess progress
Alexa McArthur from JBI, who opened the webinar, reminded us that A&F isn’t just a technical tool. It’s a method that works best when it’s locally led, repeated, and anchored in real needs.

“At JBI, we don’t just collect data—we help people understand the evidence behind it and use it to take action. That’s where the change begins.” – Alexa McArthur

Health: Trusting the Process, Seeing Results

In my presentation, I shared how eBASE used A&F to address major health challenges in Cameroon.

1. Reducing Malaria Misdiagnosis

In the Bali Health District, we applied five evidence-informed criteria across three health centers. Initial compliance was poor, some criteria scored as low as 0%. But after coaching, reminders, and updated protocols, we saw major improvements, even in conflict-affected areas.

“It wasn’t just about giving tools. It was about building trust. Clinicians began believing in the evidence again.”

2. Improving Vaccine Uptake

Low uptake of the penta vaccine stemmed from weak communication with caregivers. We trained health workers on empathy and listening, involved local leaders, and sent SMS reminders. Vaccine coverage jumped from 65% to 85%.

3. Supporting Frontline Workers During COVID-19

A&F helped identify overlooked needs among healthcare workers during the pandemic. Through peer support sessions and logistical tweaks, many facilities reached 100% compliance on resilience indicators—though mental health remains an area needing long-term investment.

 Education: When Teachers Feel Seen

Ambang Tatianne, our education panelist, shared how we’ve adapted A&F to improve teaching quality in Sub-Saharan Africa.

In a pilot across four countries og the Lake Chad Basin (Cameroon, Niger, Nigeria and Chad), teachers implemented 49 evidence-based strategies. At baseline, only 37% were applied. But with ongoing feedback and collaborative planning, that rose to 77% by the end.

“Sometimes all a teacher needs is someone to say: ‘You’re doing great, and here’s how you could do even better.” – Ambang Tatianne

In Limbe, we applied the same approach to metacognitive strategies. After three feedback rounds, compliance reached 95%. Teachers reported stronger student engagement, confidence, and ownership of the learning process.

 Peacebuilding: Making Efforts Count

Clotilda Andienza, a peacebuilder working in the conflict-affected regions of Cameroon, brought a powerful perspective. Despite years of dedicated work, peacebuilding often lacks structured reflection and alignment.

She identified three major gaps:

Technical: Limited access to synthesis tools and methods
Engagement: Fragmented collaboration across stakeholders
Resources: Minimal funding for evidence-driven peacebuilding
Her message was clear: Audit and Feedback can help create the structure and accountability needed to ensure peace efforts are responsive and sustainable.

“A peaceful society needs more than good intentions. It needs evidence that guides decisions.” – Clotilda Andiensa

What We Learned Together

Bede Yong, who closed the panel, helped us zoom out. What’s striking about A&F is that it works, not because it’s complicated, but because it’s grounded.

“We don’t invent solutions in a vacuum. We sit with people, listen, and co-create them.” – Bede Yong

Across every sector, three big lessons stood out:

A&F is cost-effective and scalable
It creates ownership and trust
And it builds a culture of continuous learning
 

What’s Next? Make It Standard—Not Special

Throughout the discussion, one shared goal emerged: let’s stop treating A&F as an exception. It should be the norm.

·                 Let’s embed A&F into everyday systems, not just projects

·                  Let’s invest in people and capacity, not just digital tools

·                 Let’s build feedback into decision-making at every level

·                 And let’s treat communities as co-leaders, not just beneficiaries

Missed the Webinar? Watch the Replay

This wasn’t a webinar full of theory. It was full of stories, results, and real lessons from the field. If you work in health, education, peacebuilding, or care about systems that serve people better, this session is for you.

Let’s keep the ripple going.