Institutions in high-income countries (HICs) are the main funders and generators of academic knowledge on health systems in low-income and middle-income countries (LMICs), and much too often this knowledge reflects their priorities rather than the needs of health systems in LMICs.12 This power imbalance between HICs and LMICs has been the focus of calls for reforms to global and HIC institutions.34 However, change must also come from within LMICs. To address this power imbalance, learning must be prioritised as a core part of strengthening health systems in LMICs.Health systems that do not learn from their own or others’ experiences can repeat mistakes, and this has often caused well intentioned policies and programmes to fail.5 Many LMIC health systems do not have sufficient capacity to effectively collect, use, and retain available knowledge and information, and to generate the new knowledge that is necessary to respond to their needs. Knowledge and skill acquisition in LMIC health systems can be inadequate, fragmented, or driven by professional or bureaucratic norms that do not encourage self-reflection and positive learning cycles.6 Health system leaders in LMICs are often too focused on day-to-day tasks of planning and implementation. It is crucial to step back and do more to embed learning into all aspects of decision making in health systems. The efforts needed to engineer a turn towards learning health systems in LMICs will require strong political commitment to drive change at different levels and learning interfaces…..more