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GLOBAL HEALTH LEADERSHIP DEVELOPMENT FOR SOCIAL CHANGE

Leaders in International Health Program Edmundo Granda Ugalde 2012 Managua, Nicaragua May 29, 2012. GLOBAL HEALTH LEADERSHIP DEVELOPMENT FOR SOCIAL CHANGE. Roderick King, MPH, MD Deputy Director, Florida Public Health Institute

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GLOBAL HEALTH LEADERSHIP DEVELOPMENT FOR SOCIAL CHANGE

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  1. Leaders in International Health Program EdmundoGrandaUgalde 2012 Managua, Nicaragua May 29, 2012 GLOBAL HEALTH LEADERSHIP DEVELOPMENT FOR SOCIAL CHANGE Roderick King, MPH, MD Deputy Director, Florida Public Health Institute Dept of Global Health and Social Medicine, Harvard Medical School Center for Public Health Leadership, Harvard School of Public Health Fulbright Nexus Scholar 2011-2012

  2. Welcome…..Check-In • Learning Team Introductions • Name and Organization • One thing you hope to get out of this session

  3. Leadership to what end… Strengthening collaborative leadership skills to accelerate results Leaders build capacity to: Resolve conflict to create positive gain Execute priorities together through high action and high alignment Solidify joint decisions that stick Use data to drive decisions Leverage contributions to the critical work Turntalk into aligned actions Stay connected to each other and the result

  4. Expected Benefits • Moving from talking about strategic plans to execution of prioritized strategies and actions, • Managing conflict to create positive gain, • Increasing accountability for individual and collective commitments. • Introduction to Results Based Leadership

  5. Why do we need a multi-sectoral call to action? LIVE WORK PLAY

  6. Leading Change The Role of Leadership and Leadership Development for Collective Action

  7. Shared Accountability

  8. Cross Sector Collaboration solutions ???

  9. Rooted in a Theory of Change Results Based Leadership Framework Population level changes are most likely to occur if a group of leaders come together across sectors and agencies and focus their efforts on achieving a desired result Urgency and Public Accountability Focus on Results Interest Based-Negotiation Results Based Accountability Collaborative Leadership Competencies Proposal Based Decision Making Action Commitments and Accountability

  10. Results from today’s session Participants will: • Reflect on their own collaborative leadership in your work • Explore and apply a results based framework for collaborative leadership • Apply a leadership tool(s) for addressing differences, disagreements and conflict and leading change • Make an action commitment related to how the tool might be used in current work

  11. Getting to Results… Moving from Talk to Action Results Based Accountability Framework

  12. Idea….discussion…action Think of a situation where you were working together to advance a project, policy or intervention • What were some of the challenges? • How did you prioritize your strategies? • How did you decide on the actions?

  13. Challenges in Collaborative work.. • No clear result that everyone agrees upon • No real sense/measure of whether you are making progress • No clear understanding of the factors impacting the issue (moving beyond individual assumptions) • Prioritization?

  14. Results Based Accountability

  15. A Framework for Collaborative Decision Making

  16. [If we are serious about taming bureaucracies … our best strategy will be a clear and unrelenting focus on results. Lisbeth B. Schorr, 1999 Author, Common Purpose: Strengthening Families and Neighborhoods to Rebuild America

  17. United Way of Tucson and Southern Arizona Population Results and Indicators COMMUNITY ACTION JOB DESCRIPTION Develop expertise in results accountability model of community change and be able to lead others in a results-based process of community change Results-Based Accountability Assistant, United Way Greater Lehigh Valley

  18. Results Based Accountability reaps rewards in Hawkes Bay “Because this allows people to look at the bigger picture, they go beyond their own organisation’s viewpoint to see their community’s needs more objectively…”

  19. HRSA, USDHHS Community Health Centers % of patients’ newborns with low birth weight % of hypertensive patients with blood pressure < 140/90 (under control) % of diabetic patients HbA1c < 9% (under control)

  20. A Framework for • Collaborative Decision Making • Common language • 2. Starting with ends and • working backwards to means • (transparently and with data)

  21. The well-being ofWhole Populations The well-being ofClient Populations Results Based Accountability is made up of two parts Population Accountability Communities – Cities – Counties – States - Nations Performance Accountability Programs – Agencies – and Service Systems

  22. DISTINCTIONS POPULATION RESULT (or OUTCOME) A condition of well-being for children, adults, families or communities. POPULATION Accountability Babies born healthy, Children succeeding in school, Safe communities, Clean environment INDICATOR A measure which helps quantify the achievement of a result. Rate of Low Birth Weight babies, Rate of high school graduation, Crime rate, Air quality index PERFORMANCE MEASURE PERFORMANCE Accountability A measure of how well a program, agency or service system is working. 1. How much did we do? 2. How well did we do it? 3. Is anyone better off? Three types: = Customer Results

  23. STARTING WITH ENDS AND WORKING BACKWARDS TO MEANS (Data-driven and transparent decision making)

  24. However beautiful the strategy, you should occasionally look at the results. Winston Churchill

  25. Mental Models: Deeply ingrained assumptions, generalizations, or even pictures or images that influence how we understand the world and how we take action. Peter Senge, The Fifth Discipline

  26. Some Noteworthy Mental Models • "Who the hell wants to hear actors talk?" H.M. Warner, Warner Brothers, 1927. • "This 'telephone' has too many shortcomings to be seriously considered as a means of communication. The device is inherently of no value to us." Western Union internal memo, 1876. • "We don't like their sound, and guitar music is on the way out." Decca Recording Co. rejecting the Beatles, 1962. • "There is no reason anyone would want a computer in their home." Ken Olson, president, chairman and founder of Digital Equipment Corp., 1977

  27. Ends-to-Means, Data-Driven, and Transparent Start at the End Data How are we doing? Data Why? Who can help? Data What are our options? Work Backwards to Means What do we propose to do?

  28. Results Based Leadership Group Exercise • Topic: Diabetes in Country X • Graph… • In your group, walk through the “Turn the Curve Exercise”, consider: • 5Why’s (exploring story behind curve) • Strategies (feasibility, leverage) • Actions (what will your team do?) • Alignment of Why, Strategy and Actions

  29. PerformanceAccountability: Performance Measures

  30. Performance Measures • How much did we do? • Who are our customers and what services do we provide to them? 2. How well did we do it? How well do we provide those services? • Is anyone better off? • What is the desired impact of those services for/on our customers (a.k.a. “customer results”)?

  31. Break- 15 minutes NEXT: DEALING WITH CONFLICT

  32. Dealing with Conflict Exploring and Addressing Differences, Disagreements and Conflicts

  33. Dealing with Conflict…Advancing your Project

  34. Check-In • Turn to the person next to you- “Learning Partner” • With “learning partner” for the next 2-3 minutes each: Discuss: One part of your work in Health/Health care you really enjoy?

  35. Reflection We all have different relationships with conflict. Some seek it out, some hold it at arms lengths and others avoid it at all costs. • Which do you do? • What conflicts or difference (if any) have you faced, experienced or avoided within the context of your international health work? • What was it, who was involved, how did it feel? Jot down your thoughts. 5 minutes

  36. Skill Development • Using the Circle of Conflict, determine the type of conflict • With your learning partner, share the conflict? 5 min • Give peer consultation: What strategies being used? What strategies might be used to address the conflict or difference? 10 min • What are your insights about possible approaches? 5 min • What might you do based on insights? 5 min

  37. Circle of Conflict

  38. Skill Development • Using the Circle of Conflict, determine the type of conflict • With your learning partner, share the conflict? • Give peer consultation: What strategies being used? What strategies might be used to address the conflict or difference? • What are your insights about possible approaches? • What might you do based on insights?

  39. Action Commitments and Accountability Name: ________ Date: ________ • What action can you commit to doing before the next meeting? • How I will do it? • With whom will I do it? • When will you do it? 

  40. Questions ? NEXT: Leading Change

  41. LEADING CHANGE: ORGANIZATIONAL PLANNING TOOLS FOR innovation The Disparities Leadership Program Cambridge, Massachusetts Roderick K. King, MD, MPH Senior Faculty, MGH Disparities Solutions Center

  42. Addressing International Health ChallengesLeading Organizational ChangeDirection?

  43. Understanding and Leading Change Tools to Help Facilitate Change

  44. Learning Objectives • Provide a framework for leading change in the global health context. • Eight Steps for Driving Change…what does it take? John Kotter(Harvard Business School)- Leading Change • Assist health leaders in understanding where they are in the process of identifying and addressing disparities. • Provide additional tools/resources for transforming organizations/”community” and advancing work on disparities.

  45. “Adventure is misery in hindsight.”

  46. Reflection We have all tried ways to do things differently…to change the way things are done. • Take a moment to think about a past effort you’ve worked on that required things to change • What were the barriers to change?

  47. Why is change so difficult? • Maintaining the Status quo (overcome inertia) • “Zero Sum Game” mindset • Forced to confront Adaptive Challenges (in addition to Technical Challenges)

  48. Leadership Challenges (Heifetz) • Examples: • reports, blueprints… • Global Health issues (tobacco, NCD’s,….) (more Adaptive Challenges) Technical Challenges Solved by existing knowledge, skill and/or technologies Adaptive Challenges Involves challenging existing models of operation Examining deeply held (often unconscious) values and beliefs Explore new ways of thinking/acting

  49. Adaptive Challenges Does making progress on this problem require changes in people’s values, beliefs, attitudes and behavior? Whose values, beliefs, attitudes or behaviors must change in order to move forward? What shifts in priorities, resources and power are necessary? What sacrifices would have to be made and by whom?

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