A call for better global health leadership – whistling in the dark?
Introductory post by Sylvia Vriesendorp, our new guest blogger:
“We want better leadership!” It is an often heard call in health programs around the world. Yet when asking those who make this call what exactly they’d like to see done or changed that would produce the missing leadership, the voices stop. Let’s look at reproductive health: one woman dies every minute in pregnancy and childbirth; 99% of these women live in developing countries (UNFPA). These women are not dying of medical mysteries; they are dying because they do not have access to simple, inexpensive, life saving interventions. They are dying because they do not have access to modern contraception methods, even when there are supplies in the country and trained staff to dispense them.
Why is that so? We believe this is happening because many health programs are poorly managed and led. And as long as we believe that only a handful of exceptional human beings, like Mother Teresa, Ghandi or Mandela, can lead and manage us out of these tragic circumstances, we are forced to stand by or throw technical solutions at what are, in essence, challenges of management and leadership. This is a huge dilemma that is exacerbated by a lack of actionable language about management and leadership. After all, if leadership and management cannot be defined, how can we know what to teach? It is also a dilemma for those who manage and lead health organizations. How can you get your staff to become better managers and leaders when you don’t have any language to help them develop? How can you yourself become a better manager and leader if you adhere to the theory of ‘Great and Exceptional Men and Women’ as they only people who can lead us out of our current stagnation?
There are countless models of leadership; many emphasize personality traits and characteristics (like charisma) that assume that true leaders are wired a particular way, from birth. If leadership were to be innate like that, we are in trouble. We are especially in trouble when we take talented health professionals away from their clinical practice and promote them up to a level where their technical skills are no longer useful and where they discover they have no clue on how to manage and lead. We have turned, in this way, countless superb clinicians into mediocre managers who do not lead. Worst of all, such an approach gives us no guidance on how to prepare current and future generation of managers who lead and produce intended results.
So what to do? We are engaged in remedying this situation in many countries and at many levels, a few teams of health managers at a time. In the process we are learning much about how to turn passive and unempowered midlevel managers into inspired activists for better health. We’d like to share these with you.