Ending on a high note with Professor McAuliffe

IFGH Conference 2014 John Kevany Memorial Lecture and Closing Keynote

Key Correspondent: Ana Belen Espinosa

There were many things which I enjoyed about Professor Eilish McAuliffe’s closing keynote given at the IFGH Conference in Dublin. She talked about her experiences working with partnerships and the importance of capacity building for empowering human resources for health and thus, strengthening health systems.

Professor McAuliffe has a strong connection and understanding of global health, due to her background as an IFGH Executive Committee member and the director of the Trinity College Centre for Global Health. She has also served as an associate professor in Trinity College until very recently, when she took on her new position as a professor of Health Systems Strengthening at the University College Dublin.

There are two main reasons why I liked this talk. The first is Professor McAuliffe’s wide experience working in partnerships for development and health in low income countries—I have to admit that I was not aware of her work in this area before the conference, and since her presentation, I have been eagerly reading many of her related articles. The second is her research work in capacity building and her experience with health performance improvement by training middle-cadre community health workers, which is an area that I personally follow and intend to work in.

Something that I found very illuminating was the idea of the “collective impact” approach. Perhaps many are already familiar with it, but as someone who has spent her life studying medicine and trying to be an efficient (yes, efficient) general practitioner, it was especially interesting for me.

The collective impact approach attempts to address the inefficiency and incompetence of “individual” impact strategies in a wide variety of issues such as healthcare, education, and poverty reduction, by using a structured collaboration between organizations and institutions (governments, for-profit and non-for-profit organizations). Established by Fay Hanleybrown, John Kania, and Mark Kramer, and it was first introduced in an issue of the Stanford Social Innovations Review (Winter 2011). Collective impact provides a theoretical justification for partnerships as it entails collaborative and coordinated work to achieve a specific common outcome.

As Professor McAuliffe explained, there are five conditions to achieve the collective impact and, following the theory, a successful partnership:

1. Common agenda: all the partners should have a shared vision. That is, while they can have their own perspective or opinion, they should recognise a common understanding of the problem and a determined agenda to solve it through agreed actions.
2. Shared measurement: partners should use the same indicators for measuring the outcomes of their actions.
3. Mutually reinforcing activities: there should be a synergy and a coordination of individual activities while following the common agenda.
4. Continuous communication: important to build trust between partners and also to ensure they are still following the mutual objectives.
5. Backbone support: this is the supportive infrastructure of the partnership and its function is to coordinate and manage all the partners towards the collective impact.

In relation to the last criterion, the infrastructural ‘backbone’, Professor McAuliffe drew attention to some key principles of adaptive leadership necessary to provide such support:

Identify the adaptive challenges or problems as an outsider, to assess the whole situation.  This is also known as applying a “balcony” perspective.  Explain the problem to the different partners making them think about the problem and about possible solutions.  This does not mean solving the problem and giving them the solution directly. Use any conflict constructively. That is, keep the discomfort necessary for adaptive work, but without allowing it to weigh on the different partners. Create an environment for the adaptive work.  This means being challenging and supportive at the same time.  Keep a disciplined attention.  If necessary, refocus on the primary task at hand. Ensure that all the opinions have been listened to and considered equitably.  That the minority opinions have been taken into account and the dominant ones have been challenged. Lastly, overview the action as a whole, try to understand the problems as a partner in the front-line.

As I said before, I really found these ideas of collective impact and adaptive leadership enlightening. In fact, I think that I have followed most of them already, without even knowing there was a structured and defined theory. I will try to keep these principles in practice from now on, not only working in international partnerships for development, but also as a clever way to avoid problems working in my own primary healthcare team.

Ana Belen Espinosa

Key Correspondent

Email: [email protected]

Twitter: @Ana_B_Espinosa