Shaping our Future: A More Inclusive, Sustainable Workforce
August 2022

By Ben Kaufman, MSW, Associate Director, Workforce Development and Capacity Building, Association of Maternal & Child Health Programs (AMCHP)

Earlier this year, the Tennessee Titans of the National Football League (non-sports fans, bear with me for one short paragraph) drafted a highly touted quarterback prospect despite already having a moderately accomplished veteran quarterback under contract. When interviewed about his new teammate, the veteran had this to say: “I don’t think it’s my job to mentor him, but if he learns from me along the way, then that’s a great thing.”

In the maternal and child health (MCH) field, we typically perceive new hires as a welcome addition as opposed to a threat. Yet, in many cases we still operate under the veteran quarterback’s premise—that learning, growth, and professional development can and should happen organically. Of course, there is some truth to this, but also some pitfalls.

The most notable one is that organic professional development is rarely ever equitable. For example, access to leadership opportunities often hinges on a supervisor’s connectedness, position within a leadership hierarchy, flexibility, or biases. The challenge in providing professional growth and development opportunities is also a highly structural one. Staff at agencies that have significant funding, infrastructure, and division of labor are more likely to participate in “all hands” activities (grant proposals, learning communities, conferences, intern supervision, etc.) where individual knowledge and skills can be developed in the context of capacity building.

A more effective way to build a more inclusive and sustainable workforce is to start with intention. We should be showing, not telling students and early career professionals that they are valued beyond the sum of their current and potential contributions, that the ways to discover fulfillment in what is often challenging work are limitless, and that the MCH field is one in which guiding and supporting others is part of the job description. It’s also important to acknowledge that competitive salaries and remote work flexibility are a big part of this equation and we need loud, urgent, collective advocacy on this front – and yet there are also factors to consider within our immediate control.

Recommendations

What does this type of intentional investment look like? Here are three broad recommendations that I encourage jurisdictional Title V programs and individual staff to consider within their respective spheres of influence:

Embrace all pathways. I started my career in grassroots anti-poverty and educational equity work, landed in disability advocacy because it seemed like a productive way to blend my burgeoning strategic communication skills with the opportunity to improve conditions of existence for families like my own, stumbled into a passion for training and capacity building, then realized about three years into my previous job that was I actually part of the maternal, child, and adolescent health (MCAH) ecosystem – all before jumping at the chance to work at an organization where conversations start and end with women, children, adolescents, and families. I have found a professional home in our field and choose to stay because I believe that our shared work provides countless platforms for pursuing justice.

I share this part of my story because it isn’t “traditional” and yet could be if we talked more about the width of the workforce pipeline in addition to the depth. There are so many colleges and universities with public health programs full of zealous, exceptionally talented students who receive little to no MCAH exposure because faculty expertise (and, therefore, the ability to offer substantial coursework) is concentrated elsewhere.

How urgently are we committing ourselves to cultivating interest among those without textbooks and/or experiential learning opportunities?

This question has real partnership implications. We can survive by picking fruit from the same trees or thrive by planting more trees, even if some of them don’t bear fruit immediately or in the ways we might have envisioned. For example, we know not every one of our Graduate Student Epidemiology Program (GSEP) interns will end up in a Title V position. Yet, we can see value in supporting the development of an MCAH lens among those still poised to influence outcomes for the populations we center by becoming leaders in related sectors such as education, emergency preparedness, criminal justice, etc. On the flip side, how are we opening doors to a diverse range of MCAH careers for people whose entry points may be other academic disciplines or their own lived experience? Can we institute hiring practices that eliminate the need to have a formal MCAH (or public health) background without compromising our unique identity?

We must answer these questions to sustain current efforts and ensure that our workforce is adequately prepared to articulate and act upon priorities as political, climate, technology, and other landscapes continue to change.

Provide space for curiosity, exploration, vulnerability, and mutual support. At the 2021 AMCHP Conference, we debuted “roundtables” designed specifically for students and early career professionals. In previous years, they were only able to submit proposals for workshops and posters, submission types whose review criteria privileges completed efforts. This alternative encouraged the submission of works in progress (e.g., thesis or dissertation proposals) in need of collective brainstorming, scoping, and/or direction.

The roundtables established a new avenue for conference attendance among a typically underrepresented segment of the workforce. And it created a temporary yet powerful, tangible manifestation of community around a new generation of MCAH leaders—undergraduate students, doctoral candidates, Title V and community-based organization staff in their first professional roles. These were spaces in which presenters could be comfortable “not knowing what they didn’t know.” They could feel free to ask more experienced professionals to point them to the right literature, people, datasets, and resources that they needed. Presenters received help in structuring content around their primary asks, and attendees received explicit instruction on how to be constructive and encouraging in delivering comments. What we heard from presenters is that they felt valued and validated with respect to the challenges they’ve experienced to date and also more enthusiastic about their pursuits. We’ve tried to create similar “workshopping” opportunities for practicing Title V and affiliated professionals through our Leadership Lab program. Participants share that they find it useful (and often relieving) to talk through adaptive challenges with peers.

How do we create these types of spaces in the context of outcomes-driven work and productivity culture?

The answer can be as simple as providing permission to debrief, reflect on, ask clarifying questions about a shared experience, or dream about what could be. Next time you participate in an advisory board or community stakeholder meeting, don’t merely invite your direct reports but dedicate time to hear how they experienced the meeting and what it prompted them to consider. As was the case with the roundtables, these could be opportunities to help early career leaders find their voice, build their contextual knowledge base and other forms of professional capital, and make critical connections between what’s immediately in front of them and transcendent, population-level priorities. These discussions only happen when we actively strive to address barriers (such as intimidation or perceived expectations to perform) so that students and early career professionals can bring their whole selves to any and every corner of the MCAH ecosystem.

Own and harness your power to lift others. A colleague and I recently presented a conference workshop on resilience in which she presented research that identifies multiple purposes of work: it is either a job, a career, or a calling.

I would venture to guess that most of us in MCAH identify with that third purpose—that’s to say, we are driven by our ideologies and therefore our work has moral or personal significance. In fact, AMCHP recently created the Sharing Your Why project to capture statements of deep passion for and commitment to the intended outcomes of our work. While that passion is near impossible to extinguish, it can also leave us open to feelings of frustration when the outcomes we aim for seem far from our reach, no matter how much effort we expend.

But what if we changed our orientation without losing sight of the broader purposes that have guided and will continue to guide our paths?

My belief is that there is immense joy to be found in the exercise of propelling someone else forward in the pursuit of the outcomes I care about, because even when the trajectory isn’t a straight line from my own, we still end up closer than where we started. Just as important, we’ve figured out how to care about each other in the process of expressing care, globally speaking, through action. And while slow, iterative change is likely to continue frustrating those of us for whom work is a calling—particularly when anger and urgency are justified—perhaps supporting others’ growth can help lighten the mental load of that frustration. From a program perspective, it might be worth considering how the development of others through teaching, coaching, and mentoring (familiar concepts to those acquainted with the MCH Leadership Competencies) is woven into measures of individual and collective success.

Concluding Thoughts

So… back to the veteran quarterback. He’s not wrong, right? It is worthwhile when those newer to the profession learn from more experienced colleagues. This requires the longer-tenured among us to hold ourselves to standards worthy of emulation and those closer to the beginning of their careers to receive and acknowledge wisdom. But a quarterback lifting a trophy marks the end of an accomplishment. The trophies we lift in MCAH (through policies passed, programs initiated, rates we succeed in increasing or decreasing) indicate the beginnings of more significant possibilities in which our fates are intertwined no matter which  “team” we may find ourselves on at a particular moment. Realizing those possibilities requires each of us to embrace all pathways, thinking more expansively about how our own teams are composed. It requires us to frame curiosity, exploration, vulnerability, and mutual support as necessary work experiences. And it requires us to channel our compassion, accelerating the leadership journeys of others as a function of our own continued growth.