# Presentation: 118066

**Keynote Address  **
**2008 MCH Training Program            All Grantee Meeting**
**April 22****nd**** in Washington DC**

- Navigating the Future        of MCH Leadership

*65 Years and Counting: Legacy and Future of MCH Leadership*

## Objective

- Identify essential elements of effective 21st century leadership that emerging and established MCH leaders and their organizations must understand and integrate into their diverse practices of maternal and child health.

## Magda Peck ScDProfessor, Pediatrics and Public Health  University of Nebraska Medical CenterFounder and Senior Advisor, CityMatCH           Director, Great Plains Public Health  			Leadership InstituteHarvard School of Public Health, ScM ’83, ScD ’86LEND Faculty UNMC, CityLeaders Facultympeck@unmc.edu    402.561.7500

## Grace Abbott, Social Reformer,                             Chief, Children’s Bureau (from Grand Island, Nebraska)

- CREDITS: 1: Child’s drawing by from Nebraska Historical Society. 2. "Grace Abbott, Chief of the Children's Bureau of the Dept. of Labor." August 24, 1929. Prosperity and Thrift: The Coolidge Era and the Consumer Economy, 1921-1929, American Memory collections, Library of Congress.

- Grace Abbott, Social Reformer,                             Chief, Children’s Bureau (from Grand Island, Nebraska)

## The leader is one who courageously holds out opportunities for people to come back together, to be engaged in the meaningful work of the organization, whatever it is.

- Margaret Wheatley

## All children, youth and families will live and thrive in healthy communities served by a quality workforce that helps assure their health and well-being.

- 21st Century Vision: MCH Training Program, HHS/HRSA/MCHB, 2008

## Slide 7

## ‘Mighty 7’ Leaders Needed Now for the Public’s Health

**Values- Driven**** Leaders**
**Ethical ****Leaders**
**Servant**** Leaders**
**Collaborative**** Leaders**
**Systems-Oriented**** Leaders**
**Ecological**** Leaders**
**Transformational**** Leaders**

- M Peck, CityMatCH 2007 Conference

## 1.  Values- Driven Leaders

- Whose life and work are driven by their commitment to equity and fairness; who acknowledge, understand and value the diverse values of the communities they  serve, organizations in the system, and other stakeholders; and who anchor the work in our core philosophy of social justice.*

- *Adapted from: Foege

## William Foege: Public Health’s Values

- The philosophy behind science is to break down the walls of ignorance to find truth.
- The philosophy behind medicine is to use that truth for your patients.
- But the philosophy behind public health is  to use that truth for **everybody**.
***Therefore, the philosophy behind public health has to be ***_***social justice***_***. ***

- William Foege: Public Health’s Values

- Personal Interview 12/14/04                     with M Peck, Chicago

**Values- Driven**** Leaders**

## ‘Mighty 7’ Leaders Needed Now for the Public’s Health

**Values- Driven**** Leaders**
_**Ethical **__**Leaders**_
**Who set and hold standards for themselves and others; who are committed to explicit, defined shared principles,        who hold themselves and others accountable for both means and ends.**

- M Peck, CityMatCH 2007

##  Great Plains PHLI: Relevance of leadership competencies, 20076.  Ethical Practice = 4.9, self reported

## ‘Mighty 7’ Leaders Needed Now for the Public’s Health

**Values- Driven**** Leaders**
**Ethical ****Leaders**
_**Servant**__** Leaders**_

- Adapted from R. Greenleaf

- Who are committed to serving the public; who possess a set of core characteristics to serve them well: *listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to human growth and building community. *

## Vince L. Hutchins  Pediatrician, public servant, Title V champion

- 	Called to a life of public service, seeing the ***"*****terrible dichotomy that existed (and still exists) between private practice and public health -*****          ******I felt a need to work to bring these two together*****."**** **

**On leadership in troubling times:                          *****“You do the job you have to do and seize every opportunity to make a difference*****.”**

## 4.  Collaborative Leaders

- Who create and foster mutually beneficial relationships among individuals and organizations to achieve results that would not have occurred as well                                           or not at all                                                   if they had not                       worked together.

- Adapted from: Winer and Ray, Larsen, *Turning Point*

## 5. Systems-Oriented Leaders

- Who have _creativity_ to generate ideas, _analytic intelligence_ to evaluate these ideas, _practical intelligence_ to implement these ideas and persuade others of their worth, and the _wisdom_ to balance the interests of many stakeholders                     and to ensure that the actions of leaders contribute to the common good.

- Adapted from: Rowitz and Lamberth

## Why did Johnny die? 

## CIRCLES OF INFLUENCE

**CIRCLES OF INFLUENCE**
**CIRCLES OF ****IMPACT**

**Systems-Oriented  ****Leaders**

## Dr. Julius Richmond says...

- From generation to generation, one needs to introduce the whole element of pragmatism. You have on only one life to live. *You can’t live it in a fantasy world and wish for complete social justice,** ****so where can you get the most leverage******?**** *

- Personal Interview 11/15/04                     with M Peck, Boston

**Systems-Oriented**** Leaders**

## What will it really take to make a real difference?

**What we (all) know ****[KNOWLEDGE               BASE]**

***3. What we get others   to do             *****[POLITICAL WILL] **

**2. What we do, together ****[SOCIAL STRATEGY]**

- From: J Richmond and M Kotelchuck

**What will it *****really *****take to make a real difference?**

**Systems-Oriented**** Leaders**

## 6.  Ecological Leaders

- Who are committed to the ongoing development and synthesis of leadership skills and competencies throughout their careers                        in response to an ever changing environment; who expect, invite, promote and sustain a culture and infrastructure of learning                          in their organizations.

- From: L Rowitz

## Slide 22

## Emergenetics: Learning never stops.

## ‘Mighty 7’ Leaders Needed Now for the Public’s Health

**Who offer a purpose that transcends short term goals, and focus on higher order intrinsic needs for the greater good.    **
**7.  Transformational**** Leaders**

- Adapted from: Rowitz and Lamberth

## And another good thing about fire...

- Peru, 2001, The Nature Conservancy, R Corvera, V Pantoja

*And another good thing about fire...*

## ‘After a fire, Bayou Ranger District, Arkansas. John Andre, USFS. 

- ‘After a fire, Bayou Ranger District, Arkansas. John Andre, USFS.

## SEROTINY: Monterrey Pine 

**SEROTINY:** Monterrey Pine

**Notes:**
It's in a file I have titled "Kori prairie flowers" which is part of
"Kori Prairie Burn.“ 
Camas is a fire adapted species that was an important food crop
for native Americans. They basically farmed it in areas using fire to
promote its growth. I helped burn some of the prairies last spring w/
WAFO to promote native veg. such as camas.

It's in a file I have titled "Kori prairie flowers" which is part of
"Kori Prairie Burn.“ 
Camas is a fire adapted species that was an important food crop
for native Americans. They basically farmed it in areas using fire to
promote its growth. I helped burn some of the prairies last spring w/
WAFO to promote native veg. such as camas.

It's in a file I have titled "Kori prairie flowers" which is part of
"Kori Prairie Burn.“ 
Camas is a fire adapted species that was an important food crop
for native Americans. They basically farmed it in areas using fire to
promote its growth. I helped burn some of the prairies last spring w/
WAFO to promote native veg. such as camas.

It's in a file I have titled "Kori prairie flowers" which is part of
"Kori Prairie Burn.“ 
Camas is a fire adapted species that was an important food crop
for native Americans. They basically farmed it in areas using fire to
promote its growth. I helped burn some of the prairies last spring w/
WAFO to promote native veg. such as camas.

## ‘Mighty 7’ Leadership:  for Maternal and Child Health

**Values- Driven**** Leadership**
**Ethical ****Leadership**
**Servant**** Leadership**
**Collaborative**** Leadership**
**Systems-Oriented**** Leadership**
**Ecological**** Leadership**
**Transformational**** Leadership**

## Slide 29

## I am thinking the future is grimmer than it has been in quite a while...I grieve to think that it may/will be a time of dismantling and more reductions, needs are increasing.”                                         Carolyn Slack, Columbus OH MCH Leader, CityMatCH Board Chair, 

-                                       Mammary Clouds, Hastings, Nebraska

**I am thinking the future is grimmer than it has been in quite a while...I grieve to think that it may/will be a time of dismantling and more reductions, needs are increasing.”**                                         Carolyn Slack, Columbus OH MCH Leader, City**M**at**CH** Board Chair,

## Immigration, revisited

- Immigration, revisited

## After the Levies Broke, April 2008

## ‘Mightier 8’ 21st Century Leadership for MCH 

**Values- Driven**** Leadership**
**Ethical ****Leadership**
**Servant**** Leadership**
**Collaborative**** Leadership**
**Systems-Oriented**** Leadership**
**Ecological**** Leadership**
**Transformational**** Leadership**
***Navigational *****Leadership**

## Navigate (nav·i·gate, v.) 

- the process of planning, recording, and controlling the movement of a craft or vehicle *from one place to another*

- Following a planned course on, across or through
- Finding one’s way on, in, or across

## Navigational Methods

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| Sample Email Link  |
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|                                          | Karl Heckman Leadership Development is a training and coaching company dedicated to developing people to be leaders in your organization. We have assisted small companies and individuals as well as global corporations to advance and prosper in the global marketplace.We are consultants to corporations, coaches to high achieving individuals, advisors to entrepreneurs, and specialists in the art of unlocking the leadership potential in people at every level of the company structure.We work with the experienced professionals in your organization to create cultures of cooperation where individual contribution is multiplied by the power of alignment and focus.  |
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| Sample Email Link  |
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**Navigational Methods**

## MCH Methods: “Dead Reckoning” 

*estimating one’s present position by projecting course and speed from a known past position.*
- used to predict a future position by projecting course and speed from a known present position.

- Source: Bowditch, 2003

## Where We’ve Been

**Where We’ve Been**
- Lessons from the Field Museum

**Power and Control in Pre- European Americas:                                              Military, Economy, Religion**

## Julia Lathrop, Social Worker First Chief of the Children’s Bureau [1891-1978] 

**“****No legislation can be secured,         no legislation when secured can be made effective, without the steady conscious push of a convinced public opinion, and the statistics of wisely conducted inquiries form the indisputable basis of facts which will at once convince and inspire public opinion.”**

**Notes:**
As brilliantly described by Theda Skocpol in her book Protecting Soldiers and Mothers: The political origins of social policy in the United States: Highly educated career women, mostly single -- women such as Jane Addams, Florence Kelley, Lillian Wald, Grace and Edith Abbott, Julia Lathrop, and Alice Hamilton -- played a crucial role in the achievement of maternalist [including MCH] social policies during the Progressive Era. (p 350)  The originators for the ideas of the [Children’s] Bureau and its first two chiefs, Julia Lathrop and Grace Abbott, had  cut their teeth in the settlement movement. Both movements emphasized a multiple approach to solving child and family problems and used information to make change. (p. 482)
LATHROP SAID: “The theory on which the [Children’s] Bureau was created [was] that  if the Government can investigate and report, the conscience and power of local communities can be depended upon for local action.”        “No legislation can be secured, no legislation when secured can be made effective, without the steady conscious push of a convinced public opinion, and the statistics of wisely conducted inquiries form the indisputable basis of facts which will at once convince and inspire public opinion.” (p.490)
Lathrop was the first federal official to use DATA into ACTION strategies to advance MCH policies and she created the plan for the Sheppard-Towner Act led to the Title V program and she had her bill sponsored in 1918 by the nation’s first Congresswoman, Jeannette Rankin of Montana.

## Justice For All ChildrenIs The Great Ideal                    In Democracy,                     --Grace Abbott

- CREDITS: Hine, Lewis Wickes, photographer. "Portrait of a Girl, Standing, Working at a Machine in a Textile Plant, Facing Right, Cherryville, North Carolina." November 1908. National Child Labor Committee Collection, Prints and Photographs Division, Library of Congress. Hine, Lewis Wickes, photographer. "Six Black Workers in the Alexandria, Virginia Glass Factory." June 1911. National Child Labor Committee Collection, Prints and Photographs Division, Library of Congress.

*Justice For All Children**Is The Great Ideal                    In Democracy*,                     --Grace Abbott

## Martha May Eliot, Social pediatrician Director, Children’s Bureau  

- “The Sheppard-Towner Act established the national policy that the people of the  United States, through their federal government, share with the states and localities the responsibility for helping to provide community services that children need for a good start in life.”

**Notes:**
For more than fifty years Martha May Eliot played a leading part in the development of health services for mothers and children. 
She was a part-time member of the Children's Bureau staff, commuting frequently to Washington until 1935 when she became Bureau director. 
During World War II, she championed a program known as Emergency Maternity and Infant Care, or EMIC for short. At its peak, one baby of every six was provided for by the EMIC program. 
During the shameful period of McCarthyism, still Chief of the Children's Bureau, she did not hesitate to intervene in the defense of members of her staff who were being wrongfully harassed. She stood against such persecution.
While she was Associate Chief, and later Chief of the Children's Bureau, she managed to visit every regional office of the Bureau, from time to time, and she observed programs in every one of the states. She kept her finger on everything, and held the reins of authority lightly but firmly through difficult times.

## Where we are: Education and Training

- MCH Timeline
- MCH Goals
- MCH Competencies
- MCH Performance Measures
- MCH Training Programs, from SPH’s to new Pipelines
- MCH Block Grant, Funding...
- ...

## Dead Reckoning’s Limitations

- DR position is only an _approximate_ position
- DR does not allow for the effect of leeway, currents, helmsman error, compass error, or any other external influences.

- Source: Bowditch, 2003

- Leeway – Drift?		Strong currents?			Errors of leadership?			False measurements?

## Have we continuously asked: What are the most important external forces for us to navigate in, through  or around in the years ahead which may impact our work in MCH?  	

## Dead Reckoning: Limitations

- Most important use of dead reckoning is to project the position of the ship into the *immediate future* and avoid hazards to navigation.

- Source: Bowditch, 2003

- What about MCH in 2020...2058...2073...3000?
- Is there a Life Course Perspective         for MCH Education and Practice

## 21st Century Navigational Leaders

- Build on the legacy of their foremothers and fathers, understand the current status of their field, collectively chart a strategic course toward a better future for populations they serve, and are continuously cognizant of conditions which may influence their progress.

-  M. Peck, 2008

## Navigational Leaders for MCH

- Ask 4 questions:
- What is the horizon we are heading toward in the long run, for the greater good?
- How does our legacy enable us to understand better what is happening now?
- What about what is happening now makes possible what may come next?
- What are key external influences we must navigate in, through or around in the years ahead which may impact our work?

## Orienteering for the Future

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## In the Spirit of Evie Zysmanb. 1910  

*It isn’t even about making a difference.           I don’t even    know how to put this...It’s        ****you gotta do something about this!***

- Personal Interview 10/14/04                     with M Peck, Omaha

## Slide 51

## Give credit where credit is due... 

- Kay Johnson, 2003 CityMatCH Conference parting montage
- Chelsey Elperding, GPPHLI
- Brandon Grimm, GPPHLI
- Isabelle Valadian, Harvard School of Public Health
- CityMatCH and UNMC