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Last year, I left a private sector job for a Global Health Corps (GHC) fellowship working with IntraHealth International in Uganda. My intention was to use my for-profit experience to make an impact within the movement for global health equity. A year later, that intention has been realized, but not without a multitude of humbling learnings and realignments of expectations.
For those of you considering a move from for-profit to global health work, I hope this post will equip you with just a few of the things that you need to succeed in your transition. Although you won’t get all the information you need, there will likely be wonderful and welcoming people along the way who will help fill in the gaps. During my fellowship year and since, I have been surrounded by seasoned global health professionals, including my GHC co-fellow, who entertained my many questions and helped me decide when a for-profit mindset was beneficial or detrimental to solving the problem at hand.
First, let’s touch on a few things I believe, generally, the NGO space can learn from the business world. These are not universally true, but these are a few ideas to look to when trying to find your place in global health as a private sector transplant:
1. Planning strategically: In many cases, NGOs lack strategic plans or have lower capacity internally for detailed planning before taking action. This is often a result of the fact that NGO workers are working within low-resource settings that make planning difficult, or are extremely focused on implementing on short timelines. My role at IntraHealth was focused on institutionalizing a methodology and system for tracking absenteeism of health workers across Uganda. When I arrived, there was some pressure to start implementing before I understood our organization’s goals, the stakeholders involved, and the massive context of working on accountability in the Ugandan health sector. However, I was fortunate to have a supervisor that granted me the time to have conversations, explore innovations, and gather learnings on past attempts to track health worker absenteeism. My capacity for planning strategically, and my supervisor’s willingness to see that process through, has allowed us to implement new interventions strategically and successfully.
2. Utilizing analytics: Collecting quality data and encouraging use of that data within global health is a challenge. As a result, monitoring and evaluation can sometimes default into simple counting stats. Often, it’s easier to ask how many districts we reached with an intervention than to ask how that intervention actually affected a district. During my fellowship, I was been able to utilize data visualization and analysis learned in the private sector to analyze and communicate more complex data so that different stakeholders can understand and be motivated to take action.
3. Understanding the value proposition: In the non-profit world, incentive structures are complicated. One thing that has been valuable for me is to constantly ask the question: “Why do people do what they do?” Understanding your “consumer” and their incentives, whether working for Amazon or for a global health organization, is extremely important to understanding how your work can be successful. Aligning incentives and selling your product — in my case, a system for tracking absenteeism of health workers — is essential. This is not always the mindset in capacity building NGOs, but I believe a healthy dose of this private sector thought process can bring a lot of value.
A health facility in-charge in Kabale District working on attendance tracking after a long day’s work
These successes of course could not have existed without massive learnings on my end. An entire book probably could not hold all that I have learned, but I will try to touch on the most impactful learnings for me over the past year:
1. Complex consensus building: The system of stakeholders in global health is exceedingly complex. There is not one person at the top who signs off on decisions and aligns the North Star for the whole sector. For those of you coming from the private sector, be keenly aware of these complex stakeholder structures, and document the process for consensus to ensure that your private sector instincts don’t take over to your detriment.
2. Low resources: This one should be obvious, but everything is easier to understand once you’ve experienced it. Early on in my fellowship, I requested for a few new reports in our online HR system to track absenteeism of health workers. In my previous work, these reports would have taken days, maybe weeks, but certainly not the months they took. Our problem was not our talent, motivation, or management, but our time and resource limitations. We are staffed very leanly in terms of software developers and thus, it is difficult to complete tasks on timelines that those in the for-profit world are accustomed to. I should have approached the problem by understanding those restraints early on, realigning expectations, and then trying to pull the right strings to free up time and talent.
3. Fatigue: Many people who have worked in broken health systems for a long time become understandably jaded by the system. People will say certain ideas or innovations will not work, because they have seen a number of other ideas fizzle out in the past because of a number of different barriers. However, coming from the private sector, you may have the benefit of not being jaded. Use that to your advantage and press on with resilience. Understand others’ perspectives, but if you believe in what you’re doing and you have planned strategically, conducted supporting analysis, and developed an intervention’s value proposition, you can try to stay realistically optimistic.
“I moved to Karamoja 30 years ago to serve the community. I have been shot five times during past times of conflict in the region. So I am wondering: where is my reward?” — Sister Jane Margaret Atai, Tokora Health Center IV, Nakapiripirit District. Jane asked this question of IntraHealth’s SHRH Uganda team during a rollout of attendance tracking to her district. Asked with a big smile, Jane’s question indicated her radiating positivity despite her trials and her sense of duty and purpose in serving her community. Although health workers like Jane may find their reward in their service, there is so much more to do to strengthen systems around them and truly reward them for their work.
In my year as a GHC fellow, I saw the value my private sector experience can provide, and I realized the immense learning someone with my experience can have by working in a new environment with new challenges and dynamics. Although the experiences I have shared can certainly not be universally applied, we all have something to learn from each other, and I believe human resources with private sector capacity can have a huge impact within Global Health Corps, international NGOs, and other mission-driven organizations. If you are considering a move from the private sector to the global health space, I encourage you to join us!
All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. Join the movement today — applications for our 2018–2019 class are open until January 17.