Q&A: Listening as the key to global health success

Since the arrival of the Sustainable Development Goals, the public and private sectors have come together in the realization that the 17 goals will not be achieved unless new ways of working are implemented.

However, for many this is new terrain; tapping into the expertise of various partners and ensuring alignment across aims and desired outcomes might be easier in theory than practice.

Jess Daly, global health director at the Medtronic Foundation believes that rather than adopting complicated methods for collaboration, the simple task of listening could ensure successful partnerships and, with them, global health success.

“Listening is something all of us can do,” Daly said, adding that there are lots of opportunities to create more dialogue with end beneficiaries, including policymakers and health care workers.

Although listening to all stakeholders may seem like an obvious way to set partnerships up for success, and presumably, something many organizations already do, Daly explained that those working in global health may not be listening with intent and an openness for critical feedback. More importantly, they may not always be listening in a meaningful way to those voices that are most important: Underserved people living with noncommunicable diseases, caregivers, and frontline health workers.

“We all think that we spend a good chunk of our time listening — and we spend so much of our time on email, on conference calls, and reviewing a wealth of material. But at the end the day, in global health, there is actually some stagnation happening in our ability to truly connect to end users and key stakeholders,” she explained. “I think all of us are guilty of this in some form because we're busy, [listening] it's actually incredibly time-consuming and can be difficult to do.”

So how can global health practitioners become better listeners in their road to global health success and what are the challenges to overcome if all stakeholder perspectives are to be adequately included in a partnership? Daly sat down with Devex to discuss some of the key ways of doing this.

This conversation has been edited for length and clarity.

In your experience of working with multiple stakeholders, how can efforts to improve global health prove successful?

Multistakeholder approaches are key to any successful sector, but particularly in global health where the payer is often not the same as the recipient, and when we're combining market demand with behavior change efforts and system strengthening transformation.

For us at the Medtronic Foundation, we recognize that unless we partner across stakeholders we won't be successful; a lot of our work has been based in public-private partnerships in particular — largely because the public sector is often the steward of health care for underserved communities.

Not only are we partnering with the government at local and national levels, but we’re partnering with local organizations that can really drive solutions with public sectors and governments in those locations — and with patients, family, health workers, and beneficiaries. We strongly believe that they should always be part of any endeavor, or else we won't be successful.

How critical is it to listen to stakeholders and gain different perspectives on the most pressing needs today and 20 years from now in health initiatives?

Right now we're at an interesting inflection point where countries are facing a double burden of disease — both from infectious diseases and NCDs. We have limited financing resources to pay for this burden and a critical realization that the health sector alone is not going to solve it.

We need to improve health care for underserved populations — health itself is often a byproduct of many sectors coming together, such as climate change, security, agriculture, and education. So it means that we can't just look at what's going on in health, we need to have an amplified view of other sectors and key challenges they're facing, and will face, in the next 10-20 years.

From there, we can start working together on addressing some of the issues that will lead to incremental impact and longer-term systemic change. We recognize that tomorrow’s solutions to health very likely will not be driven by the health sector alone.

We're at this point in time where we're used to hearing from private sector leaders and country leaders, and we really feel that they have an important voice to offer when thinking about the future of health in and outside our sector. But, we're also putting together a listening tour, a dedicated effort to seek a diversity of views not only across sectors, but within sectors, so that we have views from entry level actors and different perspectives in either agriculture, education, or financing.

We want to listen in a way that allows for the authenticity of those perspectives to come forward, even recognizing there are certain power dynamics that tend to lead us to having more vocal actors in the ecosystem.

What challenges are there in collating all stakeholder perspectives into a project?

One of the bigger challenges in listening to a wide range of stakeholders is that there are conflicting views of priority areas of convergence and divergence, and what it's going to take to solve critical health challenges.

Coalescing all of that difference and disagreement into a way forward is also where we hope to get our strength because it will reveal potential gaps that we think could reshape some of our own thinking and recheck our assumptions.

The other major challenge is that we want to be sure the voices we’re pulling together are representative of not just the individual’s interest but of the broader community each may represent. Here again, this involves some methodology in terms of ensuring that we have a representative number, that we're indeed geographically and economically diverse in what we're looking at, and that we authentically represent a broader community.

What advice do you have for development practitioners in terms of listening as a critical tool for global health success?

As we look to the future, we owe it to underserved populations to start by listening and understanding that we bring a bias into our conversation, and to try to really be conscious of that; to not use listening as an opportunity to confirm our own biases but rather to check our assumptions. Then we have to come up with new ways of trying to address what we're hearing. We think that creating space and time and investing in the listening part of what we do is really worthwhile and just a simple tool that may be very underutilized in global health overall.

If you’d like to contribute your voice to Medtronic Foundation’s listening tour, click here.