Assessing Impacts:  Engaging Women’s Health Leaders

Christina Lessels, Ontario Women’s Health Network

Women across Ontario are leading change in women’s health – at every level, in grassroots, volunteer and professional roles within and outside of the health care system and across diverse sectors. Among them are women who participated in women’s health leadership programming carried out by the Ontario Women’s Health Network (OWHN) between 2010 and 2013.

With Women’s Xchange funding, OWHN reached out to alumni to learn about the long-term impacts of the program; what aspects were most meaningful for them and the barriers and supports that they experience. This report and video highlights women’s experiences of the program and their engagement in women’s health and shines a light on the need for continued opportunities for women’s health leadership development in Ontario.

 

Background

A growing body of research demonstrates that leadership programming is effective for improving the health of individuals and communities. According to research by the Health Evidence Network on behalf of the World Health Organization (2006), empowerment initiatives such as leadership programming are effective for improving the health status of individuals and reducing health disparities of groups that experience marginalization. Similarly, an evaluation of the Pacific AIDS Network and Ontario AIDS Network Leadership Training program (2009) showed the program was a life changing event for participants, increasing their confidence and understanding of their own personality and core values. As well, evaluation of Leading to Choices (2010), a global woman-centred leadership program indicates that woman-centred leadership training has significant positive impacts for women.

OWHN’s leadership program was designed to strengthen the capacity of women to take action on women’s health-related issues and to address systemic health inequities. From 2010 to 2012, OWHN facilitated 16 three-day provincial retreats attended by a total of 178 diverse women from across Ontario. In 2013, OWHN facilitated three one-day regional forums to follow up with alumni.[1] We used a participatory facilitation approach to ensure participants learned from each other’s experiences and perspectives while problem solving together. The curriculum focused on such topics as leadership development, sex and gender based analysis (SGBA), communications and networking.

The evaluation data and feedback gathered from participants during the course of the programming spoke to the strong outcomes in terms of personal learnings and increased capacity to implement SGBA and develop initiatives to address women’s health issues. This follow-up project offered us a unique opportunity to reconnect with alumni in 2016 to better understand and reflect on the longer term outcomes of the leadership programming.

Methodology

The research methods used for this project included an online survey and telephone interviews with program alumni. 63 women participated in the survey, which we promoted through direct emails. The survey respondents indicated if they were interested in participating in an interview and from these responses we selected nine interview participants, ensuring the inclusion of women with a broad range of interests and geographic locations. Survey respondents had an opportunity to win one of four $25 gift cards; a $25 honorarium was provided to interview participants. Ethics approval for the project was sought and received from the Community Research Ethics Office.

Voices of Participants                                  

Alumni of the leadership program are of a broad range of experiences and backgrounds, representing diverse ages, abilities, ethno-cultural identities, socio-economic status and residing in urban, rural and suburban communities. They are engaged in women’s health through a variety of sectors, such as health and social services, education, private industry, violence against women and settlement services, and community and grassroots initiatives, among many others.

80% of survey respondents indicated that they have increased their community and work leadership activities since participating in OWHN’s leadership programming. The breadth of initiatives they have undertaken reveals the varying ways that women are creating change in their communities to address women’s health—such as coordinating education and support events, developing programming, giving presentations, mentoring and sharing resources, taking on leadership roles at work and on boards of directors, pursuing further education and launching new organizations.

“It has allowed me to be a stronger advocate and become an active agent of change.” 

“Increasing my skills in leadership led to better quality programs, which then benefited my community.”

“Have attracted other volunteers to the organizations I've worked with and helped to spread more awareness about women's health and human rights issues.”

Respondents pointed to such program attributes as having a safe space within which to learn and share ideas with other women, building and applying skills together and recognizing one’s own leadership skills: 

 “Being able to take part in a program that was geared specifically to help us think about our potential as leaders was very empowering, just to have that experience.”

 “I guess this was the first time I was presented with some of the information… it was the perfect way to challenge some of the ideas that are status quo about what leadership means.”

 “Women’s leadership doesn’t mean you have to have a title after your name and work for a particular organization…I think that [the program] reinforced that I have something to offer…”

Increased Confidence

Through both the surveys and the interviews, women reported an increase in self-confidence that resulted from their participation in the program that is central to their personal leadership development:   

“I believe I developed more confidence in my own skill set and feel more assured that I have something to offer.”

“Yes, it has given me confidence and the belief that everything is possible.”

 “It was a huge confidence builder for me. It really gave me wings, it really did. It felt to me like it gave me wings to pursue my ideas.”

Women Coming Together

With this program, OWHN sought to create a space for participants to network and learn from diverse women. The value of gathering together with small groups of women at the retreats is one of the most enduring facets of the program. 74% of respondents indicated that meeting and networking with other women was one of the most impactful aspects of the program, a theme repeated often by survey and interview respondents: 

“Even getting away for a few days with other women can help refocus your passion on what you are doing.  And being able to connect with others, not even in similar fields … but in the same sort of large sphere was really meaningful to me as an individual.”

 “There were some extremely impressive women in the course when I took it, I was wowed by all of them and it inspired me to challenge my fears as they related to leadership.”

“Networking with women from across the province – listening to their stories and struggles in helping their communities. Knowing we all share a common interest in women’s health.”

Using an online group forum, OWHN sought to support long term networking and connections between program participants, including between women who were at different retreats and thus had not met in person. However, the challenges that we experienced in utilizing an online tool speaks in part to the value and importance of in-person engagement.

Some respondents did indicate that personal relationships and collaborations made during their retreat have endured in the years following the program. We also heard about the difficulties in maintaining connections over time and in building networks with program participants who did not attend the same retreat as themselves.  

Curriculum Spotlight—Sex and Gender Based Analysis

A core program objective was to help build greater understanding of the ways sex, gender and intersectional factors impact health and health care, while increasing access to SGBA tools. 47% of respondents indicated the SGBA content as one of the most important parts of the curriculum. 61% are currently using SGBA in their work or activities and 59% indicated that they have increased their SGBA use as a result of the program. For some, the program offered an introduction to SGBA. For others who were already familiar with SGBA, it helped to enrich their knowledge:

 “I think it is basically impossible to talk about women’s health without considering a gender and an intersectional lens, and so those skills definitely, that was really enhanced by the training.”

“I remember one of the things we really examined was sex and gender which was really great because though I know the difference, it has never really been at the forefront for me…”

 “Thinking in gender based terms about health helps me practise in a different way.”

Barriers and Supports for Women’s Health Leaders

Several common themes emerged around the barriers and supports that women have experienced as women’s health leaders. Lack of funding and time, personal circumstances, being stretched between competing priorities, and organizational/structural barriers are among the challenges raised:  

“I think that because women are marginalized, their issues and their work becomes less important and that is reflected in the funding of programs.”

“…simply because women are stretched and exhausted.  It makes it difficult to step out and do more.”

“Lack of time is a barrier to engaging in some leadership activities.”

Predominant among the supports that women highlighted are supportive relationships, partnerships and work environments, encouragement from others and access to information and resources:

“I am usually able to surround myself with other women who are supportive and we all try to do better and lift each other up.”

“There’s something really powerful about women supporting women.”

“I honestly had no idea that there were so many resources available so that was very important and I have learned to 'look things up' more often.”

Lasting Impacts

This project offered a unique glimpse into the long-term impacts of the leadership program. The skills, confidence, relationships and ideas developed during the course of the program have had enduring impacts for many respondents, helping to shape and build their women’s health leadership capacity:

“It really helped shape my idea and my thinking of my research interest over the last number of years. It’s helped to redirect my project and even my involvement in different projects, in significant ways”

 “… this many years after the leadership program, I can say with complete confidence that was just not a confidence builder that was short-term…”  

“…it has had a very lasting impact at a pretty foundational level for me.” 

The Future of Women’s Leadership Programming in Ontario

Significantly, this project highlights the need for continued support for women to engage in leadership development. We heard loud and clear from participants about the value of the leadership program and that more training and engagement opportunities are needed:

“I feel that other sessions are so needed as they are always so refreshing, re-motivating and another gentle push towards greater accomplishments. I hope that one day we can get together in the same room again to make big plans and take big steps.”

 “That is something I would like to do more of as it was incredible, incredible knowledge that we all shared together within that space of three days. What I’ve never imagined in women’s health, I did get out of that space.”   

“This program was fantastic and I hope you will be able to continue it with the next generations of women.”

Future opportunities for women to come together to network, collaborate, share ideas and support one another towards leading change will have profound impacts for women’s health across the province.

Acknowledgements

Thank you to the women who participated in this project and shared their experiences with us. Thank you also to Women’s College Hospital Women’s Xchange for funding this project.

References

Dann, Susan. (2009). Evaluation Report: PAN/OAN PHA Level I Leadership Training. Pacific AIDS Network. Retrieved 05/28/2015 from: http://pacificaidsnetwork.org/pacific-aids-network/files/2009/10/Sept-09-PHA-Level-I-Leaderhip-Training-Evaluation-Report.pdf.

Pittman, Alexandra. (2010). A Summary of the 'Leading to Choices' Program Evaluation in Morocco: A Women’s Learning Partnership Training Curriculum. Retrieved 05/28/2015 from: http://awidme.pbworks.com/w/page/36373220/WLP%20ADFM%20Evaluation.

Wallerstein, N.  (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen: World Health Organization, Regional Office for Europe, Health Evidence Network. Retrieved 05/28/2015 from: http://www.popline.org/node/175634.

 

[1] The original program was funded by Echo: Improving Women’s Health in Ontario, a former agency of the Ministry of Health and Long-Term Care. The subsequent alumni regional forums were carried out with funding from the Canadian Institutes of Health Research.

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