Health Systems Leadership: Promoting Health Equity and Effecting Change

Dr. Krishna Rao, assistant professor in the Health Systems Program of the Department of International Health, was recently featured in the Johns Hopkins Bloomberg School of Public Health magazine in an interview with Barbara Bush, co-founder of Global Health Corps. Dr. Rao’s discussion with Barbara touched upon health equity and humility, and how to exemplify these traits in a leadership capacity. The Health Systems Program delved further into the idea of health equity as a key ingredient of effective health systems leadership by asking Dr. Rao a few questions.

1. Identifying leaders and change agents: as a teacher, how do you identify leaders and potential change agents? What are some more important qualities in a leader when it comes to promoting health equity?

In some students leadership qualities are apparent – they take charge of things naturally, don’t shy from expressing opinions and take ownership of any job given to them. There are other students who demonstrate their leadership in a quiet way – they are more watchful and reserved but are clear about what they think and how to get the job done. In both cases, I think they like taking ownership and putting in more effort than normally expected.

2. You have a lot of experience in working in human resources for health – what are some lessons you have learned about how leaders can effect change at the systems level?

Health systems are hard to change. Yet, I think, a health system is ultimately as good as the people who make it function. Particularly because all health services are ultimately delivered by people. You can take a well-designed system but incompetent people can make it ineffectual. On the other hand, there are numerous examples of individuals who have done remarkable things working in broken health systems. I have come across so many health workers – doctors, nurses, community workers, managers – who for little money and working with poor infrastructure, manage to do so much so that others can benefit from their services. So I think investing in health workers and keeping them enthusiastic about their work is as critical as the particular way a health system is organized. 

3. For researchers such as yourself, you mentioned that you can write as many papers as you want but nothing might really happen unless there are people who can see the importance of what you do – how can researchers position themselves as change agents and make sure their work is more likely to be implemented in the field?

There is an important line between being an academic and being an activist. Researchers have traditionally seen themselves as producers of knowledge, while ‘changing the world’ has been in the domain of social and political activists. More recently, you see researchers also becoming activists. In some cases it’s because the science itself is being disputed by the politically powerful like in the case of climate change. So I think there is an increasing sense that researchers should not be passive about their research and expect that it will find a voice on its own. They need to actively make it known and promote it via social media, public debates, and even demonstrations. 

For more information on Dr. Rao’s research interests and profile, read his interview with Barbara Bush, as well as his faculty feature