How Can Family Medicine Changemakers Cultivate a Gender and Health Equity Movement?

Immediate Call-to-action

Please sign this social media campaign to support this movement: Unite Family Doctors, Patients and Families for Gender and Health Equity.

Social reach goal = 250,000 by Dec 31st. Current status = 172,980 on November 28th.

How is Equity Different to Equality?

Of all the forms of injustices, educational, gender and health inequities are the most damaging to health, well-being and evolving human consciousness.   

Adapted from Martin Luther King: Of all the forms of inequality, injustice in health care is the most shocking and inhumane. 

Equality Does Not Equal Equity.

Gender and Health Equity (GHE) is the attainment of the highest level of health and well-being for all people. This includes both women's and LGBT rights.

What is the True North Vision for Primary Health Care?

Gender and Health Equity is the True North Vision for Family Medicine Changemakers.

Equal access to healthcare does not improve health for all. We must look beyond universal healthcare to gender, health and educational equity, particularly for young girls in poor countries who are denied adequate education.

The aim of Sustainable Development Goal for Education (SDG4) is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. This is difficult to do in our current political climate.

Why Political Systems Are Failing Us?

Both Brexit and the election of President Trump are failures of educational equity in preventing the development of divided nations between disconnected political classes of people. We have regressed to our fear-based, reptilians brains. We are in a state of neo-terrorism: a war of words without weapons. Class warfare perpetuates political fundamentalism and dysfunctional polarizations. 

Health is political, and politics affect health. Hate, exclusion and division have trumped over love, inclusion and unity. This political climate creates hostility toward the ideals of gender and health equity and planetary health.

We Need Changemakers to Get Us Out of this Mess.

As changemakers, we must go upstream to address the ethical and political determinants of the equity issues related to personal and planetary health. This strategy includes restoring our environmental health to assure a healthy food supply for our ever-increasing population. Overpopulation is a threat to planetary health. And planetary demise is a threat to personal health.

Amoral corporations have set a non-sustainable course of hyper-consumerism that is causing planetary demise. The Light Bulb Conspiracy documentary illuminates the dark side of planned obsolescence perpetuated by unethical corporate practices that are destroying our planet.

We must address personal and planetary health concurrently to enable us, we people and our governments, to seek the truth in a climate of lies created by the Merchant of Doubts. Conscious capitalism and social entrepreneurship are powerful allies for health in the fight against reversing these unhealthy trends.

How Can We Unite for Health?

Gender and Health Equity is the unifying outcome driver for Goal 3 of the Sustainable Development Goals. 

Ensure Healthy Lives and Promote Well-Being for All at All Ages. 

Implementing Gender and Health Equity in all Policies is the Next Health Movement for primary health care. But why do some people vehemently oppose this noble vision and mission?

Why is Equity Politically Rejected?

Right-wing politicians pejoratively view equity advocates as Social Justice Crusaders (SWCs) and Nanny State Enablers (NSEs) of public entitlements and dependency.

Libertarians reject the above image as public coercion to eat apples. SJCs deny people's choices to eat fruit, vegetables or animal products using their own resources.

Right-wing extremists see the free market and privatization as the savior for the public sector corruption and inefficiency in healthcare.

How Can We Advocate for a Gender and Health Equity Movement?

WONCA is the international organization for Family Medicine and General Practice. It is the best organization for advocating for Gender and Health Equity (GHE) in all Policies, from a primary health care perspective.

A fragmented organizational approach to gender and health equity is ineffective.  To overcome our fragmentation of disconnected groups, we must adopt an integrated, whole-systems approach. This calls for developing networked learning communities that work across all groups within Wonca and beyond.

Our Closed Mindsets are Greatest Barrier to Promoting Gender and Health Equity. 

To build the next health movement, we must open, expand and align our closed mindsets to galvanize unified action.

Gender and Health Equity is the Bullseye for Health Transformation, Systems Redesign and Service Innovation.

How Do We Build a Gender and Health Equity (GHE) Movement?

Leaders take a centrist role of equanimity in managing the polarities, conflicts and dilemmas arising from within their organizations and/or their communities. This makes the task of developing movements especially challenging, without the support of changemakers to facilitate this complex communication, networking and campaign process. We need to develop a networked leadership movement across our generalist discipline.

WONCA leaders include:

• Executive committee
• Presidents and vice-presidents of the Regional committees
• WONCA Representatives of the individual membership organizations and their Committees, Networks, Special Interests Groups (SIGs) and the Working Parties (WPs)
• Chairs and vice-chairs of the WONCA Committees, Networks, Special Interests Groups (SIGs), and the Working Parties (WPs)

How can our leaders work together to develop and implement calls-to-actions?

Leaders collaborate to build a GHE advocacy movement by mobilizing leadership, professional and social movements.

• Organizational leaders and changemakers work together with politicians and policy-makers to build global and national leadership movements
• Family doctors, general practitioners and members of the primary health care team work with changemakers to build professional movements within their own countries
• Health care professionals, patients and their families work with changemakers to build social movements regionally and nationally.

To launch this cause campaign, we need professional and public versions of the GHE pledge for communication and networking purposes, within and beyond Wonca. Here are two proposed pledge for debate.

    

Professional Version for Political Advocacy

The professional version is for politicians, policy-makers and practitioners. This version aims to evoke ongoing dialogues about how to address the ethical, political and social complexities of advocating for gender and health equity.

We, family physicians and general practitioners, pledge to use justice, equality and liberty in managing the polarity between optimizing person-centered and family-centered healthcare and implementing Gender and Health Equity in All Policies.    

 

Public Version for the People

The public version is for the people-centered health and healthcare. This version focuses on the benefits to individuals, families and communities.  

We, family physicians and general practitioners, pledge to deliver person-centered and family-centered healthcare while pursuing gender and health equity for the greater good of all.

To do justice to this cause, we need an open and transparent consultation process over a one year period to collaborate on building consensus about the wording and the use of this pledge into order to create a meme and movement.

How Can the Left and Right Hand Work Together?

With the left hand, changemakers take the risks working at the fringes of their organizations that leaders cannot afford to take at initiating change. The best innovations often arise from the fringes of organizations. To achieve greater impact, changemakers need the centrist support of their leaders.

Quote from Arthur Schopenhauer, German philosopher (1788 – 1860)

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.

Organizational leaders perceive changemakers as disruptive threats or healthy challenges to the status quo. Changemakers help leaders (the right hand of organizations) to develop new collaborative frameworks that create open, transparent and widespread ways of engaging and activating members, membership organizations and stakeholders to participate in a GHE advocacy movement.

Will the Right Hand Hold Hands, Wrestle Against, or Disengage with the Left Hand?

With the right upper hand, transactional leaders view changemakers as threats to authority. With this perception, they adopt a self-protective and defensive posture with command-and-control approaches. To maintain their positional authority, they make mis-attributions about changemakers' intentions: such as, advocating for a cause without collaboration and taking over the agenda of another Special Interest Group.

Gender and Health Equity does not belong to any one person, group, committee, constituency, stakeholder or leadership group within Wonca.

Gender and Health Equity Belongs to the People.

This cause requires large-scale collaboration, dialogue and networking.

With an open right hand, transformational leadership view changemakers' intentions as potential enhancements to organizational functioning and collaboration.

With this perception, they welcome new ideas for membership engagement, activation and participation. In response to these challenges, they make positive frames about changemakers' intentions, such as dialoguing about the merits and limitations of new ideas through a open and transparent process of due diligence.

Transformational leaders inspire and empower greater membership engagement, activation and participation by creating large-scale frameworks of dialogue and collaboration.

How Do We Create a Pledge, Meme and Movement to Develop Calls-to-action?

Leaders work with their changemakers to align stakeholder groups in developing a GHE pledge, meme and movement as an ongoing, open and transparent consultation process. These groups generate the network power to develop and implement GHE calls-to-action.

The vision of GHE advocacy calls upon us to:

• Clarify our particular passions and purposes in becoming changemakers
• Coordinate our diverse roles as changemakers for gender and health equity
• Expand our roles beyond person-centered care to people-centered care.

Gender and Health Equity is the Rally Call for Our Global Discipline.

Effective leaders engage changemakers, champions, connectors and collaborators to work synergistically on reducing gender and health inequities. They create synergy among these approaches:

• Top-down stewardship
• Horizontal collaboration across Special Interest Groups (SIGs), Working Parties (WPs), networks, committees, individual member organizations, Regional committees, and the World Council with representatives from each membership organization
• Bottom-up creativity of developing calls-to-action

This synergistic approach calls for developing for developing ambidextrous organizations: create synergy between the right hand (top-down stewardship) and the left hand (horizontal collaboration and bottom-up creativity).

To orchestrate effective change management strategies, our leaders and changemakers walk hand-in-hand to address the ethical and political determinants of health. Working collaboratively, we learn how to:

• Manage dysfunctional political polarizations
• Navigate through the political polarities of our diverse mindsets
• Use the Third Way to advocate for gender and health equity

Typology of Changemaker Roles

Changemakers have distinct roles from the leaders. They challenge our leadership mindsets and the assumptions of traditional governance processes.

Changemakers open leadership mindsets to new ways of being, doing and acting, in terms of inclusivity and diversity by activating individual membership organizations and engaging individual members of their respective organizations. They activate members to participate in networked learning collaboratives. This calls for creating innovative and scalable frameworks of collaboration, using a blend of methods, including the pivotal role of social media.

Leaders must create the emergent conditions for membership empowerment, a process that they can only influence but never control. To provide effective stewardship for this process, they purposely deploy a diversity of changemaker roles, as outlined in the table below.

Working collaboratively, changemakers become the drivers for delivering peer learning, support and coaching platforms to ensure healthy lives and promote well-being for all at all ages, such as improving health literacy and community health.

Create Organizational Synergy for a GHE Advocacy Movement

How can WONCA leadership work at all levels to:

• Collaborate synergistically with the #FMChangemakers, the Young Doctors Movement (YDM#SoMe) and all SIGs, WPs, networks and committees for GHE advocacy?
• Amplify our network power to create calls-to-action that support the development and implementation of Gender and Health Equity in All Policies?

Host Online WONCAcafes

To initiate a global dialogue campaign about GHE equity, each regional committee, Special Interest Group, Working Party, Committee and networks host online WONCAcafe events (one-hour long) with their respective committees to discuss this blog post and the blog post below, with their members watching a live or recorded event. To learn more, read this blog series about calls-to-action.

How Can Family Physicians, Patients and Families Unite for Gender-and-Health-Equity-in-all-Policies?

Using Google hangouts or Zoom with concurrent facebook and twitter pages, listeners can give real-time feedback about the event or delayed feedback by watching the recorded event. (This format copies the event organized by #Ruralcafe conducted on the last evening of the #WONCA2016 conference.)

Each regional committee can invite their individual membership organizations within their region to reproduce this WONCAcafe event to engage and activate more than 500,000 members. The final WONCAcafe event involves the Executive Committee with the regional WONCA Presidents reporting on the experiences of hosting their own events

The same process can be done for the the regional leaders of the Young Doctors Movement and their executive committee group. The same process can be applied to medical students organizations.

WONCA could set up a YouTube channel to make these events available to all. This learning process will open, expand and align our leadership mindsets to better advocate for, and implement Gender and Health Equity in all Policies.

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Call to Action

Please sign this social media campaign to spread awareness about this proposed pledge.

Unite Family Doctors, Patients and Families for Gender and Health Equity in All Policies

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Clarification: My professional views represent my experiences of attending the WONCA World Council and the North American Regional Committee meetings as an observer. This post has been informed by many conversations with conference attendees at the World WONCA conference in Brazil. These views do not represent any official WONCA position or endorsement.

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The Preconference workshop at the 2016 WONCA world conference in Brazil explored how we can develop our Family Medicine Changemaker roles. Please connect via Linked-in to request workshop materials-in-development.

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As a changemaker, I ask evocative questions that challenge our mindsets about how to advocate for Gender and Health Equity. This learning process explores how we can open, expand and align our mindsets to move gender and health equity beyond words (the rhetoric of policy) to deeds (calls-to-action).

This calls for creating blended learning opportunities for leaders, changemakers, champions and their organizations to dialogue about how to:

• Cultivate open, transparent and participatory consultation processes to advocate for gender and health equity
• Generate the network power needed to create a pledge, meme and movement for gender and health equity
• Take an integrated, whole-systems approach involving all stakeholders to develop calls-to-actions for gender and health equity

This emergent learning process will challenge our closed mindsets how we can address this complex problem.

Happy to connect and chat about creating such learning opportunities via Linked-in.

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