Leading By Following in Public Health
As a global health crisis, COVID-19 has disproportionately affected healthcare systems across the world. The pandemic has not only strained systems with the sudden influx of patients in need of critical care, but it has also led to social and economic crises. As countries grapple with saving lives and livelihoods, large-scale collaborative responses are needed at the local, national, and international levels. Reflecting on previous major outbreaks such as Ebola, collaboration, and partnership efforts are paramount in the response to an outbreak.
At the beginning of the COVID-19 pandemic in January, the Chinese government shared the full sequence of the coronavirus genome, followed by scientists in Australia who became the first to recreate the new coronavirus outside of China. These findings were made available to help efforts in diagnosing and treating the virus on a global scale. At the community level, we have seen people encouraging the use of face masks and the importance of physical distancing, donating supplies, and raising funds to support healthcare heroes, small businesses, and vulnerable communities. All of these collaborative actions require strong leadership skills to make them work, and now is the time for the world to rely on effective leadership and solidarity to defeat the pandemic.
One crucial characteristic of effective leadership is organizing the expertise and actions of people from different parts of society - public and private - to support the important elements needed to maintain effective public health systems. As COVID-19 has resulted in social and economic repercussions, it will be very challenging to address the role of social determinants of health and their connection to health disparities, which have significantly impacted morbidity and mortality rates across population groups. One way that public health leaders can act is by supporting the ideas and work of diverse partners from different sectors, such as government agencies, the private companies, local communities, and the healthcare system, as well as partners at academic institutions, and research centers. For example, while governments have access to surveillance data, academic and research institutions may have a broader range of epidemiological data on COVID-19 to provide expertise in disease projection. Along with non-governmental organizations and for-profit companies, they can work together on resource allocation and innovation to scale up the production of laboratory diagnostics, personal protective equipment, ventilators, and other essential medical equipment and ensure their equitable distribution. With correct use and interpretation from experts, this can be further used to inform policymakers and as the basis for government decision-making. Together, we can leverage the information to communicate with the public to ensure transparency and accountability.
Public health leaders can sometimes lead best by embracing and supporting the efforts of partners who work outside public health. Studies have shown that partnerships in a supportive, open, and inclusive environment will subsequently enable members to have more control over their place in the partnership and shape their roles. Using this interconnected model of mutual support will reflect a shared process involving the interdependence between leaders and followers that together create the leadership.
As followership and leadership represent a dynamic interaction that constitutes a good public health leader, it is important for public health leaders to have humility, inclusiveness, and a willingness to express vulnerability in their leadership qualities.
This will allow leaders to achieve an interdependent balance by recognizing the strengths of others, seeking different perspectives, listening to different points of view, accepting new ideas, and most importantly, building trust. A balance of followership and leadership means having a solid understanding of when and how to lead, and when to be a supportive follower and collaborator.
While the definition of public health may be different for every person, one thing that is certain is that public health involves collective actions that require both leaders and followers, as there is no leader without at least one follower. As quoted from the Mailman School of Public Health Oath, “I will continuously seek new information and be open to ideas that can better protect and promote the health of populations” suggests that followership and leadership should co-exist as we embark on our journey of learning and taking actions as professionals in this field, especially during the COVID-19 pandemic.
Dr. Denita Utami is a 2021 MPH candidate in the Department of Sociomedical Sciences. She received a Bachelor of Medical Science degree from the University of Melbourne and an MD from Universitas Indonesia.
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