Our Diversity, Equity, and Inclusion Journey

Diversity, Equity, and Inclusion (DEI) is a journey. Every organization that takes an intentional stance on DEI must embark on that journey, and along the way there are many stations where we learn about ourselves, our culture, and our colleagues. At Management Sciences for Health (MSH), we are on this journey, and I want to share some of our experiences.

MSH is a very diverse organization, but we had never really examined our diversity with an equity or inclusion lens. We are currently working on the health systems of 47 countries around the world, from working with communities as diverse as women of childbearing age in Afghanistan to supporting patient advocacy groups in Europe. Prior to the pandemic, more than 30 nationalities were represented in our largest US office in Arlington, Virginia. At any given time, 85–90% of our staff live and work in the countries of our project operations. We celebrated our diversity, but we did not examine it.

After the murder of George Floyd in 2020, MSH, like many organizations headquartered in the United States, became more intentional in trying to understand DEI. Many US staff were asking “How could this happen in our country?” and many of our global staff were asking “How could this happen in your country?” For people around the globe, this was a shocking and traumatic incident that led to soul searching. We began with staff listening sessions; we heard about our colleagues’ fears for themselves, their communities, their children, and their fellow colleagues; and we heard their questions about what we could do about it, both as individuals and as an organization. We asked: how can we do a better job in learning about each other and ensuring we are not just a diverse organization, but an inclusive and equitable one?

One facet of diversity that became very clear very quickly was that “we” is a word that contains many cultures and countless experiences. The language of DEI that we hear most often is an American idiom. But the experience of someone in, for example, Ethiopia, Ukraine, or Kenya, is vastly different. We did not want to compound the previous sins of colonialism by using the US’s cultural paradigm when talking to those from other cultures with very different lived experiences. So, one of the first things we did was gather a group of committed staff who developed a DEI survey. The survey, translated into our six most widely spoken languages, was launched in early 2021 and sent to our global staff. We learned a lot from this survey about our staff’s perceptions of MSH as an employer and their experience, whether as members of a historically dominant, non-dominant, or disadvantaged group in their home culture. But we were a little disappointed with the response rate of 27%. So, for 2022 we integrated DEI survey questions into our annual employee engagement survey, which we have run since 2012. We are analyzing the responses to that survey as I write, but I am pleased that we received a response of 72% of staff, meaning we will have a far broader understanding of MSH staff experience.

Internal communications are a deeply important part of our DEI approach as they play such a central role in developing organizational culture. MSH runs three global staff meetings a year. We used to bring together staff in their offices and present from our Arlington and Medford offices in the US, where we had better technology. During the pandemic we moved toward streaming these meetings online. This had an extraordinary leveling effect we had not anticipated. Instead of privileging our US staff, everyone is on the same level. In every meeting the chat function explodes with greetings and felicitations from around the globe in many languages. Before, featuring speakers from outside the US was a challenge. Now, anyone, anywhere can be a presenter, ask a question, or address the collected staff. These meetings have become a lynchpin of our organizational culture, and even as we transition back to offices or hybrid approaches, we will continue these meetings virtually.

In the early days of the pandemic, we struggled to find ways for people to interact virtually. We wanted to celebrate the diversity of our staff and to introduce our colleagues to each other. So, we came up with a series titled “How did I get here?” In each 30-minute episode, a member of MSH’s staff from anywhere in the world tells their story of the path they took to come to where they are today, and the series is the runaway hit of the last two years. Several times a month we hear from colleagues we may not otherwise meet and whose stories we would never have learned. It’s a great way to remind ourselves never to assume anything about anyone because of their name, their title, how they look, or where they live. Everyone has a story to tell, and these stories are spectacular.

There are several overlapping questions we are asking ourselves that have come together in our DEI approach. If there is a Venn diagram of localization, decolonization, and DEI, one of the most substantial overlaps is in moving away from the Global North as the center of operations. While MSH is headquartered in the United States, we had already made Nigeria, our largest country of operations, a regional center. Beyond our projects, we have Nigerian staff who work in our corporate support departments who would traditionally have been based in the US, including Finance, Human Resources, Business Development, Communications, and Compliance. And as we have adapted to virtual working, our technical leadership is becoming more global, with technical leaders based in many countries outside of the Global North, including Uganda and South Africa.

Other activities include conducting a DEI audit and examining our policies to ensure they are equitable and inclusive. We have a voluntary DEI committee that meets regularly to advance these issues and advise the Leadership Team, and we are among the first endorsers of the CREED pledge on racial and ethnic equity, where we are learning with other organizations on this journey. We require all our projects to report on what DEI means in their country or countries and how they are responding to those needs.

Looking further into this year, we are creating DEI training and capacity-building opportunities, including “Leading@MSH,” a leadership and management training program that will be rolled out later this year, and a DEI course for all employees to align common language, policies, and expectations around DEI, which will be rolled out next year.

Overall, we summarize our DEI approach through three commitments:

• Our People: MSH is committed to creating a diverse, equitable, and inclusive environment everywhere we work.
• Our Mission: MSH will continuously examine how we do our work for opportunities to increase diversity, equity, and inclusion.
• Our Voice: MSH will share what we learn publicly and actively engage in the global conversation.

MSH was founded on the principle of closing the gap between knowledge and practice in public health. Our Tao of Leadership approach, too, asks us to address these issues. To truly achieve this goal, we need to understand more about cultural challenges around DEI wherever we work. Without addressing these issues, we will never achieve universal health coverage.

This is a journey that will have many more stations along the way. In fact, I don’t believe there is a single destination—I think that path leads to complacency. We should always be vigilant that we do not make assumptions about our colleagues and communities where we work, and this means always examining ourselves. I look forward to sharing more with you about our journey as we continue.