PATH’s Brianna Musselman focused on international studies and ethics in undergraduate and graduate school. She says her ethics education ensured that throughout her career, diversity and equity has always been a personal priority.
Now, as a program manager in PATH’s Global Health Programs division, Brianna has been a champion for our Equity in Programming Benchmarks, a tool that enables PATH to track progress toward equity goals.
By using the benchmarks to assess a proposal or project, PATH teams can measure how each proposal or project performs against indicators aligned with PATH’s four change strategies. Staff then identify how and where to improve.
Starting last year, Brianna’s team piloted the benchmarks on the Technical Assistance Platform project. Brianna also helped coach other teams through the benchmarks process.
Why are the Equity in Programming Benchmarks important to you?
PATH’s focus on health equity is a key reason why I’m still working here. In a sector that is troubled by questions around power imbalances, the legacy of colonialism, and a very real need to let communities lead their own health interventions, I’m proud to work at PATH because I see the real effort that we, as an organization, put into being more equitable and inclusive.
Our diversity, equity, and inclusion initiatives look both within our organization and in the work that we do around the world. The Equity in Programming Benchmarks give program teams like mine the ability to be intentional and practical in how we bring these lofty goals to life.
How did a benchmarks assessment strengthen the Technical Assistance Platform?
The mission of the Technical Assistance Platform (TAP), funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC), is to strengthen a sustainable and integrated health informatics ecosystem. TAP does this by fostering coordination across countries, providing responsive technical assistance, and leveraging standards-based digital health tools, guidance, and expertise to develop and strengthen new or existing digital health infrastructure.
PATH, Jembi Health Systems, and the University of California at San Francisco each lead a consortium that implements TAP together. We were getting ready for annual work planning as PATH was developing the benchmarks. To help with pilot testing, I had the idea that PATH’s consortium could work collaboratively to conduct the benchmarks assessment. I pitched this to the consortium partners and everyone was receptive.
During our annual TAP work planning retreat, we reviewed the benchmarks and each person filled out the survey, anonymously assigning a score for each indicator. Then, as a group, we reexamined each indicator and discussed the scores. Since everybody was already familiar with the benchmarks framework, we were able to have a robust discussion, sharing reflections and nuanced insights. Through that process, we arrived at final scores.
We then began identifying actions we could take to improve our scores and make the program more equitable. A lot of the changes we brainstormed were in our ways of working. For instance, we realized we could shift ownership, power, and influence by ensuring that local implementing partners led meetings. When they create and facilitate discussions through meeting agendas, they are able to set priorities for discussion and influence how much time and attention we devote to various topics.
Additionally, TAP has in-country coordinators who play a crucial role as liaisons between funders, PATH, and local partners. We conducted a listening session with the in-country coordinators to better understand the challenges they faced in their roles. We heard that they needed more opportunities to share knowledge and lessons among each other, so we are working to set up forums for discussion. We’re also getting ready to present the results to TAP funders, to advocate for funding to convene an in-person workshop for in-country coordinators.
How are other teams at PATH making their programs more equitable?
As an Equity in Programming Benchmarks coach, I have supported other staff members through the process of assessing their projects and making an action plan based on their scores.
In working with other teams, I was excited to see that some global health funders are actively looking for proposals that center equity. It gives me hope to see that some funders are prioritizing equity in this way, and I hope more and more make it a requirement.
Additionally, working with other teams to implement the benchmarks framework has shown that doing the work better doesn’t necessarily require a larger budget. In many cases, the changes that resulted were in how the work is done.
For example, many are including strategies that shift project governance to the communities where the project is taking place and having an impact. This can look like evolving a project partnership model such that partners in project countries strengthen their organizational and leadership capacity and take on increasing project leadership, responsibilities, and autonomy (with proportional decreases in PATH’s leadership) as the project progresses.
The benchmarks also provide an especially useful lens through which to examine gender equity.
What kinds of practical steps can be taken to make global health programs more gender equitable?
By undergoing the benchmarks assessment process, many teams were able to see and understand the gaps in their efforts to design and implement programs that take into consideration and seek to address gender inequities.
In some cases, teams realized they didn’t have the information they needed in the first place. To address this, teams created systems to track the gender makeup of program participants, identify imbalances, and explore outreach/engagement strategies that may lead to more equitable representation.
Others recommended that gender, age, and other demographic characteristics are disaggregated in data collection and presentation where they otherwise may not have been. Similarly, some projects are incorporating gender equity–related learning questions into project monitoring, evaluation, and learning plans.
What’s next for PATH and the Equity in Programming Benchmarks?
It’s very easy for any organization to say they are going to be more equitable—the hard part is enacting change and doing it in a way that is sustainable over the long term. The benchmarks give us the framework for making that happen, and that makes me feel hopeful about the TAP project, PATH, and the sector overall.
We now have this concrete tool, we’ve proven that it can work and produce measurable results, and we just have to keep going. We know this is a journey—we’re not going to get it right every time, but we have to do our best, reflect, improve, and repeat. PATH has committed to “learn out loud,” or share our learnings—the good and the bad—so the sector can learn together, and I think that’s a huge part of what will keep this effort successful.
