Women Global Health Scholars Create Great Possibility

By Shipra Shukla

By Shipra Shukla A group of 28 women global health scholars recently completed a yearlong pilot program designed to address worldwide gender inequities in science and academia. The scholars, all identified as potential scientific leaders in their respective countries, met with UCSF women faculty and staff twice over the course of a year as part of the Women's Global Health Scholars (WGHS) program. Launched in 2006, WGHS is a pilot program designed to equip women health scientists from developing countries with the knowledge and skills needed to enter into and sustain leadership positions. The scholars represent a wide range of disciplines and are at varying stages of their careers. Nancy Padian, director of UCSF's Women's Global Health Imperative, leads the program with support from the Fogarty International Center, a component of the National Institutes of Health, which addresses global health challenges through innovative and collaborative research and training programs. "The problems that women face in academic positions or in scientific leadership positions are universal," says Padian. "I think all of us, myself included, are amazed by the universality." Addressing a Global Problem Indeed, universities and organizations around the world are concerned about the lack of women in leadership positions in science and academia. The United Nations Educational, Scientific and Cultural Organization (UNESCO) cited a 46-page report by the InterAcademy Council earlier this year that states: "On the whole, the disproportionately small number of women in the science and technology enterprise, particularly in leadership positions, is a major hindrance to strengthening science capacity worldwide. Immediate action is needed to help remedy the underrepresentation of women in scientific and technical fields." According to UNESCO, simply looking at the numbers can be deceiving. In Argentina, for example, women make up 51 percent of the research industry, but there are still very few deans of universities or editors of scientific journals, and women earn less pay than their male counterparts. UNESCO's Institute for Statistics is working with organizations to come up with ways to monitor and measure the solutions. These include the Glass Ceiling Index, which compares men's and women's chances of reaching top academic positions, and developing a model questionnaire to help countries conduct surveys and track the careers of those with PhD degrees. The WGHS program is modeled after leadership programs such as Drexel University's Executive Leadership in Academic Medicine, the Public Health Institute's International Family Planning Leadership and a remote learning course at the Association of Commonwealth Universities. The program consists of two one-week courses at UCSF, monthly virtual meetings and ongoing mentorship. The sessions were led by senior women faculty and staff from the schools of medicine, nursing and pharmacy, as well as the UCSF Center for Gender Equity, UC Berkeley School of Public Health and other Bay Area institutions. The courses covered topics that included writing for publications, powerful, nondefensive communication, negotiation strategies, developing and managing budgets, and building personal strengths and style, among others. The program began with a five-day course at UCSF last fall, in which the scholars identified the biases, hierarchies and structures that women face in academia, and were introduced to strategies that can be used to help overcome them.
Nancy Padian

Nancy Padian, PhD, executive director, Women's Global Health Imperative. Photo by Susan Merrell

In the months that followed, the scholars used Internet technology to review career milestones and worked with mentors both from UCSF and in their home countries, in addition to developing their own geographically based, small working groups. They came together for the second and final week of courses last month, when they assessed their success and gained deeper insight into gender inequities. Each of the scholars had exceeded the goals they had set at the start of the year. The weeklong meetings focused on gaining deeper insight into gender barriers, developing strategies to counter them and providing targeted mentorship, which can continue beyond the conclusion of the program. The final session of the week focused on institutional change. It included an examination of gender analysis by Amy Levine, director of the UCSF Center for Gender Equity. In addition, each scholar presented a review of her scientific accomplishments over the year. The session had a particular impact on Marcela Barguil, a clinical psychologist and research fellow in psychiatric genetics from Costa Rica. "We looked at how gender and the rules of society teach you to be more passive. Today, we had Amy Levine showing how gender gets in the way of negotiating for women," said Barguil. "You have to understand that in our country, things work a little differently, so a lot of these skills I didn't have. Being able to hear Amy [speak] is a wonderful experience and shows me that there is great possibility." Developing Future Leaders The WGHS program exemplifies UCSF's Strategic Plan by "developing the world's future leaders in health care delivery, research and education." The program also illustrates how the University is serving the international community, in part by identifying and addressing the problem of promoting sustainability in global health sciences. "Developing the human resources [building capacity] that will sustain and advance science and health care in resource-constrained settings is essential," says Haile Debas, executive director of UCSF Global Health Sciences. "In order to achieve this new paradigm, partnerships between institutions in developed and developing nations must be created. Our vision is a network of collaborative relationships throughout the world." The WGHS program is an example of just such a collaborative relationship. The support and mentorship follows a partnership approach in which both scholars and faculty mutually benefit. Many of the scholars thanked Padian for being a mentor, as she in turn thanked them for being one to her. "Mentoring is very much self-serving," says Padian. "The group was talking about mentors giving them confidence, yet nothing gives you more confidence than being a mentor. So it's a complete win-win. You feel as if you can help someone, but in doing so, you gain confidence as well. The best mentoring comes from being a mentor." The virtual network allows the mentoring relationships to translate into a support system, which then leads to better implementation of the leadership concepts the scholars have been introduced to at UCSF. The program is in line with the larger mission of the Women's Global Health Imperative, "developing innovative health initiatives that address gender imbalances." The scholars are able to link changes at the leadership level to change at the grassroots level. Confronting Challenges One of the more moving moments of the WGHS program was the closing session, in which the scholars shared their feelings of isolation and how it had had a negative impact on their self-worth. Most of the room was in tears as each scholar expressed how difficult it was for her to counter gender barriers on her own. A scholar from Botswana recounted, "It gets so hard when you are told your work is not good and you feel like you're the only one. It impacts you. You feel that low self-worth."
Purnima Madhivanan

Purnima Madhivanan shares how the Women's Global Health Scholars program helped her exceed her research goals. Photo by Shipra Shukla

In fact, helping more women scholars assume leadership positions is directly related to achieving excellence in research. One early success story is UC Berkeley PhD degree candidate Purnima Madhivanan, whose research examines HIV transmission in women in India. Madhivanan experienced numerous challenges directly related to gender barriers throughout the data collection phase of her research in India. "I was working in a hospital and I wanted to hire staff that would adhere to international data collection standards. But because I was a woman and I was younger, the hospital director discounted me," says Madhivanan. "I knew I wouldn't be able to guarantee the validity of my research and might be forced to drop out of the PhD program unless I just decided to go out on my own." In going out on her own, Madhivanan encountered numerous other challenges. However, since she was now in a decisionmaking position, she was able to implement changes that actually increased the validity of her results. "Retention is a big problem when you do research in India," says Madhivanan. "The women in the research studies just don't come back for follow-up visits for a number of reasons. I was able to hire a female van driver and provide child care at the clinic. The women felt more comfortable and our retention rate increased from the expected 60 percent to 95 percent - that's the international standard." Madhivanan also set up infrastructure in India that would allow for support of other scientists who want to conduct research. Earlier this year, she established the Public Health Research Institute in Mysore. The organization provides workshops in epidemiological methods and data collection, and imparts much of what Madhivanan has learned in the WGHS program to scientists in India, thereby addressing the problem of sustainability in her country. "I'm trying to make it [scientific research process] more transparent. I don't want people to lose hope or give them a false perspective," says Madhivanan. "I feel like information is empowering. That's what I'm doing: providing people with information." Looking Ahead Over the course of the year, the success of the program was measured by tracking several factors, including the number of publications, grants accepted and successful negotiations.
Women's Global Health Scholars reflect on what they've learned over the year

Women's Global Health Scholars reflect on what they've learned over the year. Photo by Susan Merrell

Moving forward, the Women's Global Health Imperative hopes the pilot phase can expand to train new cohorts of scholars on a yearly basis. The plan is to have scholars from this first group act as mentors to future cohorts, thus expanding the support network worldwide. Employing new technology factors is a vital component in maintaining the program. Qualitative and quantitative data will be collected through web forums, monthly check-ins will take place via online conferencing and quarterly progress reports will be filed online. The networks created using Internet technology seem to be going strong. Nguyen To Nhu, senior program officer at Family Health International's office in Vietnam, sent an email recently, saying, "Keeping in touch with the scholars via Skype is helpful. It helps me with my career goal setting." Madhivanan echoes that. "We can't change right away how people in our country think and act, or treat us differently because we are women. But after a course like this, we change how we react and feel empowered to do more. Eventually, we will be able to change the thinking." Related Links: UCSF Begins to Implement Strategic Plan
UCSF Today, October 19, 2007 Women's Global Health Imperative