7 lessons learned about systems change work

Since the HealthConnect Fellowship began in 2017, Mid-Iowa Health Foundation and the fellows have learned many lessons along the way. We invite our community, funders, and fellow advocates to consider the following insights to inform and advance future collective systems-change and advocacy efforts for our kids.

1. Having time and space matters.

The fellowship created a space where the fellows felt safe, supported, and able to take a pause from deadlines and stressors. Having set meetings without an agenda, solely for the purpose of engagement among the fellows, led to deeper levels of connection and trust. Many nonprofit leaders especially noted that they needed a place to talk things through and receive feedback and affirmation.

2. Organizational support is necessary.

Fellows found it challenging to prioritize systems-level work when their organizations had immediate needs arise during the pandemic. When organization leaders saw systems-change work as necessary and supported the fellows with time and space to focus on it, the fellows were more successful in their campaigns.

3. Relationships drive systems change.

“Progress happens through relationships,” said Fellow Nathan Simpson. “It’s a simple truth that I’ve been aware of for some time, but participation in the fellowship really drove that point home for me and transitioned my mindset from knowing that it’s important to understanding that it’s a requirement of systems-level change.”

“First, just because your mission aligns with another doesn’t mean personalities won’t get in the way,” said Fellow Mike Armstrong. “Second, sometimes the most important thing is doing what you can for the mental and emotional state of your partners rather than offering traditional resources for their organization.”

To build relationships that can shift systems, we first need to invest in people to drive that work. Funders have an opportunity to support individuals leading efforts instead of focusing solely on issues and the organizations working on those issues.

4. Funders need to establish a trusting culture.

By allowing the initial fellows to invite new fellows to the table, Mid-Iowa Health Foundation had to venture outside of its established relationships. That required work to foster trust and a commitment to shared values among all the fellows. Staff members participated in sessions and let the fellows guide the experience as though they were on the journey as well.

“You have to steady yourself and put organization and self in places of vulnerability,” said Suzanne Mineck, President of Mid-Iowa Health Foundation. “This is hard when you are used to being in a position of knowledge, power, and control.”

“The issues we were grappling with were so intense, are so intense, and continue to be,” said Denise Swartz, Senior Program Officer at Mid-Iowa Health Foundation. “It’s not that they weren’t always there, but we were just ripped open and talking about them immediately. Everyone had to go there.”

“Mid-Iowa Health Foundation has created an amazing culture that welcomes dialogue, disagreement, vulnerability, and trust,” said Fellow Erin Drinnin. “It’s been rewarding to open myself up to the learning opportunity.”'

5. Sustaining work over the long haul requires intentionality.

One short-term project or campaign is never going to fully address the issue each fellow is working on, even though most grant funding is set up to work in that way. Many efforts require sustained commitment. Funding is needed for that ongoing work, as well as intentional strategies for advocates to recharge and recommit.

“The biggest challenge was my own capacity to keep up, stay mentally present, overcome exhaustion, stress, frustration, and feelings of being overwhelmed,” said Fellow Lina Tucker Reinders.

6. Vision must be coupled with flexibility.

Mid-Iowa Health Foundation stayed committed to the original vision behind the creation of the HealthConnect Fellowship, while allowing the fellows to guide the journey. Staff and mentors provided core resources and learning and set up sessions based on the needs that they heard from several fellows, but also allowed each stage of the fellowship to evolve as the context changed or the fellows’ needs changed.

“It was less about completely knowing where we were going, and more about establishing guiding principles for how the work has to be done,” said Mineck.

The Foundation also emphasized listening and giving fellows and other partners the opportunity to lead.

“If we actually listen, new things can and should emerge,” said Mineck.

7. Listening authentically is crucial to the work.

The fellows learned from their colleagues of color the importance of listening to those who are disproportionately impacted by issues, to absorb their ideas for strategies and solutions.

“This has really shaped the way I assess and view best practice,” said Fellow Lisa Cushatt. “It does not necessarily mean there is one best practice across racial, ethnic, income, gender identity, and sexual orientation groups. From the field where my professional background grew, we took best practice on its face value without strategically assessing how it became a best practice.”

“Prior to the fellowship, I was too caught up in ‘evidence-based’ policies and following the lead of what the ‘experts’ recommended in terms of policy solutions,” said Fellow Mary Nelle Trefz. “While it is always important to have evidence-informed policies and to learn from colleagues and experts, I was completely ignoring the needs and the desires of the populations I was hoping to positively impact.”