Enhancing Title V Workforce Capacity to Address Complex Challenges: Impact of the National Maternal and Child Health Workforce Development Center

Abstract

Introduction: The National Maternal and Child Health Workforce Development Center provides training, coaching, and consultation to Title V programs. The flagship experience is the Cohort program, a 6-8-month leadership development program where Title V programs convene a multisector team to address a pre-selected state/jurisdictional challenge related to health systems transformation. The overall objective of this paper is to demonstrate the impact of skills developed via the Cohort program on state/jurisdictional capacities to address complex challenges.

Methods: Qualitative, post-Cohort evaluation data were analyzed using inductive and deductive coding and the "Sort and Sift, Think and Shift" method. Themes and supporting text were summarized using episode profiles for each team and subsequently organized using the EvaluLEAD methodology for identifying and documenting impact.

Results: Teams brought an array of challenges related to health systems transformation and 94% of teams reported achieving progress on their challenge six-months after the Cohort program. Teams described how the Cohort program improved workforce skills in strategic thinking, systems thinking, adaptive leadership, and communication. Teams also reported the Cohort program contributed to stronger partnerships, improved sustainability of their project, produced mindset shifts, and increased confidence. The Cohort program has also led to improved population health outcomes.

Discussion: Through working with the Center, Title V leaders and their teams achieved episodic, developmental, and transformative results through application of Center tools and skills to complex challenges. Investment in the MCH workforce through skill development is critical for achieving transformative results and solving "wicked" public health problems.

Keywords: Leadership; Maternal and child health; Program evaluation; Transformation; Workforce.

Fig. 1

Map of state team participation in the Cohort program, 2014–2020 (n = 53)^{1, 2}. ¹The Center has connected with nearly all non-Cohort participating states and offered/hosted other tailored programming to meet state needs, including customized technical assistance support and 3-day, in-state skills institutes. ²States/jurisdictions can participate in the Cohort program more than once. Oftentimes teams are addressing different complex challenges than in previous Cohorts and are comprised of different individuals; therefore, our sample size was determined by counting each time a state/jurisdiction participated in the Cohort program.