Ladder to Leadership Fellow Works to Improve Maternal and Child Health in Northern New Jersey

    • April 10, 2013

The challenge. By 2010, Jane Sarwin had worked for 10 years as a public health practitioner in and around Newark, N.J., improving the health of underserved women and children. But as director of public health initiatives at Gateway Northwest Maternal and Child Health Network, Sarwin realized that she did not have the strong leadership background and mentoring she needed to succeed. How, Sarwin wondered, could she fill this gap in her career development and prepare for the next leadership opportunity?

Steeped in public health values. Public health values and the importance of a healthy lifestyle were instilled in Sarwin as a young child growing up in New Jersey—even though she didn't know it at the time. "My grandmother was something of a pioneer," she recalled. "She ate farm to plate without knowing it was part of a future healthy food movement, and I'll always remember her homemade peanut butter and fresh corn. Thanks to her, living a healthy lifestyle was always a priority for me. When I found out about the study of public health, which was after college, I knew that this was where I had to be."

With a BS from Franklin and Marshall College in Lancaster, Pa., and an MS in public policy from Rutgers University in New Brunswick, N.J., Sarwin first worked at state and federal departments of labor and commerce. In 1996, she joined the University of Medicine and Dentistry of New Jersey in Newark as a marketing manager, and then worked as a patient satisfaction analyst for the university's hospital as she pursued a master's in public health and health policy. After completing that degree in 1999, Sarwin was named director of public health initiatives for Gateway Northwest Maternal and Child Health Network.

There Sarwin worked to boost infant and adolescent immunization rates, bolster health literacy among prenatal women, and advance maternal-child health in underserved populations in northern New Jersey. It was, she said, the "perfect combination of passions and vocation."

"It is not easy work—there are a lot of challenges, and trying to change behavior is not easy," she continued. "Public health is invisible. When it works, it's great. Clean water, clean air, immunizations, healthy babies, breastfeeding—these are all public health achievements that people don't think about."

"While underdeveloped countries struggle with access to vaccines and high mortality rates from diseases that could be prevented, in this country we face a growing vaccine hesitancy challenge. Parents are concerned about the number of shots and vaccine safety while missing the point that their children can be safely protected from many life-threatening diseases when immunized. It is a difficult challenge to educate about prevention when many parents have never seen anyone with these diseases ... but these diseases are just a plane ride away ....

Seizing an opportunity. Sarwin credits being in the right place at the right time in 2009, when she heard about a new leadership training opportunity offered by the Robert Wood Johnson Foundation (RWJF). While working as an evaluator for Baby Basics Prenatal Health Literacy Program—a three-year RWJF-funded (ID # 66445) New Jersey Health Initiatives project working with foreign-born, low-income women (ID # 66445). Sarwin learned about Ladder to Leadership: Developing the Next Generation of Community Health Leaders, created for RWJF by the Center for Creative Leadership in Greensboro, N.C.

From the beginning, Sarwin supported the program's overarching philosophy: that leadership can be developed and learned. "I was very excited when I saw this opportunity," she recalled. "I had never had a strong leadership background, or a chance to study how to be a leader or be mentored. I knew that the program would help fill a gap in developmental needs that I had never addressed."

Ladder to Leadership. From 2008 to 2012, Ladder to Leadership sought to develop a cadre of leaders to enhance the capacity of nonprofit health organizations that serve vulnerable populations, and to cope with an exodus of senior leaders as the baby boom generation retires. The program trained early-to-mid-career professionals to nurture organizational change and work across organizational barriers, develop more constituent-focused services, and adapt innovations from other fields.

The 16-month program included training sessions at the Center for Creative Leadership, one-on-one coaching and mentoring, and a team action project focusing on fellows' own communities. Over five years, Ladder to Leadership trained 219 health care professionals in eight cities and regions: Albuquerque, N.M.; Birmingham, Ala.; central New York state; Cleveland, Ohio; Kansas City, Mo.; Newark, N.J.; eastern North Carolina; and Portland, Ore.

From November 2010 to April 2012, Sarwin was one of 30 fellows in the Newark, N.J., cohort, representing a region with a 9 percent unemployment rate and a 26 percent poverty rate at the time.

Results and perspective. "Through my classroom learning, coaching sessions, and action project, I have gleaned so much," Sarwin said. "I've gained greater self-awareness, methods for communicating with difficult individuals, techniques for running more effective meetings, processes for confronting and avoiding conflict, and the confidence to speak up rather than internalize my thoughts, emotions, and ideas. By overcoming these challenges, I have become a more strategic and creative thinker, and made a stronger impact in my organization and my community than I ever thought possible."

Sarwin is particularly proud of her group's action project, designed not only to test participants' leadership and collaborative skills but also to put them into practice. Sarwin's group created Champions for Children, a project that aimed to reduce childhood obesity by teaching Newark residents about good nutrition and leading a healthy lifestyle. According to a report from the Center for Creative Leadership, "preliminary results showed that participants made significant gains in nutritional knowledge and in behavior change."

"Stakeholders often present the greatest barriers to success," Sarwin said. "However, for my action team, this was not the case. We were adept at reflecting, not pushing the process, and honoring each other's perspectives. Through our collective leadership, we created something sustainable and much greater than we could have achieved individually."

Attaining personal milestones. In February 2012, just as Sarwin's Ladder to Leadership experience was coming to a close, Sarwin received one of 20 leadership grants given out nationwide each year by the Centers for Disease Control and Prevention. Under the grant, Sarwin will continue to work to increase immunization rates for children in East Orange, N.J., with the help of a multisector public health team she has assembled.

"Thanks to my training and experience with team collaboration, I feel assured that this new team, like my action learning team, can achieve something greater than the status quo," said Sarwin. "In public health now, we have to think creatively about how to solve problems by partnering with people who we might not have worked with before. When you talk about boundary-expanding leadership, this, to me, is what it is all about."

In July 2012, when her organization merged with two others and became the Partnership for Maternal and Child Health of Northern New Jersey, Sarwin was named one of five directors. Beyond her continued duties as director of public health initiatives, she coordinates the Essex Metro Immunization Coalition, and oversees five public health programs: breastfeeding, lead poisoning prevention, quality assurance, fetal infant mortality review, and immunization. Her job has changed dramatically, she admitted, and she feels "so fortunate to have the tools, resources, and contacts from my Ladder to Leadership experience to assist me in my leadership journey."

RWJF perspective. RWJF has nurtured leaders in health and health care since its inception. "The Foundation's Human Capital Portfolio aims to ensure that we have a diverse and adequately trained health and health care workforce," said Program Officer Sallie Anne George, MPH. "The Foundation has a 40-year history of supporting the development of 'human capital.' However, we saw a gap concerning the leadership capacity of community nonprofits. We designed Ladder to Leadership to close that gap."

"We recognized that many nonprofit leaders are so focused on providing services to the most vulnerable that they are not looking to see where they fit into the larger system, and where it makes sense to collaborate," George noted. "We hoped that Ladder to Leadership fellows would gain confidence in their ability to lead regardless of their formal position, to think more strategically, and to collaborate effectively.

"There is evidence that we are strengthening collaboration in communities, and hopefully leading them to be healthier places to live, learn, work, and play."

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#LadderToLeadership trained 30 pro's in Newark, N.J., to lead health care nonprofits, including Jane Sarwin

I was very excited when I saw this opportunity. I had never had a strong leadership background, or a chance to study how to be a leader or be mentored.”—Jane Sarwin

I’ve gained self-awareness, methods for communicating with difficult individuals, techniques for running effective meetings, processes for confronting conflict, and the confidence to speak up rather than internalize my thoughts, emotions, and ideas.”—Jane Sarwin