System Strengthening & Capacity Building

“Respondents wanted midwifery educators to encourage creative problem-solving and flexibility within the structure of midwifery programs”

- Yamasaki McLaughlin p. 39

Why Needed?
  • Systems are perfectly designed to achieve the results they are achieving right now.  At first glance, when we look at how dysfunctional existing systems can be, this premise seems absurd.  For example, why would people design a system that perpetuates [racial inequity]...?  The answer that emerges from a systems analysis is people are accomplishing something they want now, something other than what they say they want.  They are receiving payoffs or benefits from the status quo, and they are avoiding the costs of change.  Payoffs to an existing system include quick fixes that work in the short run to reduce problem symptoms and the immediate gratification that comes from implementing them.” (Stroh, 2015, p.138)

  • “Burdens are shifted, unexpected results surface, and a host of other systems issues arise from good intentions.  For any complex problem to be solved, the individual players all need to recognize how they unwittingly contribute to it.  Once they understand their own responsibility for a problem, they can begin by changing the part of the system over which they have the greatest control: themselves...The greatest opportunities for lasting change arise when all the players reflect on and shift their own intentions, assumptions, and behavior.” (Stroh, 2015, p. 18)

  • Excerpts from Harper and Hurtado (2007) on Implications for Institutional Transformation derived from 15 years of campus climate research. 


What is Needed?

​Sustained commitment to solving the complex and persistent system-wide problem of inequity in midwifery education and training programs including:

“Other recommendations that respondents made which did not appear in the literature included supporting student employment,... developing sustainable employment models and expanding distance learning programs.”

- Yamasaki McLaughlin p. 50

“Another participant echoed this idea and stated that African Americans did not want special treatment but wanted “sensitivity” to circumstances common among African American women, such as decreased economic resources and single motherhood. Respondents recounted ways their instructors or preceptors had shown flexibility to help them succeed, such as audio recording a class, allowing a student to come late due to childcare and travel issues, trading work hours for tuition, or allowing the student to write an essay instead of taking a standardized test.”

- Yamasaki McLaughlin p. 44