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MCH Leadership Competencies

Competency 11: Working with Communities and Systems


Improving the health and well-being of children, youth, families, and communities is a complex process because so many intersecting factors influence the MCH population. Systems thinking recognizes complexity and examines the linkages and interactions among components— norms, laws, resources, infrastructure, and individual behaviors—that influence outcomes. Systems thinking addresses how these components interact at multiple levels, including individual organizations; the collective stakeholders; and the communities where the children, youth, and families reside. The achievement of MCH goals requires leadership within the community and among organizations to advance the collective impact of stakeholders that constitute the larger system.


MCH leaders will demonstrate a working knowledge of:

  • How organizations or practice settings function as systems, including business and administrative principles related to planning, funding, budgeting, staffing, and evaluating health care systems and organizations.
  • How organizations or practice settings function in relation to broader systems, including principles of systems thinking; features and issues of systems (including but not limited to health economics and health policy); principles of building constituencies and engaging in collaborative endeavors; and concepts of implementation science and factors that influence use of research findings in practice.


Foundational. At the foundational level, MCH leaders will:

  1. Relate the mission, vision, and goals of an organization to the broader system in which it belongs to facilitate shared understanding, responsibility, and action.
  2. Practice budgeting, effective resource use, control of standards, coordination of tasks, and problem solving.
  3. Develop agendas and lead meetings/teams effectively.
  4. Identify stakeholders and the extent of their engagement in the collaborative process.
  5. Interpret situations systemically (i.e., identify both the whole system and the dynamic interplay among its parts).
  6. Assess the environment to determine goals and objectives for a new or continuing program, list factors that facilitate or impede implementation of evidence-based/ informed strategies, develop priorities, and establish a timeline for implementation.
  7. Implement accommodations aimed at increasing inclusion and accessibility for all.
  8. Advanced. Building on the foundational skills, MCH leaders will:
  9. Manage a project effectively and efficiently, including planning, implementing, delegating, sharing responsibility, staffing, and evaluating.
  10. Use implementation science to promote use of evidence-based/informed practices.
  11. Develop proficiency in the business and administrative aspects of health care finance and policy.
  12. Maintain a strong stakeholder group with broad-based involvement in an environment of openness, inclusion, and trust.
  13. Build effective and sustainable coalitions to address specific outcomes.
  14. Use community collaboration models (e.g., collective impact) and leverage existing community improvement efforts to define a meaningful role for MCH.

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