Leslie Mancuso, Ph.D., RN, FAAN

A GLOBAL APPROACH TO MANAGEMENT

Leslie Mancuso, Ph.D., RN, FAAN
President and CEO
Jhpiego 

For 40 years and in 155 countries, Jhpiego has worked with front-line health workers to design and implement low-cost, innovative solutions to prevent the needless death of women and their families. Since Leslie Mancuso, president and CEO, began working at the organization in 2002, Jhpiego’s budget has grown from $5 million to $230 million and the number of programs has expanded from four to 119.

The non-profit has a global staff of more than 1,600 employees — of which 80 percent are in the field. The growth Mancuso spearheaded has been rooted in her belief that Jhpiego must develop the capacity of countries to create a well-prepared network of healthcare professionals and a strong health system that they can build upon to care for themselves.

Here, Mancuso discusses the challenges of accomplishing this growth and on how her management strategies are impacted by the cultural and social practices of staff and patients around the globe.

Q: How is Jhpiego focused on bringing quality healthcare to women and families around the world?

A: To achieve our mission to prevent the needless deaths of women and their families, Jhpiego designs innovative healthcare solutions that break down barriers to healthcare for the world’s most vulnerable populations. By drawing on our technical expertise and 41 years of experience in the field — as well as the creativity and science of Johns Hopkins University — Jhpiego develops approaches that are high impact, safe and effective, low-cost and accessible to all, home to hospital, village to city.

Q: As president and CEO, you oversaw tremendous growth in the organization. What was your greatest challenge during that growth?

A: When I arrived at Jhpiego in 2002, I quickly realized that in order to expand the reach of our work we had to build a truly global culture from the ground up. Of our 188 employees, 65 percent were Americans and a majority of them were based in our Baltimore headquarters, not in the field, where our programs were being implemented.

As a result of years of recruitment and development, today, 85 percent of our more than 2,100 employees, many of whom are nurses, midwives or doctors, are based in the field and a vast majority work in the regions where they are originally from. These are individuals who know firsthand the challenges of providing care in the vulnerable places where we work. Their expertise has helped save countless lives.

Also, while we are a non-profit, we still need a consistent pipeline of funding to accomplish our mission. I redirected our efforts to diversify our funding stream, focusing heavily on new program development and creating a rigorous system of compliance and accountability. Over the past 12 years, our budget has grown from $5 million to $280 million and the number of programs has expanded from four to 119.

Q: What have you learned about management from working in so many different environments throughout the world?

A: During the course of my career, I have traveled throughout many, many parts of the world and met extraordinary healthcare champions, both within Jhpiego and outside of the organization. While we are all dedicated to improving the lives of women and their families, each country has their own set of cultural and social practices we have to be mindful of. We may know that husbands and elder family members have to be brought into the conversation on birth spacing if we are going to get women access to services they need and save their lives. In Nigeria, for example, we realized that having male counselors visit men to discuss this sensitive topic was the way to go.

The U.S. staff also consists of members of the communities they serve. They understand the burden of accessing care and unequal gender roles, and they know how to address these issues.

That same lesson applies to managing an international organization operating in 50 countries. There isn’t a one-size fits all approach that will work in every country. We must trust and listen to our staff and partners on the ground — heed their advice and expertise, and use their institutional knowledge to make informed decisions.

I’ve also learned that it’s important to be hands on, to be near the people and to see what’s happening on the ground. That is why I spend almost 80 percent of my time traveling, visiting our field offices and meeting with our staff and partners in-country. This not only motivates our employees, but also helps me keep a finger on the pulse of the organization.

Q: How does Jhpiego work with corporate partners and foundations?

A: Jhpiego has a long and successful history of working with corporations and foundations, including ExxonMobil, Chevron, GE Foundation, Merck, Laerdal Medical, GlaxoSmithKline and the Bill & Melinda Gates Foundation. We approach working with them as a partnership, whereby we explore common interests and take joint actions that align with our mission. Their support can be in the form of funding, expertise or in-kind contributions, but the goal is universal, to develop innovative new ideas and approaches to advance the public health field, leverage our impact and save lives.

Q: What is next for Jhpiego going forward?

A: Importantly and deeply, Jhpiego believes that where you live should not determine if you live.

For more than four decades, Jhpiego has worked hand-in-hand with countries — their governments, local organizations, communities and the private sector — to help make that goal a reality. Carrying that commitment forward, Jhpiego will focus its efforts on leading the Maternal and Child Survival Program, the U.S. Government’s largest global health program aimed at reducing maternal, newborn and child deaths. This groundbreaking new initiative will introduce key life-saving interventions in 24 high priority countries such as Afghanistan, South Sudan and Myanmar. Jhpiego will also address the unique health needs of adolescents, a demographic that makes up one quarter of the world’s population and will build the foundation of the world’s future. Finally, Jhpiego will begin field testing several exciting new low-cost global health innovations that have the potential to change how care is delivered and save lives.

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