Insights from Digital Square's Director, Skye Gilbert Yoden

WHILE THIS SEEMS TO BE GRADUALLY CHANGING, IT’S STILL NOT VERY COMMON FOR CEOS AND EXECUTIVE DIRECTORS TO TAKE PARENTAL LEAVE. YOU RECENTLY CAME BACK FROM FOUR MONTHS OF MATERNITY LEAVE. WHAT WAS IT LIKE TO PLAN FOR YOUR ABSENCE, BE OUT, AND THEN RE-ENTER? (AND CONGRATULATIONS, BY THE WAY!)

Thank you! And, you’re right. A year ago, I started researching to see what other executive directors, CEOs, and principal investigators of large government contracts did for parental leave, and realized that most people either don’t choose parenthood, power through with minimal leave, or assume leadership roles like these when their kids are older. My experience was helped by a number of things, including that I got some great advice from two women who had been in a similar position, I’m based in Washington state, U.S., where most workers are eligible for up to 12 weeks of paid parental leave, and I’m fortunate enough to work at PATH which is an institution that is very supportive of families and parenthood. Finally, and most importantly, I work with amazing people at PATH and Digital Square. All of those enabling factors helped me craft a backfill plan that provided stretch roles for members of the team and recruited interim positions to help ensure reasonable workloads. This approach allowed Digital Square to continue having an impact while I was out being a full-time parent. 

Coming back, I spent the first month listening to the team and the digital health community. What stretch roles did people assume very successfully and should retain? What roles do they need partnership to grow into? What roles were people eager to give back? We reviewed the backfill plan with this lens and used it as input into crafting where and how I spend my time now. And… it looks different compared to when I went out, which is a good thing.

WHAT’S DIFFERENT?

One of the things I struggle with most in a leadership role is that I miss being an individual contributor. I love designing programs, weighing in on research, and thought partnering on procurement processes, just to name a few examples. But the truth is, the Digital Square team does all of these things really well without me. So, I have to let go of carrying out weekend analytics projects, writing brainstorming emails to propose process innovations, and line editing research questions. Instead, I heard from the team and community that what you all missed most were my strategic contributions, and my ability to make connections across many different aspects of our work and the high-level frameworks that help us communicate simply and elegantly about what we do and why it’s important. My role is evolving to be more of that.

DID YOU HAVE ANY MAJOR INSIGHTS WHILE YOU WERE OUT?

Parenting in the United States is very different from parenting in other countries, and it’s made me think a lot about Digital Square’s vision of building an ecosystem of choice. If you’re a parent in France, or in India, the guidance you receive from your family and society is a lot more directive. In the United States, apart from physical safety, the general culture is to give parents a lot of freedom. It sounds like a good thing and, for major decisions, it is. But when I’m trying to decide, for example, how to help my son to sleep through the night, I want a clear, concise, default approach that I can adapt if it doesn't work, instead of a recommendation to read five books that all have slightly different approaches before choosing where to start. 

A good ecosystem of choice provides choice where it’s important, but doesn’t overwhelm people with lots of small, nuanced choices. I often worry that in our current digital health ecosystem, we overwhelm stakeholders with small, nuanced choices and exclude them from the big choices. I’d like Digital Square to work to change that.

CAN YOU SAY MORE ABOUT THAT?

Can we get to a world where public health leaders, rather than donors and implementing agencies, choose the digital systems that scale in their country? What if, instead of investors coming to countries and saying, “If you pick product x, we’ll support digital transformation of your health system,” we instead had investors saying, “Can we partner on an open, transparent, rigorous digital procurement to get you the system you want and need?” 

At the same time, can we take trivial choices off the plates of health leaders so that they have the time to focus on the big choices? For example, how many health leaders want to spend an hour-long meeting deciding whether a logo should go in the upper left or upper right corner of a user interface? In that case, imagine how much more efficient it would be to have a default design that leaders have the option to change, rather than holding an hour-long, multi-person meeting on this topic! That hour could instead go toward preparing to make the big decisions.

DO YOU FORESEE DIGITAL SQUARE DOING ANYTHING DIFFERENTLY, FOLLOWING THIS INSIGHT, AROUND BUILDING AN ECOSYSTEM OF CHOICE FOR HEALTH LEADERS?

Our new technical director, Phil Veltsos, and our managing director, Zahra Lutfeali, are currently looking at our work that strengthens the global goods ecosystem and advances country and regional digital health implementations. We’ll be asking for feedback and input this year to inform a pretty substantive strategic refresh in early 2023. I anticipate that the desire for a better ecosystem of choice may impact the way we package global goods and partner with countries to scope digital procurements. I also anticipate that a large part of our country and regional systems work will focus on meeting the digital learning objectives of health leaders, and that as our understanding of those learning objectives continues to deepen, we’ll develop a better understanding of which choices truly are big and critical for health leaders.

IS THERE ANYTHING ELSE YOU WANT TO SAY TO THE GLOBAL DIGITAL HEALTH COMMUNITY?

I just want to thank you for being “in the arena” with Digital Square, and in global health, these past two years during the pandemic. Most of us have had to navigate the tough dynamic of meeting growing demands to support pandemic response efforts, while also grappling with reduced resources to meet those demands—in particular, with many of our teams navigating life adjustments like needing to take medical leave and adapting to new caregiving responsibilities. It would be easy to give up and walk away in exchange for less challenging work, and I’m heartened that so many of us are leaning in and stepping up to support our local and global communities in improving health equity throughout the world. Thank you for all that you do, day in and day out.

About Digital Square: Digital Square is a PATH-led initiative funded by the United States Agency for International Development, the Bill & Melinda Gates Foundation, and a consortium of other partners. Since its inception in 2016, Digital Square has raised more than $100M from 15 investors to catalyze a range of digital health investments—working with ministries of health around the world to align adaptable, interoperable digital technologies with local health needs.

Digital Square’s coalitions, resources, and its portfolio of mature digital public goods for health (global goods) support large-scale, high-quality, sustainable implementations of digital health interventions. The Digital Square team brings together a robust and diverse skillset to play a leading role in digital health transformation efforts designed to close the health equity gap around the world.