Advancing Black Feminism In Public Health

Dr Quinn M. Gentry

By Dr. Quinn M. Gentry

Welcome to my blog on “Advancing Black Feminism in Public Health.” My goal is to move black feminism from the margins to the center of public health by applying 10 key principles as legitimate and comprehensive frameworks for adequately addressing health threats and related social and structural determinants of health in the lives of black women and girls.

Principle 6:
Focus on changing organizations in advancing black feminism in public health

In this blog, I highlight the significance of organizational change as fundamental to principle no. 6 (of 10): Frame change within the context of organizational, structural, and individual transformation in advancing black feminism in public health.   


Organizational change refers to the systemic tasks needed to build capacity in key areas that increase organizational effectiveness. For public health, I focus on organizational capacity-building to enhance programs for better participant outcomes.

“Challenging power structures from the inside, working the cracks within the system...requires learning to speak multiple languages of power convincingly.”

Understanding organizations’ governing protocols, approach to personnel, policy guidelines, and partnership selection is crucial to implementing organizational change within public health initiatives. Once organizations are operating at full capacity, individuals participating in programs and services are better positioned to commit to the behavioral changes needed for optimal health outcomes.


1. Consciousness-raising

As a public health program evaluator, I am deeply troubled by some administrators’ “blame the participant” narrative when programs fail to meet key performance measures. Armed with Hill Collins’ insistence that we challenge power structures from within, I integrated organizational performance measures into evaluation designs for diverse health programs funded at the federal, state, and foundation levels. This afforded me the opportunity to observe organizations’ effectiveness in program implementation using measures beyond individual change in behaviors. While it is beyond the scope of this blog to provide an exhaustive list, I have shared some organizational-level data pertaining to recurring themes about organizations’ limitations in program effectiveness.

Lessons Learned in Building Organizations' Program Capacity (non-exhaustive)

2. Complementary approaches

The conceptual frameworks below contribute to the process of organizational change and are especially helpful in public health and social service agencies.

  • Tuckman’s stages of organizational development hypothesizes that organizational/program capacity-building, leadership development, and high performing teams undergo a process of: (1) forming, (2) storming, (3) norming, and (4) performing.
  • Gender responsive frameworks begin with rigorous gender analysis exploring how inequalities stemming from gender norms and roles shape health behavior. Gender analytic findings are plotted along a continuum, where organizations’ practices are mapped as: (1) gender blind; (2) gender exploitative; (3) gender accommodating; (4) gender aware; or (5) gender transformative. Within pubic health, organizations identified as less than gender transformative should strive for gender equity, by either adjusting its gender responses or completely redesigning health systems to address barriers to health information and health services.
  • Trans-theoretical model-stages of change theory outlines five specific stages for developing better health through lifestyle and behavioral changes, that organizations must have ample program capacity to navigate public health program participants through: (1) pre-contemplation, (2) contemplation, (3) preparation, (4) action, and (5) maintenance. 
  • Health equity frameworks focus on mapping strategies aimed at full and equal access to opportunities that enable black women and girls to lead healthy lives. 

3. Change Organizational Capacity

In advancing black feminism in public health, I built a body of work for assisting black women- and girls-serving organizations to achieve optimal levels of effectiveness. My working definition of “organizational effectiveness” is the intersection of efficacy (ability to achieve its mission, goals, and objectives) and efficiency (working within allotted resources). I operationalized my definition of organizational effectiveness into “10 domains of organizational excellence”. Each domain requires competent leadership and management for high organizational performance over long periods of time and should be an area of focus for improvement to achieve organizational excellence.

10 Domains OF Organizational Excellence at a Glance

4. Call to Action

“Organizational Leadership is a contact sport: you really learn what matters most after you lead a team through a crisis with internal threats to your integrity and systems and external factors aiming missiles at all of your competitive advantages and resources.”

As black feminists advocating for health equity, we must be bold enough to challenge power structures from inside the public health and medical systems, as we observe cracks in the very systems and organizations funded to fix patients whose health is a matter of life and death. As bold, brilliant thought leaders, never lose sight of what MATTERS most in Public Health! 

Leadership M.A.T.T.E.R.S. in Public Health Framework

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