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Reflecting the Complexity of Change in Social Impact Reporting

In a context filled with volatility, uncertainty and ambiguity, we recognize that change cannot be measured through a single metric alone but with meaningful indicators and right-sized approaches to help us gain a fuller and more nuanced understanding of the Center’s impact in the world.
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At Johnson & Johnson, we are bold and ambitious in the social impact commitments we make and hold ourselves accountable to them. When the world came together to set global health goals, from the MDGs to the SDGs, Johnson & Johnson made public health commitments to accelerate progress towards those goals and reported progress annually. 

The Johnson & Johnson Center for Health Worker Innovation (the Center) was founded in September 2019 in response to the human resources crisis in global health—according to the WHO, we are facing a 15 million shortage of frontline health workers to achieve global health goals such as universal health coverage by 2030. The Center is tasked with guiding a $250 million commitment from the Johnson & Johnson Foundation and the Johnson & Johnson Family of Companies to support and champion one million nurses, midwives and community health workers with skills, tools and growth opportunities by 2030. We have continued to report progress against that goal as part of J&J’s ESG strategy in the annual Health for Humanity reports. 

Concomitantly, we created a Monitoring and Evaluation (M&E) plan that sought to take our reporting for the Center beyond just the reach numbers required for J&J’s enterprise reporting to provide a fuller picture of how the Center was helping to drive change. 

Reporting 2021 numbers
(updated as of October 2022)

Grants from the Johnson & Johnson Foundation and the Johnson & Johnson Family of Companies provided support for the Center’s programming that reached 755,233 frontline health workers in 2021, primarily nurses and community health workers. 

  • 75% of frontline health workers reached identified as female.
  • 98% of our programs supported health workers already in the workforce.
  • About 75% of programs in North America supported health workers who identified as Black or Latinx.
  • 55% of the projects supported health workers in Asia and Africa and contributed to 95% of our overall reach.
  • 75 million lives, including children and infants, are expected to have an improvement in their health as a result of the Center’s programming in 2021.

Notable in this data is that we have reached 74% of the 10-year target to reach one million frontline health workers in 2021 alone, primarily as a result of the reach of our digital health programming. We are working to recalibrate our targets and shift towards measuring health system strengthening outcomes for the years ahead in line with our mission to achieve health equity and access to health for everyone, everywhere. 

The next level of impact reporting—exploring the “so what” behind the numbers 

In an effort to go beyond output or reach numbers, we included an outcome survey that asked our partners how many of the actual health workers who benefited from the programs we funded reported an improvement in self-efficacy in areas such as knowledge building, resilience, collaboration and leadership—96% of survey respondents cited an improvement in at least one area. While our grant managers regularly dig deep into the efficacy of our programming with our partners, aggregating of this data portfolio-wide had not been done previously. 

The question then became, would outcome surveys be meaningful enough? Collecting stories was our attempt at giving life to the numbers by providing more context. Below are excerpts from some of the stories we collected. 

“I found my voice in this course through learning how to leverage my strengths after taking the strengths finder assessment. This completely changed my outlook, how I interact with people and how I view myself.”

“Through FAH’s support, including a mix of technical advisory services and capability building efforts, the county government secured a domestic budget line for community health of USD 1.12M for the financial year ending June 2022.” 

“Mai said her pre-delivery anxiety was quickly calmed by nurse Phuong's assured manner, underpinned by her training on early essential newborn care steps as part of a five-year UNICEF project to reduce maternal and neonatal mortality among ethnic minority women.” 

“It is really great to see a poor girl from a countryside where there is no school around to decide to move away from her family at young age and pursue her education with help from the foundation and some of her relatives and be a doctor to help her country.” 

The stories submitted by grantees provide emerging evidence that the Center is realizing its theory of change of improving healthcare by solving the challenges facing frontline health workers. We realize, however, that some of the most meaningful outcomes require substantial time to manifest and these effects may take well over a year to occur and the one-year reporting window may not be well-suited for all grants. This may also account for the low overall participation in the outcomes survey this time around. 

An M&E journey with our partners 

At the Center, our strategy and M&E inform each other. We use our results and insights to decide what programs to scale up and when we have to rethink our approach. But beyond using M&E as a management tool for decision-making, we also bring partners to the table not just as passive contributors of data. We have tried to present results in a way that helps our partners see the impact of the work we have been doing together. 

This by no means provides a finished story of the impact of the Center’s work but our attempt to go beyond reach numbers is a start and signals our appreciation for the complexity of change. The Center’s interventions are grounded in a context filled with volatility, uncertainty and ambiguity. Our task is to recognize all of those not through a single metric alone but with meaningful indicators and right-sized approaches to help us gain a fuller and more nuanced understanding of our impact in the world. We believe the learnings we have gleaned in this reporting cycle will position the Center and its partners to create the meaningful change needed to support health workers and build the strong health systems we need to face complex health challenges.