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Learning Together: Building change collectively to support organizational health equity capacity

Cette ressource est également disponible en français.

This document is part of a series of knowledge products to be written to support the Organizational Capacity Initiative, which is the second iteration of the NCCDH’s Learning Together series. The first Learning Together series offered resources related to population health status reporting and was released in 2012.

A model for successful organizational change

Based on literature and learning circle discussions, this document focuses on the concept of collectively built change processes. While there is a focus on health equity capacity, the content of the document is applicable to collectively built organizational change of any kind.

A learning circle process identified support from senior leaders in the form of early and sustained engagement, followed by continued buy-in and commitment, as necessary for successful organizational change. Further, learning circle members noted that organizations wishing to increase health equity capacity should:

  • incorporate health equity priorities in all areas of organization-level strategies;
  • allocate time and resources to capacity-building;
  • develop strong internal and external relationships;
  • create a collective understanding of health equity concepts; and
  • measure the impact of change. 

Important role of middle management

This document describes the importance of moving away from top-down directives, encouraging organizations to invest into models centered in collaboration from a variety of sources across all organizational levels.

Middle managers are described as being in a unique position to communicate laterally as well as vertically within an organization. They also have an essential role in strategic, administrative, leadership, decision-making and communication roles.

Understanding individual and organizational context for change is noted as necessary to effectively lead change on an organizational level. The resource also explores the necessity of support from senior management in the form of ongoing engagement, as well as for clear communication around all aspects of the desired change.

Discussion guide

The included discussion guide will help organizations thoughtfully incorporate strategies to improve capacity for health equity through organizational processes.


Use this resource to

  • discuss with middle and senior management what actionable approaches can be taken to be successful with collective organizational change;
  • embed health equity action in all processes and strategies within your organization; and
  • support middle management in implementation of organizational changes through development of quality improvement goals.


View other resources from our Organizational Capacity Initiative


Related resources

Public Health Speaks: Organizational standards as a promising practice for health equity (2013)

Learning pathways for public health middle managers (2018)

Webinar recording: Increasing the success of health equity change initiatives: Organizational enablers and barriers (2019)

Webinar recording: Governance and decision-making for health equity (2019) 

Webinar recording: Living health equity values within public health organizations (2019) 


National Collaborating Centre for Determinants of Health. (2020). Building Change Collectively to Support Organizational Health Equity Capacity. Antigonish, NS: NCCDH, St. Francis Xavier University.

Tags: Competencies & organizational standards, Leadership & capacity building, Organizational capacity, Document, Report / Document, Learning Together