Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH.

Irene Akua Agyepong,Edith Frimpong,Aku Kwamie,Suzanne M Babich,Elizeus Rutembemberwa,Jill Olivier,Gina Teddy,Uta Lehmann,Boroto Hwabamungu,Lucy Gilson

doi:10.1093/heapol/czx162

Abstract

Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH with support from the Rockefeller Foundation. This paper presents findings of research to verify relevance, identify competencies and support programme design and customization. A mixed methods cross sectional multi-country study was conducted in Ghana, South Africa and Uganda. Data collection involved a non-exhaustive desk review, 34 key informant (KI) interviews with past and present health sector leaders and a questionnaire with closed and open ended items administered to 271 potential DrPH trainees. Most study participants saw the concept of a pan-African DrPH as relevant and timely. Strategic leadership competencies identified by KI included providing vision and inspiration for the organization, core personal values and character qualities such as integrity and trustworthiness, skills in adapting to situations and context and creating and maintaining effective change and systems. There was consensus that programme design should emphasize learning by doing and application of theory to professional practice. Short residential periods for peer-to-peer and peer-to-facilitator engagement and learning, interspaced with facilitated workplace based learning, including coaching and mentoring, was the preferred model for programme implementation. The introduction of a pan-African DrPH with a focus on strategic leadership is relevant and timely. Core competencies, optimal design and customization for the sub-Saharan African context has broad consensus in the study setting.

Highlights

Despite improvements in health outcomes, much of Sub-Saharan Africa continues to lag behind global averages (GBD 2010; United Nations 2013)
The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building
A consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH with support from the Rockefeller Foundation

Summary

Introduction

Despite improvements in health outcomes, much of Sub-Saharan Africa continues to lag behind global averages (GBD 2010; United Nations 2013). Health systems include all the resources, actors and institutions related to the financing, regulation and provision of health actions; where health actions are any set of activities whose primary intent is to improve or maintain health (Murray and Frenk 2000). Health systems are part of the core concern of public health. Drawing on the Institutes of Medicine report, by public health we refer to a discipline whose mission is ‘assuring the conditions in which people can be healthy’ (IOM 1988). Public health seeks to achieve this mission by preforming the three related core functions of assessment (information collection, analysis and dissemination), assurance (implementation) and policy development (decision making)

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Conclusion