Gaps, Challenges, and Opportunities for Global Health Leadership Training

Abstract

Background: Global Health Leadership (GHL) programs are essential for training emerging health care professionals to be effective leaders. Synthesizing knowledge acquired through experience implementing GHL programs can inform future recommendations for GHL.

Objective: To describe the lessons learned, highlighting gaps, challenges and opportunities, during implementation of two GHL capacity building programs, namely the Afya Bora Consortium Fellowship in Global Health Leadership and the Sustaining Technical and Analytic Resources (STAR) fellowship and internship program for global health professionals.

Methods: A mixed methods case-comparison study was conducted, using qualitative data (expert opinion) collected from the Program Directors in order to understand the experiences of the two GHL programs. A structured response guide was used to assess the overall experience in GHL program implementation, operational challenges and reported gaps. Afya Bora and STAR have been implemented for 8 and 2.5 years respectively. Thus, the analysis reflects a snapshot of the two programs at different stages.

Findings: The results reflect knowledge gained through extensive experience in implementing the two GHL programs. Afya Bora has trained 188 multi-disciplinary fellows, and 100% of the African fellows are engaged in leadership positions in government departments and non-governmental organizations (NGOs) in their countries. STAR has placed 147 participants (89 fellows and 58 interns) in more than 25 countries globally. Both programs were successful in strengthening south-south and north-south collaborations for a common goal of improving global health. Implementation of both fellowships identified room for improvement in operational procedures and financing of the programs, and highlighted knowledge and skills gaps, as well as challenges in sustainability of the training programs.

Conclusions: Afya Bora and STAR have had significant impact and have contributed to changing the leadership landscape in global health. Future GHL programs should address sustainability in terms of financing, delivery modalities and domestic integration of knowledge.

Figure 1

Model Program Components for Global Health Leadership Program. The proposed Model Program of Global Health Leadership informed by the experiences of STAR, Afya Bora and reinforced by the literature, presented above and the three key pillars for a successful Global Health Leadership program are borrowed from the Donabedian’s Process Improvement Framework which measures overall quality and align improvement work in health delivery settings [31]. This framework is based on input, process and outcome components. Details about the (input) educational content can be found in Table 1 of this manuscript, while content of the (process) competency components can be found in Table 2. The success metrics of the model stand on the continuous financial, management, mentorship and political support of the implementing partners. However, flexibility is allowed depending on the programmatic design in each of the model components and depends on the available resources, goals of the program, and intentions of the program partners. The length of a program depends entirely, if the fellows are familiar with the host institution or not. If they are not familiar, a longer fellowship increases the value and outcomes of the fellow to the organization.