A way ahead for:-

Leadership and Management training for Public Health Professionals in India

Leadership is a key building block for any health system (World Health Organization, 2007), and effective leadership is associated with a range of positive organisational outcomes in health settings, including staff turnover, performance, and work satisfaction (Ciccone et al., 2014; Gilmartin & D’Aunno, 2007).

They said that professional education "has not kept pace with these challenges, in large part due to fragmented, outdated, and static curricula that produce ill-equipped graduates... [including] weak leadership to improve health-system performance." (Frenk et al., 2010) Frenk et al.

Summary of the article

Primary objective:

To document the design of the LMP, specifically the curriculum, the evaluation approach, and its underlying theory.

Figure 2. Intended learning outcomes for the Leadership & Management Programme.

Methodology:

A prospective multistage multimethod study was conducted from October 2019 to February 2022. Data sources included a scoping review, qualitative interviews, workshops and focus groups, document review and an online survey. The program was based on co design inspired from work of four international co authors Oliver Johnson,  Ann H. Kelly, Nick Sevdalis and Kerrin Begg. They emphasizes the need of student to be contributor in study design. The study design was based on Kern six stage model for medical curriculum development.

The quantitative data was summarised descriptively, with thematic analysis used. Qualitative interview data, verbatim transcripts were uploaded onto Nvivo 12 software.

Ethical permission were granted from King’s College London and the Sierra Leone Ethical & Scientific Review Committee.

Kern’s Six Stage Model

Result & Discussion:

Identification of the issue and evaluation of general needs (Stage 1):

It all began with an assessment of Sub-Saharan Africa's leadership development programs.  28 doctors were interviewed, and a leadership and management program was created. Participants recognized a variety of leadership issues, such as.  failure of the administrative system, etc. A leader's leadership style can be influenced by a variety of factors, including family, education, religion, and leadership training.

Initial programme design (Stages 2–4):

Based on qualitative study three high level goals were identified:-

Goal were based on four major themes:-

Assessment methods would include continuous assessment(attendance register and a mentor's report), a written exam, and a structured oral exam where the QI projects would be presented and discussed.

Stage 5 of implementation:

This entails securing political backing, consulting widely with the health industry, determining the resources that are required, and identifying obstacles.

Evaluation and feedback (Stage 6):

A mixed method approach was employed for evaluation using Kirkpatrick's (2006) method (response, learning, behavior, and results).

The co-design process produced five key issues that needed to be discussed further:

The expansion of the leadership domain to encompass management was the crucial phase in the entire process. Co-designing was used, which was another strength. According to Ward et al. (2018), co-design approaches can help in health care settings to make sure that treatments are created to take into account practical considerations, stay focused on their intended goal, and have a stronger motivation for adoption.

Conclusion:-

In light of the need of strong and resilient health systems in all settings, effective leadership has received more attention in recent years. Studies on health leadership development programs in Sub-Saharan Africa, however, have revealed that many of them are lacking a clear theoretical basis in leadership or enough adaptation to assure sustainability and local relevance.

Importance of Leadership and Management Training :-

Training is investment in future. Leaders can bring change. We can learn from the Covid pandemic; the change in the right direction and at the right time is the need of the hour. Being a good Doctor means also being a good manager. Its not only about treatment, but also about the logistics, data entry, staff management , sanitation , economical management and many more things.  A bit of training would help a lot not only to professional, but also to the overall improvement of health care system.

Public Health Cadre :-

Leadership skills are necessary for all health professionals, and in health systems, authority is frequently divided among professional cadres. These cadres must work together to create consensus on choices and reform (NHS Improvement, 2019). There are several instances where people mostly belonging to non health sector background are dealing with the health sector. Inspite of having a complete knowledge in health sector field the Doctors mostly lack the leadership & management skills. Even if they do they don’t get enough chance.The Public Health Cadre is the way forward to improve the health sector by training the public health professionals. A path full of opportunities & threat.  It will aid to ‘Heal in India’ initiative.

References:

• World Health Organization. (2007). Towards better leadership and management in health: Report of an international consultation on strengthening leadership and management in low-income countries. https://apps.who.int/iris/ handle/10665/70023

• Ciccone, D. K., Vian, T., Maurer, L., & Bradley, E. H. (2014). Linking governance mechanisms to health outcomes: A review of the literature in low- and middle-income countries. Social Science & Medicine, 117, 86–95. https://doi. org/10.1016/j.socscimed.2014.07.010

• Gilmartin, M. J., & D’Aunno, T. A. (2007). Leadership research in healthcare. Academy of Management Annals, 1(1), 387–438. https://doi.org/10.5465/078559813

• Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., (2010). Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756), 1923–1958. https://doi.org/10.1016/S0140-6736(10)61854-5

• Kirkpatrick, D. J., & Kirkpatrick, J. D. (2006). Evaluating training programs: The four levels (3rd ed.). Berrett-Koehler Publishers.

• Ward, M. E., de Brún, A., Beirne, D., Conway, C., Cunningham, U., English, A.. (2018). Using co-design to develop a collective leadership intervention for healthcare teams to improve safety culture. International Journal of Environmental Research and Public Health, 15(6), 1182–1117. https://doi.org/10.3390/ijerph15061182

Citation to original article:-

• Johnson O, Bawoh M, Begg K, Bell N, Jalloh MB, Gbao D, N'Jai A, Sahr F, Samai M, Kelly AH, Sevdalis N. Designing a leadership and management training curriculum for undergraduate health professions students: Lessons from the University of Sierra Leone. Glob Public Health. 2023 Jan;18(1):2222322.