One health leadership and team building training.

BackgroundAntimicrobial resistance (AMR) is a global public health concern currently mitigated by antimicrobial stewardship (AMS). Pharmacists are strategically placed to lead AMS actions that contribute to responsible use of antimicrobials; however, this is undermined by an acknowledged health leadership skills deficit. Learning from the UK’s Chief Pharmaceutical Officer's Global Health (ChPOGH) Fellowship programme, the Commonwealth Pharmacists Association (CPA) is focused to develop a health leadership training program for pharmacists in eight sub-Saharan African countries. This study thus explores need-based leadership training needs for pharmacists to provide effective AMS and inform the CPA’s development of a focused leadership training programme, the ‘Commonwealth Partnerships in AMS, Health Leadership Programme’ (CwPAMS/LP).MethodsA mixed methods approach was undertaken. Quantitative data were collected via a survey across 8 sub-Saharan African countries and descriptively analysed. Qualitative data were collected through 5 virtual focus group discussions, held between February and July 2021, involving stakeholder pharmacists from different sectors in the 8 countries and were analysed thematically. Data were triangulated to determine priority areas for the training programme.ResultsThe quantitative phase produced 484 survey responses. Focus groups had 40 participants from the 8 countries. Data analysis revealed a clear need for a health leadership programme, with 61% of respondents finding previous leadership training programmes highly beneficial or beneficial. A proportion of survey participants (37%) and the focus groups highlighted poor access to leadership training opportunities in their countries. Clinical pharmacy (34%) and health leadership (31%) were ranked as the two highest priority areas for further training of pharmacists. Within these priority areas, strategic thinking (65%), clinical knowledge (57%), coaching and mentoring (51%), and project management (58%) were selected as the most important.ConclusionsThe study highlights the training needs of pharmacists and priority focus areas for health leadership to advance AMS within the African context. Context-specific identification of priority areas supports a needs-based approach to programme development, maximising African pharmacists’ contribution to AMS for improved and sustainable patient outcomes. This study recommends incorporating conflict management, behaviour change techniques, and advocacy, amongst others, as areas of focus to train pharmacist leaders to contribute to AMS effectively.

Students’ Attitudes Towards Different Team Building Methods

Gender is a key factor operating in the health workforce. Recent research evidence points to systemic gender discrimination and inequalities in health pre-service and in-service education and employment systems. Human resources for health (HRH) leaders’ and researchers’ lack of concerted attention to these inequalities is striking, given the recognition of other forms of discrimination in international labour rights and employment law discourse. If not acted upon, gender discrimination and inequalities result in systems inefficiencies that impede the development of the robust workforces needed to respond to today’s critical health care needs.This commentary makes the case that there is a clear need for sex- and age-disaggregated and qualitative data to more precisely illuminate gender-related trends and dynamics in the health workforce. Because of their importance for measurement, the paper also presents definitions and examples of sex or gender discrimination and offers specific case examples.At a broader level, the commentary argues that gender equality should be an HRH research, leadership, and governance priority, where the aim is to strengthen health pre-service and continuing professional education and employment systems to achieve better health systems outcomes, including better health coverage. Good HRH leadership, governance, and management involve recognizing the diversity of health workforces, acknowledging gender constraints and opportunities, eliminating gender discrimination and equalizing opportunity, making health systems responsive to life course events, and protecting health workers’ labour rights at all levels. A number of global, national and institution-level actions are proposed to move the gender equality and HRH agendas forward.

Background: Canada is currently experiencing a health workforce crisis, reflective of the global workforce challenges. Integrated models of care such as Ontario Health Team (OHTs), in Ontario, Canada are important examples of large-scale reform focusing on local populations and a regional health workforce. To ensure a workforce that meets the needs of their population, a regional approach to workforce planning is required. While significant work has been published on health workforce planning, there are few examples of how regional integrated care systems can apply workforce planning models to address population needs. The overall aim of this project is to inform policy to support regional workforce planning for integrated care strategies. Approach: An exploratory mixed methods single case study design was used. The study was conducted in partnership with one Ontario Health Team that served as the case. Lived experience patient partners were core members of the research team, providing input throughout the project. The Health Workforce Planning Model was identified in a scoping review and applied to the OHT. A mixed methods approach included multiple regional, provincial, and federal data sources to describe the population, health needs, and service providers. Interviews were conducted with the OHT leaders and community members to obtain insights into workforce planning from the regional context. A document analysis of publicly available workforce planning documents across all OHTs was completed. A deliberative dialogue was held to obtain input from the OHT, provincial and federal decision makers to inform policy recommendations. Discrete analysis was conducted for each data set and the quantitative and qualitative data was merged through a process of pattern matching. Results: Using the Health Workforce Planning Model, we attempted to capture data related to service requirements (population data demographics, health status, health services utilization) and service capacity (health workforce) to examine fit and identify gaps. Data were gathered by a complex web at federal, provincial, and regional levels. Six federal/provincial data sets were used to describe the population. Nineteen of 93 regional organizations completed surveys to obtain workforce data. A review of 54 OHT websites found only 12 OHTs had documents mentioning health workforce planning, including strategic plans (66.7%) and other reports (e.g. year-end). Fourteen interviews were completed with regional OHT leaders and community partners, providing insights into contextual factors including current status of health workforce planning, driving forces, capacity for change and solutions. Key recommendations focused on the need for: 1) health workforce planning governance structures and accountability provincially and within OHTs, 2) standardized and comprehensive data and reporting across all sectors and 3) infrastructure at the provincial level and within regions to support health workforce planning. Implications: Despite the crisis in the health workforce there remains significant challenges in obtaining data to inform workforce planning and little infrastructure within integrated care systems such as Ontario Heath Teams to support regional planning. Ongoing efforts need to focus on consistency and standardization of workforce data and building in targeted resources and infrastructure to support regions to proactively plan for population needs.

BackgroundMaternal mortality in the Middle East and North Africa (MENA) region decreased significantly between 1990 and 2017. This was uneven, however, with some countries faring much better than others.MethodsWe undertook a trend analysis of Maternal Mortality Ratios (MMRs) of countries in the region in order to understand differences in reduction across countries. Data were extracted from several databases for 23 countries and territories in the region on measures of women’s empowerment, availability of vehicles and human resources for health (as a proxy to the three delays model). We identified factors associated with MMR by grouping countries into five different Stages (I-V) of obstetric transition from high to low MMRs.ResultsAmong the four Stage II countries, MMR is associated with “antenatal care coverage (% with at least one visit)” and “medical doctors per 10,000 population”. Among the eight Stage III countries, MMR is associated with “Gender Parity Index in primary and secondary level school enrolment” and with “nursing and midwifery personnel per 10,000 population”. Among the 10 countries and one territory in Stages IV and V, MMR is associated with “GDP per capita”, “nursing and midwifery personnel”, and “motor vehicle ownership/motorization rate”. Two factors were associated with changes in MMR from the period 2006–2010 to 2011–2015: 1) change in adolescent birth rate (r = 0.90, p = 0.005) and 2) Gender Parity Index in primary level school enrolment (r = − 0.51, p = 0.04).ConclusionThough impressive reductions in MMR have been achieved across countries in the MENA region since 1990, governments should realize that there exists an opportunity to learn from each other to bring MMRs as close to zero as possible. Immediate steps in the right direction would include investment in human resources for health, particularly nurses and midwives; measures to improve adolescent sexual and reproductive health; and greater investments in achieving gender equity in education.

This article is the lead article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH) under the theme of leadership and management in public health and will be published article by article over the next few weeks. The journal has invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog.This opening article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented.Despite rising attention to the acute shortage of health care workers, solutions to the human resource (HR) crisis are difficult to achieve, especially in the poorest countries. Although we are aware of the issues and have developed HR strategies, the problem is that some old systems of leading and managing human resources for health do not work in today's context.The Leadership Development Program (LDP) is grounded on the belief that good leadership and management can be learned and practiced at all levels. The case studies in this issue were chosen to illustrate results from using the LDP at different levels of the health sector.The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.

Francis Omaswa: tackling the shortage of health workers

This article aims to analyze the integrated communication strategy grounded in marketing paradigms implemented by the Siwalima Museum to enhance youth engagement. The study is motivated by the declining interest of younger generations in cultural institutions such as museums, and the urgent need for adaptive and innovative communication approaches. Employing a qualitative methodology, this research uses a case study design, participatory observation, and in-depth interviews with museum administrators, young visitors, and strategic partners. Findings reveal that Siwalima Museum structures its communication strategy through six key stages: situational analysis, goal setting, audience targeting, message formulation, communication program development, and evaluation. These strategies manifest in thematic events, digital media utilization, creative advertising, and student-specific discount programs. The museum also applies three core marketing approaches: internal marketing through team building and staff training; integrated marketing by aligning product, price, and promotion; and relationship marketing via partnerships with schools, communities, and private sector actors through the “Friends of Siwalima Museum” initiative. The novelty of this study lies in its integration of marketing principles within public and educational museum communication, offering a holistic approach that bridges cultural values with the communication preferences of younger audiences. The study recommends that other cultural institutions adopt integrated communication strategies responsive to youth dynamics to ensure social relevance and institutional sustainability in the social sciences and humanities domain.

BackgroundHealth workforce data and planning capacities have made significant progress across EU countries in recent years. However, the health and care workforce crisis is deepening and the implementation of evidence-informed workforce strategies remain limited. Effective workforce planning and forecasting is a continuous, adaptive process that requires institutionalisation to ensure projections are regularly evaluated and aligned with evolving developments and policy priorities. This integration must translate into action across healthcare and education systems. To achieve this, strong multi-level governance is needed involving national and regional authorities and engaging a wide range of stakeholders -professional groups, training institutions and sectors beyond health. Transsectoral and inclusive governance and inclusive approaches are essential to balance interests and enable coordinated implementation. These implementation challenges raise important questions on how countries can build capacity to effectively govern and operationalize workforce planning in a sustainable way. the link between evidence and practice, and organise and manage the institutionalisation of health and care workforce planning.ObjectivesThis workshop seeks to identify how institutionalisation can bridge the gap between evidence and practice and support resilient workforce planning systems across Europe. It will examine the governance structures and capacities required to effectively implement planning and forecasting mechanisms drawing on evidence from both national and European experiences. Adapting a health system and multi-level governance approach, the workshop highlights the importance of strengthening implementation by focusing on organisational and managerial conditions and the institutional frameworks responsible for translating health workforce data and projections into actions. The session will contribute to the development of concrete policy recommendations to support sustainable and adaptive workforce planning.The workshop builds on findings from EU funded HEREOS project - a flagship initiative to strengthen health workforce planning - and incorporate best practices from across Europe. Bringing together public health expertise in health and care workforce, governance and leadership, the session connects global, European and national perspectives. Structured as a policy dialogue, the workshop begins with an introduction overview by the organisers highlighting selected results from the HEREOS project. This will be followed by a critical reflection on implementation and sustainability and a practical country example illustrating opportunities for innovation. A moderated panel discussion will then align insights and generate recommendations. The concluding discussion will foster knowledge exchange among the participants, encouraging actionable strategies to address the global health and care workforce crisis.Key messages• Bringing evidence into practice and building institutional capacities for implementation is key to effective health workforce planning and policy.• Future health workforce planning may benefit from closer connections with public health expertise, governance, and leadership approaches.Speakers/PanellistsGareth ReesUniversidad ESAN, Lima, PeruMarius-Ionuț UngureanuBabeș-Bolyai University, Cluj-Napoca, RomaniaKasia CzabanowskaMaastricht University, Maastricht, Netherlands

Background The lack of community leaders with effective health leadership skills has fostered the proliferation of Health Leadership Programs, which are essential in training and enhancing leaders’ skills, enabling them to return to their communities to change behavior and improve health, consequently sustaining healthier communities. This paper examines the development of the Morehouse School of Medicine’s Community Health Leadership Program at the Satcher Health Leadership Institute. It identifies its structural components and its developmental process. Methods This community-academic partnership was developed through several in-depth meetings and a thorough feedback process involving several stakeholders. Literature reviews, Iterative feedback sessions, and group discussions involving these partners culminated in the development of a structured training program. The collaborative process yielded a series of didactic sessions, field experiences, application experiences, networking experiences, and public speaking opportunities for participants, among others Lessons Learned The thematic lessons learned include the importance of Community Engagement, Leadership Skills Development, and the use of evidence-informed Decision-Making, Collaborative Problem-Solving, Cultural Sensitivity, and Adaptability, Resource Mobilization and Sustainability, Empowerment of Marginalized Groups, Health Literacy and Behavior Change, Challenges of Limited Resources, and the Multiplier Effect of Training, among others. Conclusion The Community Health Leadership Program (CHLP) seeks to give participants the information, abilities, and resources they need to successfully lead health programs, advocate for legislative reforms, and encourage community involvement. The Program establishes a long-lasting basis for enhancing health outcomes and decreasing inequalities by prioritizing culturally appropriate methods, interdisciplinary cooperation, and evidence-based practices. acts as a catalyst for the development of healthier, more resilient communities by equipping up-and-coming leaders with the ability to effect change.

Background: Leadership development is an important part of strengthening Human Resources for Health (HRH) and navigating the complex, dynamic, and interdependent nature of health systems in low- and middle-income countries (LMICs). These health systems are frequently characterized by uncertainty, resource limitations, and fragmented service delivery, necessitating contextually grounded and adaptive leadership on all levels. Despite this, conventional public health staff training programs in LMICs often overlook leadership competencies and fail to incorporate learner-centric, affective, and experiential learning methods. The objective of this review was to synthesise evidence from leadership development initiatives implemented in LMICs to identify common success factors, gaps, and contextual adaptations, and to propose a strategic framework for strengthening leadership capacity among human resources for health (HRH) especially for LMICs. Methods: This study employed a qualitative thematic synthesis of nine leadership development initiatives implemented across LMICs between 2000 and 2022. Initiatives were selected based on defined inclusion criteria: targeting HRH, reporting contextual adaptation, and including participatory or applied pedagogies. Braun and Clarke’s six-step framework for thematic analysis was applied to extract and synthesize key findings from the selected case studies. Results: Four major crosscutting themes emerged from the synthesis: (1) contextual relevance and local ownership; (2) adaptive and participatory pedagogies; (3) multilevel stakeholder engagement; and (4) progressive skill development and reflective practice. Based on these findings, we propose a comprehensive strategic approach to leadership development that integrates adult learning theories, blended instructional designs, and adaptive training ecosystems. Emphasis is placed on co-design with stakeholders, including policymakers, healthcare providers, academic institutions, and communities, to ensure relevance and sustainability. Discussion: Aligning global standards with local contexts, this approach positions leadership development as a central driver for the strengthening of health systems. The paper offers practicalrecommendations for health system leaders, training institutions, and global health policymakers committed to building resilient and inclusive HRH leadership in LMICs. Drawing on thematic insights from nine leadership initiatives, the study emphasizes the importance of participatoryteaching-learning methods, stakeholder engagement, and adaptive training ecosystems.

Global Health Service Partnership: building health professional leadership

Workforce planning ensures that the health workforce is aligned with current and future population needs. Engagement with partners and knowledge users is a leading practice in planning and is essential for planning to be successful. The goal of this study was to explore the considerations and processes involved in integrating engagement into workforce planning. Through a case study of primary care workforce planning in Toronto, we address the role of engagement, how it can be integrated into planning, and how lessons from engagement support spread and scale of effective workforce planning. In the course of engagement with five Ontario Health Teams between September 2023 and February 2024, we learned that there is considerable enthusiasm for planning, but that support is needed, and that engagement guides investment and strengthens relationships. We offer guidance for leaders with respect to actualizing engagement and building capacity for health workforce planning across the health system.

Effective healthcare leadership is essential for ensuring high-quality patient care, enhancing organizational performance, and fostering the professional development of healthcare professionals. This paper seeks to review some of the different approaches and styles of healthcare leadership basing information on 12 relevant and up-to-date literature sources. The different leadership styles that emerged from the literature include opinion leadership, ethical leadership, authentic leadership, servant leadership, distributed leadership, situational leadership, transformational leadership, and digital leadership. In addition, clinical leadership and the role of innovation in healthcare leadership are discussed within the paper. The key point of the main conclusion shows that it is necessary to have adaptive strategies in healthcare leadership in relation to the possible rise of issues in the healthcare sector. The review also outlines the criticality of patient-centered leadership in creating effective healthcare interactions and organizational effectiveness. The literature captures leadership practices of effective communication, motivation, and team building. All these three form the core of patient-centered care. In conclusion, this research is emphasizing on leadership importance in healthcare while indicating its ways of implementations. Flexible and patient-centered leaders in health are important to address needs within a complex, dynamic health care system and bring change for better delivery of health care and health outcomes. Therefore, the findings from this review imply that adaptive leadership competencies among healthcare professionals should be developed to a higher level as it meets the unprecedented challenges and demands of the industry. Consequently, effective health care leadership practice will ensure optimal patient care, organizational performance, and a healthy and vibrant health care workforce.

The results from school-based, peer-led psychosocial smoking prevention programs suggest that this approach is effective in reducing smoking onset rates. This paper provides a theoretical rationale for using peer leaders as a major strategy in school-based drug abuse prevention programs and reviews the available literature assessing the impact of peer leadership in such programs. Furthermore, some of the practical issues involved in selecting and training peer leaders and teachers are discussed, and process evaluation data from studies conducted at the University of Minnesota are presented. The authors conclude that peer leadership can be an effective vehicle for drug abuse prevention among adolescents. However, increased research is necessary to clarify the conditions under which the impact of peer leaders is enhanced.