Welcome to Public Health Leadership

Public health leadership website

The purpose of this website is to catalyse, nurture and support public health leadership. It will advocate for initiating/ expanding efforts to catalyse strong public health leadership at all levels. Public health leadership can be nurtured through providing training/education and experience sharing. Finally, the current leadership can be supported by providing a space for discussion among current public health leaders.

Why public health leadership?

Improving the quality of public health leadership at all levels is critical. Sustainable development goal 3 relates to good health and wellbeing. Its ambitious specific goals to be achieved by 2030 include reducing maternal and under-five mortality; premature mortality from non-communicable diseases; and mortality and injuries from road traffic accidents. It seeks to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases; combat hepatitis, waterborne diseases and other communicable diseases; and strengthen prevention and treatment of substance abuse. It calls for ensuring universal access to sexual and reproductive health; achieving universal health coverage; and substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination. Covid pandemic has further complicated the task of achieving these goals (UN SDG report 2021).

In addition, there is a need to improve equitable access, quality and affordability of health services. Advances in medical and health technologies put cost pressure on health systems amid growing expectations of people for easier access and better quality. Digitization and telemedicine can contribute to meeting some of these challenges.

In view of the above, several authors have called for increased attention to developing public health leadership (Reddy et.al., Day et.al., Manabe et.al., Srivastava et.al.).

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Public health leadership competencies

Competences to lead health care organizations can be drawn and tweaked from required leadership competencies discussed in literature on business leadership.  However, public health leaders also require specific competencies. Covid pandemic has taught us that leadership was exercised by a whole variety of leaders including political, clinical, medical research, and civil society in addition to public health leaders. Therefore, public health leaders need competencies to not only collaborate with them but also influence them based upon scientific evidence.

Achieving many of the health goals require behaviour change at individual and community level. Therefore, public health leaders, particularly at grass roots level, need to work with community leaders. There is growing awareness of the need to address social and environmental determinants of health, which requires influencing inter-sectoral actions. Thus. Public health leaders need to go beyond their organizational boundaries.

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Leaders and managers

Leadership and managerial competences are different (see figure 1).

Figure 1. Intersecting circles of leadership and management

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Each circle has several components, indicating an appropriate set of actions for either leadership or management. In short, the distinctions between the two can be thought of as:

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Effective leadership requires appropriate emphasis on leadership and management (Doing the Right Things Right) to achieve success.

This difference has been translated by many in the literature into a distinction between leaders and managers in the organization. However, achieving results in a specific context would require a mix of leadership and managerial competencies. For instance, a well-functioning programme would largely require performing managerial and some leadership tasks. On the other hand, a new programme requiring considerable change will need significant leadership skills and some management tasks. Therefore, in recognition, terms like “managers who lead’, and ‘leaders who manage’ were coined.

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Leadership development

During the period 1990 and 2010, many agencies invested resources in identifying potential leaders and supported them through leadership development. A variety of frameworks and programmatic approaches were used including classroom learning, experiential learning, mentoring, creation of community of leaders in specific geographies and supporting leadership actions. Sometimes such efforts were combined with improving organizational effectiveness by targeting first-second line of professionals in organizations and including learning on performance improvement. However, this interest has waned since then, perhaps because of disappointment in terms of achieving short-medium term direct results through these efforts.

Another approach was to strengthen leadership competencies of current leaders through mentoring/coaching and awards/recognition to help them expand their zone of influence. Some of these approaches continue although I have not seen a careful evaluation of these efforts in terms of their impact on performance.

References

Day M, Shickle D, Smith K, Zakariasen K, Oliver T, Moskol J (2012). Time for heroes: public health leadership in 21st century. Lancet 2012; 380: 1205–06.

Manabe Yukari C, Yohana Mashalla, Carey Farquhar and Nelson K Sewankambo (2020).  Leadership training to accelerate progress in public health in sub-Saharan Africa: time for action. www.thelancet.com/lancetgh Vol 8 October 2020

Reddy Srinath K, Manu Raj Mathur, Sagri Negi and Bhargav Krishna (2017).  Redefining public health leadership in the sustainable development goal era.  Health Policy and Planning, 32, 2017, 757–759

Srivastava VK, Kunwar R (2018). Leadership in public health. Indian J Public Health 2018; 62:165-6

UN (2021). Sustainable Development Goals Report 2021

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