A competency-based leadership framework for public health trainers in Meghalaya: insights from a multi-method study

Abstract

Introduction: In the post-COVID-19 world, effective leadership acts as a catalyst in building critical competencies among healthcare providers that significantly improve performance, resilience and quality care delivery. Trainers of public healthcare providers play a vital role in strengthening the training ecosystem and health systems at the grassroots level by cascading these skills to deliver programmatic and non-programmatic trainings. This study aims to develop a leadership competency framework for facilitating curriculum design and implementation of a leadership training programme, LEAD-PHT (Leadership Enrichment and Development for Public Health Trainers) for public health trainers in Meghalaya, India., Methods: The doctoral research is anchored around Kern's six-step framework, and this substudy focuses on the first two steps, that is, problem identification and targeted needs assessment, with an output focused approach. For framework development, a multi-method study comprising literature review, stakeholder in-depth interviews and a modified e-Delphi study was undertaken. A detailed literature review informed the tool development for other methods. Thematic and content analysis was done for qualitative data. The data were sequentially triangulated for role-specific competency mapping followed by consensus generation on the framework and curriculum development strategies., Results: The proposed leadership competency framework for public health trainers encompasses four core competency buckets, namely, leadership behaviours, systems thinking, communication, and capacity building and 21 subcompetencies. Consensus generated via modified e-Delphi study with agreement ranging from 84.2% to 100% (against a predefined agreement of 70%), empirically validated the overall structure of the framework, competency-based objectives, training mode, duration, monitoring and evaluation methods and teaching-learning strategies., Conclusion: The framework's high agreement levels underscore its contextual relevance and ability to inform the development of a de novo competency-based leadership training programme for public health trainers in Meghalaya, India, with a potential to influence leadership programmes in other similar settings in India and other Low- and middle-income countries (LMICs). This research also contributes to the global best practices for public health leadership framework development for trainers. Copyright © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. Published by BMJ Group.