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

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.

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.

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.

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.