Identifying leadership competencies for Indian public health leaders using LEADS framework

Purpose There are few studies exploring leadership competencies for public health leaders in low-middle-income countries, including India. The purpose of this study is to discern the leadership competencies the public health leaders might need by adapting the LEADS framework of leadership competencies and understanding the characteristics of the Indian public health system that influence the practice of these competencies. Design/methodology/approach The authors followed a sequential multiphase mixed-method design. Phase I included a concurrent literature review and in-depth interviews of senior public health leaders in western India. Phase II was an online leadership competency survey (10 statements each for knowledge, skills and behaviors) of 88 district-level public health leaders. Phase III included focus group discussions with 33 district-level public health leaders to better understand survey results. Findings The practice of leadership competencies was determined by health system characteristics, governance and managerial processes, health system culture and sociopolitical environment in which the health system shared an interface. In total, 20 out of 30 competencies were categorized under the first two LEADS domains of “Leading self” and “Engaging others.” “Achieving results” was affected by the centralized nature of health programs’ planning and monitoring. The health systems context provided limited scope to practice competencies under the “Developing coalitions” and “Systems transformation” domains. Practical implications Findings from this study can help address gaps in leadership competencies and tailor leadership development programs. Originality/value Past research on leadership competencies in India has used Western frameworks without adaptation. Through this study, the authors tried to conceptualize and contextualize competencies for Indian public health leaders adapting the LEADS framework.