A qualitative needs assessment of strategic leadership training for the Nigerian health sector

In Nigeria, there is a dire need for the development of leadership competencies in the health sector to enable strategic leaders to manage and lead better so that teams, units and organizations can fully use and continuously develop their potential to transform health systems. Current models of leadership capacity building address the need for core technical and management competencies [1, 2]. However, skills relevant to managing complex relationships and navigating the political environment in sub-Saharan Africa are also critical [3]. This study therefore conducted an assessment of strategic leadership training needs among relevant stakeholders to better inform the development of the course structure for the Doctoral Programme in Health Leadership Africa (DRPH-HLA). The study adopted a descriptive, cross-sectional qualitative design. We used in-depth interviews and document review to explore leadership training needs and inform the DRPH-HLA curriculum. Three in-depth interview guides were designed for three categories of respondents: policymakers, tutors (lecturers), and prospective DRPH students. A total of 18 respondents were interviewed (10 policymakers, six tutors, and two prospective students). In addition, 21 key documents were reviewed. Ethical approval was obtained, and informed consent was secured from all participants. The environment for strategic leaders was found to be difficult and unconducive. Key competencies identified included policy-related skills, managerial skills, and interpersonal/ethical competencies. Formal training was deemed essential, and curriculum content should include courses on contextual health factors, health system challenges, and interdisciplinary problems. To ensure that trained leaders can effectively lead health institutions, follow-up training, regular supervision, and mentoring are essential. What is already known on this topic Leadership capacity-building models in sub-Saharan Africa mainly emphasize technical and management competencies [1, 2]; however, relational skills are also critical in the sub-Saharan context [3], necessitating context-specific training to enhance health system resilience [4]. What this study adds This needs assessment revealed suboptimal core competencies, low advocacy for Nigerian strategic health leaders, and limited formal training institutions and recommended a contextualized DRPH curriculum that integrates coursework, research and internships to address environmental barriers. How this study might affect research, practice or policy By informing tailored DRPH curricula, this study could guide policy for trainee service bonds, resource incentives, and enabling environments to foster resilient African health leaders to strengthen subnational and national systems and for evidence-based policymaking.