Building leadership and management competencies of national immunization teams in 16 Gavi-eligible countries through the EPI leadership and management programme

Abstract

Background: Strengthening leadership and management competencies among national Expanded Programme on Immunization (EPI) teams will be critical to achieving global immunization targets and other sustainable developmental goals. However, there is little empirical evidence of the effectiveness of investments in leadership and management capacity in the context of national EPI programs. Therefore, we sought to evaluate the EPI Leadership and Management Programme (EPI LAMP), a nine-month certificate program for EPI teams in national Ministries of Health from Gavi priority countries in Anglophone and Francophone Africa and Asia.

Methods: We used a mixed-methods longitudinal evaluation to describe EPI LAMP at four levels: (1) participant response to the training experience based on program administration records and satisfaction surveys; (2) change in management and leadership skill based on competency surveys and exit interviews; (3) change in behavior in the workplace based on exit interviews; and (4) impact of the training on EPI program performance based on the results of each delegate's leadership project.

Results: In the first three cohorts, the programme engaged 16 countries (63 participants) and achieved an 86% graduation rate (54 alumni). Participants demonstrated significant improvement in management and leadership competencies across eight domains with the largest improvement observed in the domain of governance and leadership. Women showed greater increases than men, especially in the domains of Operations Management and Political Advocacy and Dialogue. We observed no difference in the gains made by French-speaking delegates compared to English-speaking participants. Breakthrough projects developed by each team improved EPI program performance, as measured by metrics specific to each project.

Discussion: Our results show that team-based leadership programs can foster improvements in management practice, collaboration, and problem-solving, and that engagement the broader policy and organizational context is needed to foster the systems thinking capacity required to address complex challenges and improve system performance.

Keywords: Health management education; Health systems strengthening; Immunization programs; Leadership and management; Vaccination.