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Abstract
Objectives We aimed to understand how capacity building programmes (CBPs) of district health managers (DHMs) have been designed, delivered and evaluated in sub-Saharan Africa. We focused on identifying the underlying assumptions behind leadership and management CBPs at the district level.
Design Scoping review.
Data sources We searched five electronic databases (MEDLINE, Health Systems Evidence, Wiley Online Library, Cochrane Library and Google Scholar) on 6 April 2021 and 13 October 2022. We also searched for grey literature and used citation tracking.
Eligibility criteria We included all primary studies (1) reporting leadership or management capacity building of DHMs, (2) in sub-Saharan Africa, (3) written in English or French and (4) published between 1 January 1987 and 13 October 2022.
Data extraction and synthesis Three independent reviewers extracted data from included articles. We used the best fit framework synthesis approach to identify an a priori framework that guided data coding, analysis and synthesis. We also conducted an inductive analysis of data that could not be coded against the a priori framework.
Results We identified 2523 papers and ultimately included 44 papers after screening and assessment for eligibility. Key findings included (1) a scarcity of explicit theories underlying CBPs, (2) a diversity of learning approaches with increasing use of the action learning approach, (3) a diversity of content with a focus on management rather than leadership functions and (4) a diversity of evaluation methods with limited use of theory-driven designs to evaluate leadership and management capacity building interventions.
Conclusion This review highlights the need for explicit and well-articulated programme theories for leadership and management development interventions and the need for strengthening their evaluation using theory-driven designs that fit the complexity of health systems.
- health services administration & management
- public health
- health equity
- health services accessibility
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Supplementary materials
Supplementary Data
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Footnotes
Twitter @BosongoS, @drbelrhiti
Contributors SB, ZB, BM, FC and BC conceptualised the study. SB conducted the database searching. SB, JE and CK screened abstracts and full texts, extracted data and synthesised data. SB drafted the initial manuscript. SB, ZB, BM, FC and BC contributed to manuscript revision. All authors read and approved the final manuscript. SB is the responsible or guarantor of overall content of this manuscript.
Funding This work was supported by the Directorate-General Development Cooperation and Humanitarian Aid, Belgium in collaboration with the Institute of Tropical Medicine, Antwerp as a part of the doctoral programme of SB, grant number 911063/70/130. The funder had no role in the whole process of the review from the design to the publication.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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