Leadership & Engagement for Improved Accountability & Delivery of Services Framework (LEAD)

What does good program leadership and management entail?

According to the WHO, “Leadership is about creating a vision, communicating this to others, developing strategies, motivating people, and negotiating for resources and other support to achieve their goals. [Managers] make decisions on how best to use staff, budgets, drugs and other resources, and are responsible for making things happen. In the resource constrained and difficult environments of many low – to middle-income countries, a manager must also be a leader to achieve optimum results.”

Strengthening leadership and program management at the subnational level creates an important bridge between the national, subnational, and community levels. This bridge contributes to achieving outcomes and overall strengthening of a high-quality health system. Community engagement is increasingly becoming a critical part of this work, making programs more sustainable and aligned with the local context while facilitating local ownership.

What is LEAD and why is it useful?

LEAD supports programs in defining, prioritizing, and solving operational challenges while also leveraging opportunities for process improvement and building management and leadership skills. The framework uses the actual current challenges and opportunities that health program managers face and helps them resolve these challenges using already available resources.

LEAD draws upon organization development, leadership learning, participatory action research, quality improvement methods, and principles of community engagement to improve operational delivery at the district, clinic, and village level. LEAD employs a systematic process, involving continual problem diagnosis, action planning, implementation and evaluation to build capacity for change management through a series of workshops, meetings, trainings, coaching, and mentoring over the course of the planning cycle.

Who should use this tool and how?

LEAD is intended for use by subnational health program managers and directors, officers (medical, nursing, environmental health, surveillance, M&E, health promotion), pharmacy managers, and administrators working at the provincial, district, health facility, and community levels, as well as national health program managers, who want to: 1) develop leadership and management capacity, 2) increase productivity, coverage and quality of operations, 3) empower frontline workers to take ownership, solve challenges, and act on decisions, and 4) optimize limited resources, while integrating for efficiency with other programs.

The framework guides the user through distinct modules to identify key stakeholders, prioritize operational challenges and opportunities to improve operations, determine solutions, develop indicators to measure progress in implementing those solutions, and integrate successful solutions into the health system. Implementation of the LEAD Framework is best followed with steps to develop and implement a process improvement action plan, and can be used alongside other tools in the MEI toolkit including the Malaria Budget Advocacy Framework and the SUSTAIN Tool.

LEAD tool