Empowering Healthcare Leaders in Low- and Middle-Income Countries: Lessons from a Leadership Development Series in Madagascar

INTRODUCTION: As investment in surgical healthcare in low- and middle-income countries (LMICs) increases, local clinical leaders, namely surgeons, are expected to successfully manage growing teams; oftentimes even without formal leadership or system-based practice training, The World Children’s Initiative, in collaboration with Operation Smile and Centre Hospitalier de Reference Regionale (CHRR) in Madagascar, created the Leadership Development Series (LDS) to address this often-overlooked capacity building training gap. METHODS: LDS was composed of 7 sessions, delivered to 14 participants via hybrid virtual and in-person training at CHRR between February and August 2021. Session feedback was collected via anonymous 9-question Likert-scale survey. Overall course impact was assessed via the EvaluLEAD method, a 103 Likert-scale and qualitative question survey focused on individual experiences at the individual, team/organization, and community level. RESULTS: A total of 8 (57%) of participants were women and 6 (43%) were men. Ten of 14 (71%) participants were Chief/Major of their respective clinical services, and 2 were surgeons. The LDS provided most impact per participant at the personal level (284/4), compared with the organization level (203/4) and community level (111/4). On conclusion of LDS, participants had implemented 5 new hospital-based quality improvement projects, 4 participants added new leadership roles, and 8 were actively applying course takeaways within their clinical teams (Fig. 1).CONCLUSION: LDS proved that through a combination of local and international partnership and a hybrid education model, a diverse group of hospital leaders at a regional hospital in Madagascar could acquire valuable skills necessary to lead both within their teams and within their hospitals.