Sustainability of Global Public Health Management and Leadership Capacity Building Programs: A Case Study Review

Background: Health systems strengthening is a global health priority and an essential component of sustainable public health interventions. Building management and leadership capacity is a critical building block of any health system. Three countries in particular, Botswana, Malawi, and Vietnam, have seen improvements in management capacity and specific health outcomes, by adapting the Center for Disease Control and Prevention's Sustainable Management Development Program model. This paper uses a case study approach to identify elements within each country's program that are consistent with the sustainability literature.

Methods: Methods of data collection included: key informant interviews, program observations, and review of current and historical documents. Responses were categorized into common themes, and compared to the literature on sustainability of public health programs.

Results: Case study countries demonstrated progress towards building program sustainability through country ownership and stakeholder inclusion, alignment of the program to the needs of the target audience, and establishment of the program within an existing institution with relevant technical expertise. Observations indicated that funding limitations and changing sources have hindered program coordinators' efforts to strategically plan future activities.

Conclusion: To advance their efforts, the case study countries need to integrate more rigorous monitoring and evaluation, pilot projects, and case study analyses into routine operations. Results of these types of efforts would be beneficial to document and disseminate, as there is an identified lack of evidence on effective interventions for implementing and sustaining management and leadership capacity building programs.