Global Health System Leadership: setting out the E’s and C’s for an impactful agenda ahead

The Health Services Management Centre (HSMC) Dubai are embarking on a journey to combine the civic tradition of University of Birmingham with a research, education, and development offer tailored for the Middle East and North Africa (MENA) region. To do so, HSMC Dubai aim to provide an inclusive space for dialogue and knowledge exchange about the global health challenges we face and the universal healthcare coverage (UHC) and sustainable development goals (SDG) that are needed to enable health security for all.

The launch of our global health system roundtable panel series brought together a range of expert contributions to explore the theme of Leadership for Impact: Shaping the Future of Global Health Systems.

A range of insights were shared by our panel that raised key messages about inspiring leadership for change, promoting an inclusive approach to policy making, and greater recognition of the social determinants of health. Local policymakers and professionals echoed these sentiments and stressed the importance of workforce and population engagement.

Our reflections on the discussion led us to consider leadership for global health impact across the following areas, what we consider as the ‘e’s’ and ‘c’s’ for impact. They are as follows:

Education

An education offer that can support the development of knowledge, skills, and competencies system leadership to happen needs to be realised. The launch of our MSc in Global Health System Leadership provides a landmark contribution to this endeavour with foundations rooted in essential public health functions and building a resilient health workforce tailored to local and regional needs. Decolonising the curriculum is front and centre to our efforts to embed local knowledge and understanding for leadership success. How education encourages inter professional development and how it can be better integrated across the life course - by working with school and college education for example – should be recognised.

Experience

Workforce recruitment, development, and retention represents a key global health system challenge. How we respond to such a challenge requires adapting our leadership styles according to the particular contexts we face. The styles and skills we need include the following:

• leadership that is directive in providing clarity of communication and upholds quality of care;
• leadership that provides transparency and enrichment with regards to career progression and development opportunities;
• leadership that is inclusive where staff and patients are acknowledged and empowered that their knowledge and expertise informs decision making.   
• leadership with compassion that acknowledges the hearts and minds of people and communities. That within turbulent times, any such engagement requires sensitivity and empathy in recognition that people are doing their best,

Environment

Effective leadership of teams and organisations are the key to the creation of inclusive and productive environments.  Global health system leadership for impact requires the translation of these skills into a multi-layered system thinking approach. It recognises the diplomacy skills to influence power from above, as well as skills to work within (intra) and across (inter) different work and field environments. Complementing any leadership approach is the development of intelligence gathering skills to assess population health trends and challenges in order to better understand the social determinants of health. When working in complex and unpredictable environments, leadership also requires a pragmatic approach: that in responding to contextual constraints and conditions, priority setting and making ‘good enough’ decisions is inevitably needed.

Collaboration

Global health system leadership challenges require societal collaboration and the proactive search for government joint working in the face of complex problems. Such a dynamic can bring challenges where competition and rivalry have been and continue to be the dominant worldview. To overcome division requires building trust: where conditions of connection are created where people feel psychological safe to let go and engage in new ways of thinking and working. Communication and transparency are central to trust build activity in order for people to see and feel the potential and actual benefits or working together. Again, pragmatism prevails in finding synergies for mutual benefit with focused activities that can generate improved efficiency, responsiveness, sustainability by working together.

Common Purpose

Holding on to the synergies of collaboration leads us and the discussion into the final condition for impact: building common purpose. Global health system leadership is truly realised when a shared endeavour of health for all is achieved. This means that leadership is distributed and connected (‘us and we ‘) rather than individual and heroic (‘them and me’). This is goal we should also work towards.

In an era of polycrisis, the Middle East and North Africa (MENA) region faces a complex array of health system challenges. Now more than ever is the time for us all to work together and generate global health system leadership for impact.

We hope that these e’s and c’s for global health system leadership continue to be developed and adapted by all, and that HSMC Dubai provides an anchor for knowledge exchange and development.