ICAP, Columbia University, USA.
Afya Bora Consortium.
Ann Glob Health. 2021 Jul 12;87(1):63. doi: 10.5334/aogh.3221. eCollection 2021.
In an era of global health security challenges such as the COVID-19 pandemic, there is greater need for strong leadership. Over the past decades, significant investments have been made in global health leadership development programs by governments and philanthropic organizations to address this need. Evaluating the societal impact of these programs remains challenging, despite consensus on the importance of public health leadership.
This article identifies the gaps and highlights the critical role of monitoring and evaluation approaches in assessing the impact of global health leadership programs. Importantly, we also propose the theory of change (TOC) as a common framework and identify a set of tools and indicators that leadership programs can adapt and use.
We carried out an informal review of major global health leadership programs, including a literature review on leadership program evaluation approaches. Current practices in assessing the short- to long-term outcomes of leadership training programs were explored and synthesized. We also examined use of program theory frameworks, such as theory of change to guide the evaluation strategy. We find the TOC approach can be enhanced by integrating evaluation-specific frameworks and establishing broad stakeholder buy-in. We highlight measurement challenges, proposed outcome indicators and evaluation methodologies, and outline the future direction for such efforts.
Most evaluation of current leadership programs is focused on short-term individual-level outcomes, while reports on long-term societal impact were limited. Reciprocal impacts on and benefits for the "host" organizations were not included in evaluation metrics. Most programs had program logic or result chains, but with no well-articulated program theories.
Key stakeholders involved in leadership training programs benefit from the evidence of rigorous program evaluations to inform decisions that address barriers in fostering global health leadership and improving population health outcomes. Insight into reciprocal change in host organizations is important. Evaluation of global health leadership training must go beyond the individual trainee and encompass organizational and community-level impacts. Documentation of long-lasting organizational and societal impacts is essential for donors to appreciate the return on their investment.
Evaluation plays an important role in understanding how leadership development takes place and how it contributes to improving public health outcomes.Making the case for investments in leadership development programs requires robust evidence from monitoring and evaluation strategies that link investments beyond the individual-level to longer-term societal impacts.The first critical step towards a strategy for success is for leadership programs to clearly build, articulate, share, and use their program theories or theories of change.Theories of change help identify the pathways (and potential tensions) through which leadership development programs effect change at the individual, organizational and community levels.Evaluation methods that examine outcomes of leadership programs should be multi-method, multi-level, and where possible include counterfactual outcomes.Allocation of funds to evaluate on-going and long-lasting societal impact of leadership programs should be a routine practice.
在全球卫生安全挑战时代，如 COVID-19 大流行，对强有力的领导力的需求更大。在过去的几十年中，各国政府和慈善组织为满足这一需求，在全球卫生领导力发展计划方面投入了大量资金。尽管人们普遍认识到公共卫生领导力的重要性，但评估这些计划对社会的影响仍然具有挑战性。
本文确定了差距，并强调了监测和评估方法在评估全球卫生领导力计划影响方面的关键作用。重要的是，我们还提出了变革理论 (TOC) 作为一个通用框架，并确定了领导力计划可以采用和使用的一套工具和指标。
我们对主要的全球卫生领导力计划进行了非正式审查，包括对领导力计划评估方法的文献综述。探讨并综合了评估领导力培训计划短期和长期结果的现行做法。我们还研究了使用计划理论框架（如变革理论）来指导评估策略的情况。我们发现，通过整合专门的评估框架和建立广泛的利益相关者的认同，可以增强 TOC 方法。我们强调了衡量方面的挑战、提出了预期结果指标和评估方法，并概述了这方面的未来方向。
目前领导力计划的大多数评估都集中在短期的个人层面结果上，而关于长期社会影响的报告则有限。评估指标中没有包括对“主办”组织的互惠影响和收益。大多数计划都有计划逻辑或结果链，但没有明确的计划理论。
参与领导力培训计划的主要利益相关者受益于严格的计划评估的证据，这些证据可用于做出决策，以解决培养全球卫生领导力和改善人口健康结果方面的障碍。了解主办组织的互惠变化很重要。对全球卫生领导力培训的评估必须超越个人学员，包括组织和社区层面的影响。记录持久的组织和社会影响对于捐助者来说是必要的，这使他们能够认识到投资回报。
评估在了解领导力发展的方式以及它如何有助于改善公共卫生结果方面发挥着重要作用。通过监测和评估战略为领导力发展计划的投资提供有力证据，将投资联系到个人层面以外的更长期的社会影响，这对于投资来说是很重要的。领导力计划的第一步关键步骤是明确制定、表达、分享和使用他们的计划理论或变革理论。变革理论有助于确定领导力发展计划在个人、组织和社区层面产生影响的途径（和潜在的紧张关系）。评估领导力计划结果的评估方法应该是多方法、多层次的，并且在可能的情况下包括对照结果。将资金用于评估领导力计划的持续和长期的社会影响应该成为一种常规做法。
