Insights and experiences on leadership development: South African Learning Alliance for the District Health System

Overall, current evidence suggests that there is a need to rethink and advance health system learning and management development in South Africa. This policy brief outlines the key conclusions we have reached in the SALAD network on strengthening leadership and management capacity in and for the DHS. The focus in this brief is on the development of leadership capacity.

SALAD collectively recognizes that strengthening leadership and management capacity in the DHS is pivotal to unlocking improved outcomes and responsiveness to citizens and to future implementation of health system reforms such as National Health Insurance. Yet:

• Despite widespread training of individual managers, there is general disillusionment with the value of this training, which is often ad hoc, dependent on external funds and with limited practical applicability to the workplace.
• Proposals for a strategic orientation and systematic approach to leadership development, including succession planning, outlined in key national policy documents, have yet to be implemented.
• Workplaces are often not considered ‘safe learning spaces’ for leadership development, where managers can learn from difficulties, problem solve and innovate.

Overall, current evidence suggests that there is a need to rethink and advance health system learning and management development in South Africa. This policy brief outlines the key conclusions we have reached in the SALAD network on strengthening leadership and management capacity in and for the DHS. The focus in this brief is on the development of leadership capacity.

We propose three key areas for policy action on leadership development:

1. 1. leadership development programmes centered on workplace-based learning;
   2. alignment and integration of leadership development with provincial human resource (‘people management’) systems;
   3. creating enabling health system contexts.