Building capacity for health leadership: The impact of training on competence development in low- and middle-income countries

Purpose of review This narrative review synthesizes recent evidence to examine the design and delivery, the development of competencies, the impact and the sustainability of training programs in low- and-middle-income countries (LMICs). Recent findings Effective training programs are intentionally designed, most effective when experiential learning is incorporated, and contextualized to local needs. Evidence suggests that training enhances leadership competencies such as decision-making, communication and resource management. These were seen to have measurable improvements at individual and organizational levels, leading to better service quality and improved patient outcomes. There is also evidence that blended and online training can expand access while also exacerbating inequities. Therefore, equity should be a central consideration, influencing content, delivery and learner support. A key determinant of sustaining training and competence development is the integration of training into organizational learning frameworks. Summary Leadership training is essential for developing competent health leaders in LMICs. Training can have the greatest impact when it is intentional, shaped by contextual needs, interactive and anchored in workforce application. LMICs should sustain training to achieve lasting improvements in leadership and health outcomes.