Strengthening Leadership for Emergency Preparedness: New Insights from Six Countries

A strong, resilient health system is more than its infrastructure, products, and services—it depends on the people who lead and manage it. A new multi-country study affirms that with the right tools, structured processes, and self-agency, public health teams can use data to learn together, make timely collective decisions, and implement locally appropriate solutions to complex challenges—including emergencies.

Published in Evaluation and Program Planning, the study evaluates Management Sciences for Health’s (MSH) Leading and Managing for Results in Pandemics (LMRP) program, implemented in Kenya, Malawi, Nigeria, Peru, Rwanda, and Uganda with funding from the U.S. Centers for Disease Control and Prevention (CDC) under the “Building Capacity for National Public Health Institutes (NPHI)” project.

The findings reinforce one of MSH’s core beliefs: strong leadership, management, and governance (LMG) systems are essential for effective public health emergency prevention, preparedness, and response. Drawing on five decades of experience, MSH has long recognized that when leadership development is embedded within broader health system strengthening (HSS) efforts, it helps health institutions recover from shocks and sustain high-quality, accessible, and lifesaving services.

Leadership in Action

Unlike traditional didactic training or executive leadership coaching, LMRP emphasizes team-based, experiential learning. Over 14 to 15 weeks, diverse teams of health workers applied structured tools, including the Challenge Model, root cause analysis, and stakeholder mapping, to solve real challenges in their day-to-day work.

To assess impact, the evaluation used an outcome harvesting approach to identify tangible changes in behavior, collaboration, and system performance. The results were clear:

• Participants reported stronger leadership and management skills.
• Team members communicated more effectively and made decisions more collaboratively.
• Leaders shifted from reactive to proactive approaches during outbreaks.
• Health teams grew more autonomous, empowered, and less reliant on external support.

Participants didn’t just learn—they led. Many teams applied their new skills beyond COVID-19 to strengthen local responses to cholera, dengue, and Ebola. Others used their experience to streamline workflows, improve coordination, and advance priorities related to global health security (GHS) and routine service delivery.

Strengthening Systems from the Inside Out

The study showed how increased leadership and management capacity rendered teams of public health practitioners better equipped to work together: effectively managing the response at their levels, enabling better stewardship of scarce resources, more transparent decision-making, evidence-informed prioritization of urgent activities, improved coordination and collaboration, and greater resilience in the face of current and future public health threats.

The evaluation highlights how the LMRP helped build the habits, confidence, and structures that underpin resilient health systems. Even in a short timeframe, participants became more agile, more effective, and better prepared to face the unexpected.

A Proven Model for the Future

As countries work to prevent and prepare for future health threats, MSH offers a proven and adaptable model to strengthen leadership and improve performance at every level of the health system. Building on lessons from LMRP, the findings of this study, and five decades of experience, MSH developed the Leadership and Management Accelerator (LMA)—a scalable, field-tested model for strengthening LMG systems in any context.

The LMA is already helping health institutions around the world generate and implement breakthrough solutions to their most pressing challenges.