Leadership Incubation Program for Health

(2019 – Present)

The Bill & Melinda Gates Foundation (BMGF) awarded AIHA a second capacity development project in 2019 to support the development of a cadre of public health leaders fully capable of supporting the Ministry of Health’s strategies and objectives as the government works towards developing a strong, fit-for-purpose health system to meet the needs of its citizens.

The Leadership Incubation Program for Health (LIP-H) strives to develop future leaders in public health and provide opportunities for them to make significant contributions to the health sector at all levels of leadership. The program recruits, develops and nurtures young professionals who display exceptional commitment and passion for the health of the population and who demonstrate health sector leadership potential.

Context and Background

Ethiopia faces a high disease burden. High morbidity and mortality rates are attributed to preventable infectious diseases and nutritional deficiencies. Ethiopia’s Federal Ministry of Health (FMOH) is best positioned to respond to these challenges. The FMOH seeks to promote the health and well-being of all of its citizens by providing, promoting, and regulating a comprehensive package of high-quality and equitable, preventive, curative, and rehabilitative health services. However, providing services effectively is not only a technical matter; it also requires good management and leadership from the government.

The Health Sector Transformation Plan (HSTP) Mid-term Review conducted in December 2018 recommended leadership, management, and governance capacity-building efforts to address critical gaps in the health sector, explicitly calling out areas in need of improvement, including the inadequate capacity to implement a decentralized health system; low utilization of health services; lack of follow-up on the implementation of policies and guidelines; insufficient application of standards and protocols; and poor coordination of public-private partnerships in health.

To address these issues, the FMOH must be able to rely on its greatest asset – its people – to plan, guide, develop, and implement need-driven national health programs and initiatives. Ministry staff must excel not only in public health but also in thinking and acting as true leaders and visionaries for their country’s complex health system. Specifically, skills such as critical leadership, communications, and management need to be strengthened to permit them to emerge as leaders of the FMOH, which is critical to the national effort to promote the health and well-being of all Ethiopians.

The Project

To meet the health sector’s leadership challenge, the FMOH launched the Ethiopia Leadership Incubation Program (LIP) in 2019. With support from the Bill & Melinda Gates Foundation and based on a concept paper and then a full proposal developed by AIHA, the LIP was born. This project is being co-managed by AIHA, the Human Resource Development Directorate of the FMOH, and the International Institute for Primary Health Care – Ethiopia (IPHC-E).

Project Design and Implementation

The LIP project aims to support the FMOH, its agencies, and Regional Health Bureau staff to develop a cadre of highly trained public health leaders in Ethiopia at all levels so that they can equitably deliver quality health services to improve health outcomes. The LIP is a competency-based, six-month in-service training program, with three trainings envisioned over an initial 18-24 month period. The project was extended in 2021 for another two years and another three trainings were added, one of which has been completed; the second currently in progress; and the third, to be comprised exclusively of female trainees, is in the recruitment phase right now.

Participants in the training program are health professionals currently working in the health sector or health science education graduate interns who:

aspire to work in public health leadership, program management, or supervisory roles, and
are preparing for higher-level leadership roles and are early in their careers

This includes experienced case team leaders or early career supervisory/ management staff with little to no experience in program leadership or management. The LIP-H provides leadership training and experience, so fellows become more competent in these areas. Fellows are recruited and selected through a competitive process from various healthcare institutions- particularly the FMOH, Regional Health Bureaus (RHBs), and its agencies from Addis Ababa and the regions.

LIP training in session

A team of dedicated trainers and coaches were identified from multiple sectors and deployed to deepen the knowledge of leadership literature, raise self-awareness, and unlock the leadership potential of the trainees. This is being done through a blended learning approach that combines traditional classroom learning with individual mentoring, coaching, and experiential learning opportunities.

The project provides the fellows with leadership experience in areas such as planning, implementation, management, and evaluation through specialized hands-on training and mentorship. LIP fellows are also assigned to a ﬁeld site where they are provided opportunities to develop competencies as skilled program leaders and provide services that will improve public health.

In addition to meaningful and challenging on-the-job activities, the LIP-H provides formal instructor-led didactic training with a focused and short block course of 4-5 days maximum. Skills are further developed through hands-on developmental activities that enable LIP-H fellows to learn and practice skills essential to leading and solving public health problems. The curriculum is interdisciplinary and applicable to as many participants as possible. The training includes essential and universal leadership skills such as conﬂict management, negotiation, customer service, time management, as well as strategies to develop interpersonal skills.

A strategic problem-solving course is also provided, which involves identifying an existing problem in a real-world setting and applying learned skills and methods to develop solutions that address public health issues. The fellows choose topics related to their current work in a group, design capstone projects, and propose solutions that could be implemented at their respective institutions.

Emphasis is also placed on developing competence in program and operations planning, program management and evaluation, oral and written communication, team building, negotiation, ethical consideration, emotional intelligence, and conflict resolution.

During their training period, the responsibilities of the fellows include designing, developing, implementing, and evaluating programs, supervising staff, establishing and maintaining community partnerships, managing timelines and project work plans, or other public health-related duties as assigned. Individual assignments and opportunities were made available either at their primary training site or elsewhere to provide accelerated on-the-job learning.

Graduating from the LIP-H program signifies that the fellow has gained extensive experience in public health leadership and developed both the management and leadership competencies needed to serve as an effective public health leader in Ethiopia and beyond. Graduates from the program are expected to contribute to improved health planning, management, and, ultimately, outcomes.

The following are some of the activities conducted during the LIP-H that make it a success.

Project Accomplishments

As of September 2023, four cohorts of trainees have graduated from the Leadership Incubation Program, totaling 128 trainees.

The first cohort of future leaders comprised 25 trainees enrolled from various directorates of the FMOH. From this group, 21 successfully completed the leadership training program in both the technical subject matter and the identified core set of soft skills.
The second cohort included 11 trainees from regional health bureaus, two from agencies, three from federal hospitals, and 11 from the FMOH. In addition, five trainees were recruited from COVID-19 Care and Treatment Centers. A total of 29 out of the 32 trainees successfully completed the course.

Dr. Kebede Worku, former State Minister of Health, at the graduation ceremony of the 2nd cohort

The third cohort had 29 graduates, of which 18 were from FMOH and Federal Hospitals and 11 participants were from RHBs. Please click here to read the booklet distributed to participants at the graduation ceremony celebrating LIP’s third cohort of trainees.

Group picture of the Minister of Health, Directors, trainers, and coaches, with the 3rd cohort graduates

The fourth cohort was comprised of 50 trainees, 22 of whom were female. The trainees were recruited from FMOH (29), Regional Health Bureaus (10), and Federal Agencies (11).
The fifth cohort of 40 trainees who were recruited from the FMOH (5), Regional Health Bureaus (8), Federal Agencies (8), and Federal Hospitals (19) graduated in September 2023.

It is anticipated that additional sixth cohort of 60 trainees will be recruited and trained by the end of the project, which will make it a total of 230 trainees for the entire duration of the LIP-H training program. This sixth cohort will be comprised entirely of female trainees to maximize the number of female leaders in the health sector. Advocacy workshops were conducted in seven regions (Hawassa, Bahir Dar, Afar, Jigjiga, Dire Dawa, Benishangul Gumuz, and Gambella) with the sole purpose of encouraging and motivating women to apply for the training. The LIP-H team and selected LIP-H graduates provided orientation sessions to the female healthcare workers at the regional health bureaus.

Female orientation session in Oromia

The LIP-H project has a high profile in Ethiopia. As a true testament to the importance and success of the project, graduation ceremonies have been attended by prominent leaders from the FMOH, including the Minister of Health.

Ethiopia’s Minister of Health, H.E. Dr. Lia Tadesse, headlines the graduation ceremony of LIP’s 3rd cohort

The FMOH declared that it would prioritize the LIP-H graduates for Leadership positions before considering others for the posts. The declaration was based on the changes observed and commented on by the Directors of the graduates. Directors commented on the positive attitude and aptitude change of the LIP-H trainees. Particular mention was made about performance improvement, time management, enthusiasm for their work, professional presentations, and communication skills.

Quotes from Supervisors at a Regional Health Bureau

LIP-H Participant Testimonials

For a profile of some of the participants of the Leadership Incubation Program, please click here.

To watch a video highlighting what graduates learned through the program and how it is helping them in their day-to-day work, click here.

Below are quotes from some of the program’s participants.

“I have a hard time on how to express in a few words about the program; one thing I know is that it helped me develop myself a lot, and now I am always advocating for it.”
“When you work at a hospital setup, you only see a few thousands of patients in your lifespan, but when you work in the public health sector, you get to help the community on a bigger scale in a shorter amount of time.”
“As someone who studied medicine and practices medicine in Ethiopia, I believe I have seen where the leadership could be better, so this was a golden opportunity for me just to go out there and see how to make it better.”
“I realized after this training that networking is a crucial and critical part of your journey. It was after the training had begun that I met with a few of the instructors who, after a few discussions have offered us a job: a new job where I’m currently working right now, so I don’t think I would have been able to get this opportunity if not for the program.”
“I believe leadership is a part of all things. Especially in our building groups, leadership is the central part. If there is a good leader in an organization, all the building blocks will function properly. I want to be a better leader.”
“This fellowship is a think tank of diverse minds and dynamic life experiences from the best leaders from different sectors and regions, all coming together for one unified purpose. Nowhere else could I have accessed such vast resources of knowledge and experience in one place, and in such little time, I am grateful for the opportunity I was provided.”
“The projects I submitted for this program were accepted, and the capstone project of LIP-H helped me to write such a project. It is the first time Ethiopia is represented in this program. Since they loved my project, they sponsored me for the first time in the training program’s history and paid for my expenses. Not only that, they paid to register the Eka General Hospital, and it is now the first hospital to be registered under the International Hospital Federation; all this is because of my participation in the LIP-H, it opened my eyes”.

Graduates of the LIP presented their capstone projects at the International Conference on Primary Health Care Sept. 5-7, 2023 in Addis Ababa. Strong health systems require strong, forward-thinking public health leaders, and this program is helping train Ethiopia’s next generation.