In 2002, the Egypt Ministry of Health and Population, with funding from the US Agency for International Development (USAID) and assistance from Management Sciences for Health, introduced a Leadership Development Programme (LDP) in Aswan Governorate. The programme aimed to improve health services in three districts by increasing managers' ability to create high performing teams and lead them to achieve results.The programme introduced leadership and management practices and a methodology for identifying and addressing service delivery challenges. Ten teams of health workers participated. In 2003, after participation in the LDP, the districts of Aswan, Daraw and Kom Ombo increased the number of new family planning visits by 36%, 68% and 20%, respectively. The number of prenatal and postpartum visits also rose. After the USAID funding ended, local doctors and nurses scaled up the programme to 184 health care facilities (training more than 1,000 health workers). From 2005 to 2007, the LDP participants in Aswan Governorate focused on reducing the maternal mortality rate as their annual goal. They reduced it from 85.0 per 100,000 live births to 35.5 per 100,000.

Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. Management Sciences for Health (MSH) developed the Virtual Leadership Development Program (VLDP) with support from the United States Agency for International Development (USAID). The VLDP is a Web-based leadership development programme that combines face-to-face and distance-learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. The USAID-funded Leadership, Management and Sustainability (LMS) Program adapted the VLDP for HR managers to help them identify and address HR challenges that ministries of health, other public-sector organizations and nongovernmental organizations are facing. Three examples illustrate the results of the VLDP for teams of HR managers: (1) the Uganda Protestant and Catholic Medical Bureaus; (2) the Christian Health Association of Malawi; and (3) the Developing Human Resources for Health Project in Uganda.

Background: The purpose of the study was to test the hypothesis that strengthening health systems, through improved leadership and management skills of health teams, can contribute to an increase in health-service delivery outcomes. The study was conducted in six provinces in the Republic of Kenya.

As doctors, nurses and public health professionals are promoted into management and leadership positions in resource-poor countries around the world, they are tasked with leading teams and managing drugs and financial and material resources.

This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH).

As part of the special feature on leadership and human resources, Management Sciences for Health profiles three leaders who have made a significance difference in the HR situation in their countries.

This article is the lead article in the Human Resources for Health journal's first quarterly feature. The series of seven articles was contributed by Management Sciences for Health (MSH) under the theme of leadership and management in public health. The journal invited Dr. Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines, to launch the feature with an opening editorial in the journal's blog. This opening article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented. The case studies in this issue were chosen to illustrate results from using the Leadership Development Program (LDP) at different levels of the health sector. The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.