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To achieve the health-related Millennium Development Goals (MDGs), many low-income countries need to significantly scale up coverage of priority health services. This report by the World Health Organization is based on deliberations from an international consultation on strengthening leadership and management as an essential component to scaling health services to reach the MDGs. The consultation took place in Accra, Ghana in January 2007. The focus was on low-income countries though the principles discussed concerned leadership and management in other settings as well. The report describes a technical framework adopted by the consultation for approaching management development and sets out key principles for sustained and effective capacity building. The consultation and discussions resulting in this report involved some 80 participants from 26 countries.

The framework proposes that for good leadership and management, there has to be a balance between four dimensions. These include: ensuring adequate numbers and deployment of managers throughout the health system, ensuring managers have appropriate competences, the existence of functional critical support systems to manage money, staff, information etc and creating an enabling working environment. The participants highlighted the importance of strengthening leadership and management as one part of a range of activities to reach specific health goals. It is recommended that leadership and management strengthening should be designed according to the principles of harmonisation and alignment described in the Paris Declaration. A number of action points are identified which include that providers and commissioners of training for health workers should ensure that leadership and management subjects are incorporated into more basic and post-basic health worker curricula and that their training reflects all four dimensions of the framework.

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