Training Global Health Leaders: A Critical Review of Competency Gaps.

Background: Global health leadership training seeks to strengthen the existing global health workforce to build leaders that have the necessary knowledge, attitudes, and skills to deliver a vision for public health and healthcare delivery. In order to develop impactful training curricula, there is a greater need to understand the areas of focus required to strengthen the global health workforce. Objectives: This paper seeks to present a critical analysis of the competency gaps among participants of a single global health training program. Methods: This is a cross-sectional observational study conducted during the implementation of the Sustaining Technical and Analytical Resources (STAR) project from May 1, 2018 to May 31, 2020. We utilized descriptive statistics to analyze the baseline competency assessment of STAR participants using a customized framework that was developed for the program. Findings: Among the 74 individuals enrolled in the study, we identified that there were significant differences in milestone achievement across participant types for all eight competencies (p < 0.001). Overall, US-based fellows reported higher perceived competency levels than low- and middle-income (LMIC)-based fellows in all categories except Capacity Strengthening (4, 23.5% leading vs. 12, 63.5% leading). LMIC fellows reported lower achieved milestones in Gender Equity (only 6, 31.5% at practicing) and Development Practice (only 6, 31.5% at practicing). Conclusions: Our study identified critical needs in the domains of public health ethics, health equity, and social justice and gender equity. Further emphasis on these domains in global health curricula and other professional development is critical to strengthen the knowledge and skills of individuals who are well-placed to advance the development of an equitable global health workforce.