Organizational leadership competencies for effective and equitable public health governance in Canada.

Background: Organizational-level leadership competencies are critical for the development and governance of resilient public health systems that can endure and thrive in an ever-evolving economic, social, and political context. Analysis: A mixed-methods research study identified 20 organizational leadership competencies for public health in Canada, across eight domains, including: systems thinking (e.g., leaders are able to adapt, are nimble, and innovate), policy development/implementation/evaluation (e.g., leaders engage multiple actors in policy) and resource stewardship (e.g., leaders develop a resource allocation strategy that balances efficiency and equity). Policy Options: Recommendation: Governments across Canada should undertake legislative and regulatory efforts to implement organizational-level leadership competencies in public health organizations to strengthen system-level governance. Status quo: Without a systemic approach, some organizations will continue to undertake actions that strengthen their governance, while others will not. This could exacerbate inequities in population health outcomes and organizational performance. Conclusion: Strengthening organizational leadership competencies is critical for the effective and equitable governance of public health organizations in Canada. Failure to do so could undermine their resilience in a resource-constrained and changing context.