Cultivating competent leaders who can manage and govern the health delivery system in Northwest Ethiopian: Quasi-experimental study

Background: Nurturing leadership and governance is salient to strengthen health systems. However, literature that reports the effect of programs related to this, particularly in low and middle-income countries’ health systems is limited. Aim: To examine the effect of integrated health system leadership, management, and governance capacity-building program on institutional delivery performance. Methods: A prospective quasi-experimental study, on one-hundred-thirty-four health facility teams, was conducted in northwest Ethiopia. Teams were allocated to intervention and control groups in a 1:1 ratio, non-randomly. Integrated leadership, management, and governance capacity-building program was employed in teams of the intervention group over six months. Using a challenge model, they implemented a six-month project on institutional delivery performance. Here, the outcome of interest was mean institutional delivery performance. Data from each group were collected at baseline and end line. Data were analyzed using analysis of covariance. Statistical significance was determined at p<0.05. The program’s effect size was reported using partial eta squared, which was also double-checked with a 95% confidence interval in the contrast-results. Results: Integrated leadership, management, and governance capacity-building program had a statistically significant effect on mean institutional delivery performance (p<0.001). The program’s effect size was 65%, somewhere between 12.2 and 15.8. Conclusions: Integrated leadership, management, and governance capacity-building program is a plausible cause of improved mean institutional delivery performance. The current findings could make the program sustainable across time and scalable across similar settings.  To identify the program’s true causation, further research could be done using a randomized control trial.