Developing A Leadership Framework for Successful Implementation and Sustainability of Non-Communicable Disease Programs

Abstract

ABSTRACT: Background and Aim: Non-communicable diseases (NCDs) demand multifaceted responses from health care systems, which must be complemented with continued health care programs in a sustainable manner and leadership supportive. As a result, we designed a framework to describe and guide appropriate leadership for successful implementation of NCDs management programs. Methods: This mixed-method study was fulfilled using a scoping review, researcher-made sustainability assessment tool together with qualitative interviews with 46 managers in charge of NCD programs, expert panel and Delphi method. this study has been conducted in the years 2018 to 2023. Results: The developed leadership framework consists of three parts including the characteristics of leadership, sustainability elements of NCDs programs and functional levers of the health system. leverage are classified into five categories, including financing, human resources, infrastructure and inputs, legal, executive, administrative, as well as inter-sectoral collaboration, and management and policy-making challenges. The second dimension of the framework shows the leadership characteristics, which includes all the competencies, tasks and leadership styles required by NCDs managers. leadership competencies could be placed into 15 leadership competencies, four leadership tasks and five leadership styles. The total mean score of sustainability was 3.54. Funding stability obtained the lowest mean value and program adaptation received the highest mean score among other sustainability domains. Discussion: The results revealed that lack of sustainable finance, HR's insufficient knowledge and weaknesses in the intersectoral collaboration were the important challenges to successfully implementing the program of NCDs in Iran. Also, considering the mutual influence between the functional levers and the leadership structure, it is necessary to empower the leader of the NCDs program with knowledge, competency towards resource management, inter-departmental cooperation. Also, considering the average stability of the NCDs program and the obstacles in the functional levers of the health system, training courses were presented to empower the leader of the NCDs program. Key words: Non-Communicable Diseases, Sustainability, Professional Competence, Leadership, Leadership Style