Table 1.

Components, Measurement, Challenges and Lessons Learned of ELM Activities of Global Health Leadership Programs.

PROGRAM NAME	TARGET AND NUMBER OF PARTICIPANTS	INNOVATIONS IN EXPERIENTIAL LEARNING	INNOVATIONS IN MENTORING	PROGRAM OUTCOMES AROUND ELM	METRICS FOR ASSESSING PROGRAM OUTCOMES	CHALLENGES IN IMPLEMENTATION	LESSONS LEARNED FROM IMPLEMENTATION
Afya Bora Global Health fellowship http://www.afyaboraconsortium.org/index.html	Doctors, nurses, public health specialists 189 fellows since 2011 from Uganda, Kenya, Tanzania, Botswana, and Cameroon, China, USA	Each fellow undergoes two four-and-a-half-month placements at an attachment site. Attachment Sites are organizations that serve as the basis for experiential learning internships for Fellows in the African partner countries. These organizations include both governmental (Ministries of Health) and non-governmental organizations (NGOs), and other international health organizations. The placements allow fellows to integrate into local organizations as well as to network with local and regional actors in the field of global health. While at the attachment site, each fellow is supposed to create a research project that is addressing the observed challenges under the mentorship of the site mentor and primary mentor.	Each fellow has a primary mentor and is assigned a site mentor at the attachment site. There is also an overall country mentor for each cohort. All fellows receive quarterly in-country group sessions or more as required. Each fellow designs a standard meeting schedule with their primary mentor but may request more meetings as needed. While at the attachment site, each fellow has regular meetings with their site mentor depending on the site mentor’s level of involvement with their work.	Individual outcomes: 1. Career advancement 2. Improved performance 3. Increased research skills 4. Professional network broadened 5. Improved communication skills Workplace outcomes 1. Increased leadership capacity 2. Improved efficiency 3. Increased research capacity 4. Sustainable mentorship	Evaluations are conducted regularly (e.g., after each module and apprenticeship), and include self-assessments, feedback through journaling, and competency-based performance checklist. Mentors also provide feedback on performance. At each joint meeting, fellows present their progress, including their projects, and receive feedback from mentors across the countries.	Mentors workshop is held every year after recruiting. In some cases, trained mentors are unable to mentor (e.g., MOH turnover) or mentees require a new mentor, which results in constant need for retraining. Striking a balance between fellows’ regular jobs and the needs of the fellowship, especially when facing funding cuts at their workplace. Location of attachment sites: some recruited fellows are from rural areas or districts, and for them to attend place of attachment and training they have to re-locate to be able to achieve the expectations of the fellowship. Instability of internet connectivity in various countries for distance learning modules. Tracking and follow-up of fellows beyond the fellowship period. Selection of topics and methods may exceed the one year to Implement them, causing partial fulfillment of the targets.	Fellows may be forced to take more time to take the modules or get alternatives on how to download the modules, including downloading content to flash drives for ease of access
Chatham House Leadership Program	This fellowship is open to Africans working in Africa who have a background in public health sector management and who possess leadership potential. 14 total (6 per cohort, on average)	A hallmark of the fellowship is its mix of intensive orientation, interaction with leaders in public health and high-level remote mentoring.	Mentoring is provided by leading experts at the Chatham House Centre on Global Health Security in London and at the Leadership Academy of the African Union in Addis Ababa, Ethiopia. The major requirement is that fellows complete a relevant independent project, under virtual mentoring, while maintaining their jobs in their home countries.	1. Strengthen their capacity to develop, implement and evaluate public health initiatives 2. Hone their leadership skills 3. Improve their ability to assess public health in their own country 4. Build networks across relevant sectors.	Fellows are evaluated through their leadership research projects, and leadership development progress through the remote mentorship, measure	Limit in size of cohorts due to lack of physical space. Value for money and cost effectiveness of program.
Collaboration for Health Policy and Systems Analysis in Africa (CHEPSAA) https://www.hpsa-africa.org/index.php/emerging-leaders-news	The Emerging Leaders Programme (ELP) was one component of the broader CHEPSAA program. Participation was open to academic staff and public sector officials only from the CHEPSAA African partner countries (South Africa, Tanzania, Kenya, Ghana and Nigeria) who are engaged in the field of HPSR plus academia and who had the potential to develop as leaders in the field over time. 26 emerging leaders (ELs) from across all of CHEPSAA countries including representatives of both the academic partners in CHEPSAA and non-academic partners.	The CHEPSAA ELP was unique because it permitted aspiring leaders to design their own program of capacity building based on their own perceived competency needs. Furthermore, they were provided the funding and professional support from an international consortium to pursue these goals. The ELP consisted of three face-to-face capacity building workshops addressing leadership skills, curriculum development and a special session at the biennial Health Systems Research Symposium.	Leadership training was embedded in the fact that the program coordinator was an EL. ELs were exposed to senior HPSR researchers as well as life coaches who contributed to the hands-on exercises in the capacity building workshops.	1. Training in curriculum development 2. Training in facilitation skills 3. Enhanced personal skills, writing skills, project management skills, networking skills, understanding and knowledge of HPSR&A, understanding of the health system, teaching skills, and research skills. 4. Enhanced networks and collaborations 5. Enhanced understanding about unique approaches to leadership, management and self-realization	1. Leadership: ELs spearheaded a conference session entitled Emerging Leaders in Health Policy and Systems Research: Assuming Leadership in HPSR&A – Personal reflections and lessons. 2. Facilitation and management skills: Prior to the conference, ELs convened face-to-face to finalize the organized panel, decide on ways forward for the ELP, host an expert facilitated session on Mentorship skills, etc. 3. International presentations: ELs presented their experiences from the ELP at various conferences in South Africa and elsewhere. 4. Networks and collaborations: Cross-country EL relationships included analytical support from a Kenyan EL to a Nigerian EL, and planned joint publications between a Ghanaian and S. African ELs.	ELs joining the program with different interests and knowledge of HPSR. Ensuring all ELs felt equal co-ownership of the program was challenging. Varying levels of engagement across the ELs	Varied practices across partners to recruit ELs had led to a highly motivated group of individuals, but also quite a diverse group which sometimes proved difficult when trying to meet different individuals’ expectations of the program. More pressingly, participants voiced considerable concern about the sustainability of the program once CHEPSAA ended, feeling that the program needed a longer timeframe to truly come to fruition. Programs such as these could be of most value for ELs at similar stages in their careers who have similar goals and needs from such a program and can be co-creators in the evolution of the objectives.
Emerging Voices for Global Health http://www.ev4gh.net/	Health policy and systems researchers, mainly from the Global South. Also includes other health systems actors such as activists, service managers, journalists and health practitioners. Seven cohorts between 2010 and 2020 totaling 290 participants from 65 countries.	The format of the program has evolved over the years. The 2018 program was comprised of a 2-month distance learning program complemented by an intensive 6–10 day face-to-face program that culminates in a preconference prior to the biennial Health Systems Research (HSR) Symposium. The face-to-face program offers practical skill building, peer feedback, coaching, mentoring and production of high quality products for various audiences. Learning includes role plays, simulations, fishbowls, case studies, mock interviews and musical productions. It also includes visit to local health system’s relevant organizations. For each cohort, the program counts with the support of a local partner institution.	For each cohort, the majority of the facilitators are EV4GH alumni who volunteer to plan and execute the program. These facilitators serve as mentors during the venture but often after as well. In addition, the network is supported by junior and senior health policy and systems research (HPSR) researchers from around the world who serve as additional mentors. Peers also serve a critical role in feedback, support and coaching thereby also serving as mentors. Coaching and mentoring occur during both phases of the venture.	1. Enhanced networks and collaborations. 2. Greater opportunities for knowledge sharing. 3. Improved oral, written, networking, leadership, mentoring, collaboration and communication skills. 4. Leadership skills and confidence. 5. Advanced Knowledge Translation skills. 6. Comfort in thinking globally and critically. 7. Commitment to EV4GH’s sustainability.	1. Enhanced networks translate into collaborative writing, joint proposals for funding, invitations to present, etc. 2. Knowledge sharing through engagement in the E44GH program, contributions to the International Health Policies blog, social media posts tagging @EV4GH, sharing through the EV4GH listserv. 3. Empowerment and confidence translates into applications (and successful acceptance) into leadership roles (e.g., selected as plenary speaker for the HSR symposia, journal editorial board, leadership in HPSR society, etc.) 4. Advanced KT skills through utilization of innovative and tailored approaches relevant to different audiences. Winning prizes for best poster at HSR. High-quality, impactful presentations and speeches at HSR (and beyond). 5. Volunteer commitment and capacity: The venture depends on alumni volunteers. The number who provide time and knowledge to driving the cohort is an indicator for ownership, buy-in and value of the program.	Functioning of the network between cohorts to ensure regular engagement and exchange of information. Face-to-face as a core component for the development of enduring networks. Its length is limited by funding constrains. How to include under-represented regions, who do not fall within funders’ categories (e.g., Eastern Europe, some Latin American countries). Visas for participants have become a problem during the last cohorts: some participants miss in-person component due to visa restrictions.	To have diversity in the levels of the candidates has been important, in terms of gender, regions, backgrounds and levels of leadership skills. The program intentionally seeks out those who can benefit from the training and the network, those who have not yet “emerged.” Partner institutions have been fundamental for the delivery of the in-person program by providing the opportunity to think about the local context where global events take place, and to engage with different actors of a given health system.
Fogarty Global Health Fellows* https://www.fogartyfellows.org, *The information in this table pertains to one consortium – the Northern Pacific Global Health Fellows consortium.	Post-doctorate trainees and doctoral students in the health sciences and allied fields. This program funds 6 US-based consortia, each including 4 US academic institutions, with collaborations in more than 35 countries. 178 trainees over past nine years from Cameroon, Ghana, Peru, Kenya, Uganda, Thailand, India, Nepal and Liberia.	Weekly on-line “Core Competencies for Global Health” curriculum provides an opportunity for all trainees to establish competency in eight thematic domains relevant to global health research as they implement, conduct and analyze their research projects. Curriculum learning activities are tailored for each year’s cohort via a survey at the start of the fellowship year to identify interests and perceived needs of the cohort.	Each trainee has a mentoring team that includes a U.S. based mentor and at least one mentor from the host country. In addition, in 2020 the program included a junior mentor chosen from among the past 7 years of our Global Health Fellows and Scholars. Junior mentors provide opportunities for trainees to learn from the practical experiences of junior mentors acquired during their training period within the country, as well as provide an opportunity for the junior mentors to learn new mentoring skills under the guidance of more experienced mentors.	Trainee outcomes: 1. Upon completion of the training program, trainees will be familiar with modern principles of global health research 2. Trainees will develop and demonstrate skills necessary to pursue a career in global health research. Program objectives: 1. Provide a high quality research environment 2. Provide program support to trainees in program logistics 3. Provide support to nurture trainee interest in global health research. 4.Provide high quality interdisciplinary mentoring from both international and US-based mentors. 5. Provide professional development opportunities and support for mentors.	The program uses a variety of standardized program and mentor evaluations completed by trainees from each cohort: 1. Tracking and reviewing of multiple trainee performance indicators 2. Trainee pre- and post-fellowship self-assessment of competence in the global health research competencies 3. Mentor evaluation of trainee performance 4. Trainee evaluation of mentoring and program 5. Trainee and mentor evaluation of trainee’s impact on the research site.	Building an inclusive network across the nine collaborating countries that host trainees spanning 14 hours of time zones. Our solution was to develop a weekly series of calls covering core competencies and works-in-progress. Providing sufficient methodologic support and guidance on scientific writing to ensure each trainee is able to implement and publish the results of a mentored research project.	Weekly internet-based calls have provided opportunities to build a cohesive network of trainees who learn through peer review of each other’s projects. Calls have been adjusted each year to include more focus on scientific writing of manuscripts and grants and have incrementally increased the number of sessions that address development of leadership skills. Early in the fellowship period, many trainees had sufficient available time to participate in facilitated online courses in program management and leadership—skills we felt would be particularly useful for building careers in global health research.
STAR Program Fellows https://www.ghstar.org/	Mid-to-senior level global health professionals who play technical support roles at USAID or in secondment to Ministries of Health in LMICs 56 Fellows (20 US based, 36 overseas)* *Between program start and midway through Y2 (~18 months)	Not applicable	Hybrid design of facilitated peer-to-peer group mentorship with option to add 1-on-1 technical mentor pair. All STAR participants receive group mentorship for 6–10 sessions over 3–6 months. For Fellows paired with Technical Mentors, it is expected that the pair meets 3–4 times per year and their engagement is self-initiated.	The mentoring program will: 1. Reinforce all of the STAR core competencies and how they apply to individual work environments. 2. Promote partnering and collaboration [This links to larger program outcomes for STAR Learning and STAR overall] [10]	1. Annually, mentorship groups provide an opportunity for fellows to prepare for and/or discuss capacity building and knowledge sharing activities outside of STAR [assessed via regular check-ins]. 2. Mentoring groups will support fellows’ achievement of “practicing” level on core competencies by the end of the fellowship[assessed through endline competency assessment]. 3. Quarterly, fellows report that mentorship groups are good use of their STAR Learning time [assessed via regular check-ins].	Getting regular attention and attendance to mentorship groups. Establishing enough rapport to have thoughtful reflection. Ensuring that Technical Mentors actually meet mentees. Originally intended for mentorship groups to be facilitated by a GH expert, likely external to STAR, but it was difficult to balance the effort required by facilitation without actually incorporating the expert into the STAR team. Getting buy-in from on-site supervisor to take time away from work for mentorship group meetings.	Changed mentorship group meeting times from every 2 weeks to weekly to establish regularity of the group. Post-session monitoring of mentorship groups was too frequent and did not provide substantive feedback. Moved to evaluation survey after group meetings had ended. Making technical mentorship optional allowed for more opt-in approach, resulting in more commitment from fellows. Also reduced the burden on Technical Mentors who were experts external to the program. Using STAR facilitators for groups (rather than external experts) allowed for more control and consistency on content and delivery. Fellows have more time early on to dedicate to mentorship groups.