Summary of included studies for a scoping review of the evidence regarding the effectiveness of donor supported leadership development programs intended to promote women's leadership in public health systems in LMICs

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Methods:
The scoping review was based on Arksey and O’Malley’s methodological framework which comprises the following key steps: 1) identifying the research question, 2) finding relevant studies, 3) study selection, 4) data charting and 5) collating, summarising and reporting results (Arksey and O’Malley 2005).

Search strategy and selection criteria:
A systematic search for relevant literature was conducted on January 2020 using PubMed, SCOPUS, ProQuest and PsycINFO. A combination of key terms was used, which were grouped according to key concepts – health sector, women, leadership development and LMICs using truncation, proximity and Boolean operators ‘AND’ or ‘OR’. The search string was developed and refined in Scopus in consultation with a librarian and adapted for the other databases (refer to supplementary material for search string). We excluded non-English publications and restricted our search to papers published after 2000. The date range 2000–2020 was chosen as a point of reference as it encompasses a period of proliferation of LDPs intended to promote women’s leadership. Database searches were supplemented by hand searching of reference lists of identified articles. We also searched websites including Google and Google Scholar for non-peer-reviewed literature. Additional grey literature was identified through searching websites of key bilateral and multilateral development aid donors including DFAT, the United Kingdom Department for International Development, USAID and the Swedish International Development Cooperation Agency. These organisations were purposively sampled from among the Organisation for Economic Co-operation and Development top contributors of aid in support of gender equality and women’s empowerment both in relative and absolute terms. Title and abstract screening was conducted by a single reviewer (SM) with cross-validation of a random sample by a second reviewer (NS). The same approach was taken for full text screening of relevant articles. A third independent reviewer (EL) was available for consultation to resolve any conflicts which arose. Studies were included if they were evaluations of donor-supported leadership development interventions, based in public health sectors in LMICs, and included female participants in leadership and/or managerial roles. We excluded studies if they described evaluations of non-donor-funded LDPs, or donor-supported interventions implemented beyond the scope of public health sectors in LMICs. Theses, dissertations, book reviews, commentaries/opinion pieces, editorials and conference papers were also excluded. For the purpose of the review, we defined the public health sector as public entities at the national and sub-national levels which deliver health services including government ministries of health and health care institutions (i.e. hospitals and primary health care facilities) (Ayeleke et al. 2016). Women’s leadership refers to women in formal leadership and/or managerial roles across the health sector, and aid donors refer to agencies which finance development interventions in LMICs including bilateral and multilateral sources

Data extraction and analysis:
Data was extracted from eligible studies by two reviewers (SM, NS) using an agreed extraction template which addressed general study characteristics, and outcomes and impacts of interventions including evaluation challenges. Studies were not assessed for quality or risk of bias as the scoping review approach provides an overview of all relevant literature regardless of study design (Arksey and O’Malley 2005). However, limitations of the included studies were identified and discussed, and future directions for research articulated including the types of studies or evaluation designs which could be used to assess the effectiveness of women’s leadership interventions. A numerical summary of study characteristics was provided, and key outcomes and methodological challenges were summarised using a narrative synthesis. In addition, we analysed the gender composition of included evaluations based on participants demographic characteristics. We developed a theory of change for leadership development and gender transformative programmes to guide our data analysis and synthesis.

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