This policy brief highlights district-level informal, workplace-based learning through which key leadership competencies can be developed. The brief adds to the relatively small body of empirical literature on informal learning in the health system and complements existing leadership development thinking, much of which is focused on formal training through courses or workshops.

Key findings and policy implications

• District-level staff are key to health reform implementation but are often not adequately trained for leadership roles
• Staff can implement various workplace-based strategies to build leadership strategies such as: delegation and shadowing
• Leadership competencies help staff to push back against structural constraints and fulfill their roles effectively
• Health system managers should consider ways of incorporating informal leadership development strategies into workplaces
• Informal leadership strategies are cost-effective and can lead to more applicable training to everyday settings