Strong leadership and management competencies have long been identified as key elements for encouraging health systems that are responsive to population needs. While these competencies are important in any context, the particular circumstances of low and middle-income country (LMIC) health systems, characterised by resource scarcity and high burdens of disease, suggest that these skills are particularly needed.

This paper undertakes a review of the existing management and leadership literature from LMIC settings with a view to unpacking the roles of leaders and managers, the competencies required, and the key approaches to developing these management and leadership competencies.