The district health system (DHS) has a critical role to play in the delivery of primary health care.

Effective district management, particularly leadership is considered to be a crucial element of the DHS. Developing leadership competencies such as motivation or empowerment of staff, managing relationships and fostering teamwork are argued to be possible through formal and informal training.

During the study two informal learning strategies were evident - learning from others (communication and delegation) as well as fostering team-based learning which nurtured leadership in the finance team and some parts of the broader district.

Recommendations for policy

• This article offers first-hand accounts, experiences and practical strategies which can be incorporated into everyday settings.
• While the advantages of formal learning have been documented in the literature, some weaknesses reported include difficulty applying theory/knowledge to work settings or formal learning being expensive. Informal learning addresses challenges associated with formal learning, it is also associated with team-based learning/fostering teamwork.
• Given the financial constraints that many low and middle-income settings face, these findings offer practical strategies which are useful and draw attention to cost-effective ways of developing leadership competencies.

This study illustrates that it is possible to develop leadership competencies through creating and nurturing a learning environment (on-the-job training) which could be incorporated into everyday practice.