ABSTRACT:
Chronic disease is recognised as a significant health challenge in developed and many emerging economies. Virtually all healthcare organisations within the system that deliver services, including those who plan, fund, and coordinate services, have a role in chronic disease prevention, management, and sustainability. Leadership, resources, incentives, and quality improvement across the healthcare system and within individual organisations are prerequisites to successful implementation and sustainability as part of the framework’s practice and system changes. A qualitative research study was undertaken in Malaysia, Nepal and Australia. Purposeful sampling was used to identify and select study participants. A semi-structured interview guide was used to conduct in-depth interviews with critical informants in leadership roles across urban, rural, and regional health districts in 3 countries. Study findings highlighted critical approaches to leadership and engagement in implementing non-communicable disease programs at the district level. Leadership at the district level is constantly challenged by a lack of human, material, and technical resources in implementing chronic disease programs. This shortage affects leaders' decision-making and their handling of social and professional workplace relationships. Several issues emerged, including fostering collaborative leadership, setting a clear vision, engaging the community, and managing district-level resources. Effective and committed leadership is critical and should be emphasised for the implementation and sustainability of chronic disease programs. There is a demand for healthcare leadership development, which will undoubtedly improve the health system's micro-level managerial, administrative, and teamwork capacities, thereby strengthening healthcare and improving health outcomes.