Women's leadership development programmes and gender equality: a systematic review in healthcare, academia and beyond.

Abstract

Background: Women comprise 70% of the global health workforce yet hold only around 25% of leadership positions. Women's leadership development programmes (WLDPs) are widely implemented as organisational equity strategies; this review examined whether their reported outcomes extend beyond individual development to measurable organisational change.

Methods: Systematic review without meta-analysis (PROSPERO: CRD42024554419), reported in accordance with PRISMA and SWiM. Nine databases were searched from 25 September 2015 to 5 July 2026. We included peer-reviewed studies evaluating structured WLDPs delivered to adult professionals in formal organisational roles that reported outcomes for women. Student-only populations and mentorship- or coaching-only interventions were excluded. Summary data were extracted from published reports by two independent reviewers using a standardised template incorporating TIDieR intervention-description items; quality was assessed using design-appropriate Joanna Briggs Institute critical appraisal tools. Outcomes were mapped using an extended Kirkpatrick framework spanning individual to organisational outcomes.

Findings: From 2314 records, 57 studies evaluating 52 WLDPs across 23 countries were included. Most studies were from the United States (n = 36). Designs were predominantly mixed-methods or qualitative; none used randomisation, and four included comparison groups. All studies reported individual-level outcomes, most commonly self-reported improvements in confidence, knowledge, leadership capability, and behaviour. Thirty-two studies reported any organisational outcome, usually promotion or retention indicators. Subjective measures predominated over objective outcomes. Demographic reporting was limited: only 22 studies reported race or ethnicity, and very few reported sexual orientation, disability, or disaggregated advancement outcomes.

Interpretation: WLDPs appear to support individual development, but current evidence cannot establish organisational transformation. Their broader equity potential depends on structural accountability: transparent and equitable recruitment pathways, institutional investment, and disaggregated outcome reporting, a reorientation of responsibility from individuals to organisations.

Funding: The Australian National Health and Medical Research Council (NHMRC).