To analyze extant scholarship on competencies for public health policymakers, we conducted a scoping review of the literature, a method best served to map knowledge, identify gaps, and clarify concepts [16, 17]. The study, first, takes inventory of the literature that addresses competencies of relevance to policymaking in public health. The retrieved scholarship is then examined to synthesize identified skills to understand their significance in public health policymaking. Following the approach put forth by Altheide [18] and Bowen [19] and further developed by Sternkopf et al. [20], this assessment follows an eleven-steps methodological process represented in Figure 1.

The scoping review aimed to identify existing literature on competencies related to policymaking in public health. The search was conducted using a clearly defined set of terms, as well as inclusion and exclusion criteria to ensure reproducibility and transparency. To synthesize as much evidence as possible, we did not limit our search by any specific observation period, including all relevant literature regardless of publication date or time frame, nor by any specific geographical region. Searches were performed in the English language. The searches were conducted between February and March 2024 in the well-known and indexed public health databases Cochrane Library, PubMed, Science Direct, and Web of Science. To capture non-indexed but relevant studies, Google Scholar was also consulted. Search results were imported and deduplicated using Zotero reference management software. Notably, only peer review publications were included in the analysis, as well as studies that explicitly addressed policy making competencies. This led to the exclusion of frameworks aimed at public health practitioners or professionals.

Search terms were defined based on the research goal and limited, at first, to title, keywords, and abstract: “policymaking” OR “policy making” OR “policy develop*” OR “policy design” OR “policy formulat*” OR “policy implementat*” OR “policy evaluat*” OR “policy decision mak*” OR “policy agenda setting” AND “competencies” OR “skills” OR “capabilit*” AND “public health” OR “health policy”. Search terms were adjusted to each database. These are displayed in Supplementary Appendix 1.

We analyzed all retrieved results, except on Google Scholar, where we reviewed the articles contained in the 10 first pages given the lower precision and lack of advanced filtering in the database. After removing duplicates and papers without abstracts, the searches resulted in 416 hits in total. Title and abstracts were then carefully screened for inclusion on the basis that articles (a) focus specifically on (public) health policies or public policies in general, (b) address specifically policymakers, either alone or in combination with other actors (e.g., health professionals), and (c) focus, whether explicitly or implicitly, on any stage of policymaking (agenda-setting, formulation, adoption, implementation, evaluation, and termination). Doing so, we exclude research that focuses on public policies unrelated to health (e.g., energy, housing, etc.), that does not deal with policymaking, that only addresses healthcare practitioners without referring to policymakers, that focuses only on tools for acquiring competencies (e.g., software and platforms) or addresses competencies gained during education (e.g., curriculum analysis), and that cover topics outside the defined scope, such as clinical trials. All the listed inclusion criteria are necessary conditions, but not sufficient on their own. On the other hand, any of the exclusion criteria are sufficient to exclusion.

A PRISMA flow diagram of the review process (Figure 2) is presented. For a full included listing of articles, see Supplementary Appendix 2.

To support the analysis of the retrieved literature, a structured data extraction template was developed using a deductive approach (see Annex 3). This template captured key dimensions including metadata, country focus, policymaking level (e.g., national, subnational), policymaking stage(s) addressed (e.g., agenda setting, formulation, implementation, evaluation), and the specific competencies referenced.

All articles selected for inclusion were analyzed thoroughly by a lead researcher who also extracted data into the template to guide the systematic identification and recording of key data points (completed templates are available upon request). Two additional researchers replicated this process for 15% of all articles to validate the findings and ensure coder reliability. The articles selected for verification were randomized.

Through our scoping review, we identified a total of 64 unique competencies from the retrieved literature. We followed Braun and Clarke [22] guidelines for thematic analysis, involving familiarization with the data, initial coding, searching for themes among coded segments, reviewing themes for coherence and distinctiveness, defining and naming themes clearly, and finally categorizing competencies into thematic domains.

We mapped and synthesized evidence found in the scoping review using thematic analysis. This qualitative analytical approach allows researchers to identify, analyze, and report recurring themes and patterns in the data in a systematic and transparent way [22, 23]. Our thematic analysis followed an inductive approach. The final set of themes was defined, named, and organized systematically, providing a structured synthesis of the competencies identified in the literature. Following this, the quality of the studies was evaluated following the GRADE scheme in line with Pieper et al. [24].

Based on our thematic analysis, we developed an analytical framework to systematically organize the identified competencies required for effective public health policymaking. The framework classifies competencies into inductively-derived thematic domains, each capturing specific areas of knowledge and measurable skills.

We define competencies as observable abilities integrating knowledge, skills, and attitudes directed at performing specific tasks that are applicable across multiple activities, which can be developed or eroded over time depending on contextual conditions such as training availability and practice opportunities. These competencies were inductively categorized into eight clearly defined dimensions, each reflecting particular knowledge areas and skills critical to public health policymaking: (a) analytical and research, (b) political, (c) leadership and management, (d) design thinking, (e) collaboration, interpersonal, and networking, (f) communication, (g) resource mobilization, and (h) technology readiness. The domains, the specific competencies by domain, as well as the studies that these appear are presented in Table 1.

In terms of frequency across the reviewed literature, analytical and research competencies emerge as the most prominent domain, referenced in 72% of the included articles. This strong emphasis suggests a continued prioritization of skills such as data interpretation, evidence appraisal, and policy-relevant analysis—all core capabilities for evidence-informed public health policymaking. The next most frequently cited domain is design thinking (48%), reflecting a growing interest in problem-framing, creative solution-building, and systems-oriented approaches that accommodate the complexity of policymaking processes. Collaboration, interpersonal, and networking competencies are mentioned in 37% of the papers, underlining the recognized importance of trust-building, multi-stakeholder engagement, and effective coordination across institutional boundaries. Political competencies, found in 32.5% of studies, highlight the need to understand power dynamics, stakeholder interests, and the policy environment. Leadership and management competencies were also identified in 28% of studies, particularly in relation to strategic direction, team management, and implementation oversight.

By contrast, competencies related to communication (16.3%), resource mobilization (11.6%) and technology readiness (11.6%) were referenced less, however, with clear recognition, perhaps more recently, of their critical importance in effective policy-making.

A temporal reading of the included studies—which span from 2008 to 2023, with a mean publication year of 2017.5 — reveals that not all domains have been equally prominent across time. Analytical and research competencies are the most established in the literature, with references dating back to 2008 and appearing consistently throughout the entire review period. Design thinking and collaboration, interpersonal, and networking competencies began emerging in the early 2010s but grew substantially after 2015, reflecting a gradual shift in the literature toward more systemic and relational approaches to policymaking. Political competencies, despite their practical centrality, appear almost exclusively in post-2015 studies, with only one reference pre-dating that threshold. Resource mobilization is the most strikingly recent domain—entirely absent from the literature before 2016 — suggesting it has only recently been recognized as a distinct competency area. Technology readiness follows a similar pattern: while one early study from 2011 touched on science and innovation foresight, the competencies most specific to this domain—AI tools, big data analytics, and cybersecurity—appear exclusively in 2023 publications, reflecting the very recent emergence of digital transformation as a policy concern. Leadership and management, and communication competencies are present throughout the review period but with a clear concentration of studies in the post-2015 window. Analytical and research competencies involve the application of analytical methods and conducting research tailored to public health policymaking. These competencies enable policymakers to systematically utilize evidence, engage effectively with research methodologies, and apply analytical insights to complex policy issues. This domain comprises seven competencies out of the 64 identified across all reviewed studies and is the most referenced domain. The most frequently cited competency in this domain is the ability to apply analytical and research skills to generate and utilize evidence for policymaking, referenced in 19 different studies. For instance, one study notes that it is imperative to “develop policy in an evidence-based fashion, i.e., using knowledge produced by a diverse group of professions and the best empirical information available” ([61] (p588)). The second most frequently cited competency is the ability to integrate contextual information into policy analysis, as one article explains: “evidence should be used in conjunction with contextual factors, including public opinion, equity, feasibility of implementation, affordability, sustainability, and acceptability to stakeholders” ([26] (p4)). Other competencies in this domain include the ability to recognize and balance different methodological strategies and apply and translate knowledge. These competencies collectively underpin policymakers’ ability to leverage evidence effectively and navigate complex informational environments. Their frequent appearance in the literature underscores the centrality of research capacity for effective policymaking.

While analytically-oriented competencies focus on working with evidence—its generation, appraisal, and translation into policy-relevant knowledge—design thinking competencies are concerned with working with problems: diagnosing root causes, imagining context-appropriate solutions, accommodating complexity, learning iteratively from experience, and engaging in foresight. A policymaker may be highly proficient in evidence appraisal and yet lack the capacity to creatively frame a problem or adapt a solution to a changing context. These are distinct and complementary repertoires, and their separation into two domains reflects this difference in orientation. In contrast, design thinking competencies refer to the capacity to apply innovative, creative, and strategic thinking to address challenges in public health policymaking. These competencies help policymakers creatively solve problems, adapt to complexities, and iteratively improve policy interventions. This domain includes 11 competencies. Among the most referenced ones is the ability to diagnose policy problems, identify root causes, and generate context-appropriate solutions, with one article highlighting that the foundation of policymaking is the “proper definition of the policy problem”, stressing the importance of having a clear and unambiguous understanding before advancing to subsequent stages of policy development ([41] (p5)). The ability to accommodate complexity in policymaking is also widely cited, reflecting the need to navigate dynamic systems and uncertainty, as well as the ability to evaluate and continuously improve policy interventions. Less frequently but notably, studies refer to foresight, experiential learning, and feedback mechanisms across the policy cycle. Collectively, these competencies equip policymakers to iterate and adjust policy solutions in response to challenges.

Collaboration, interpersonal, and networking competencies encompass skills required to effectively engage, build relationships, and collaborate and mobilize within and beyond organizational boundaries in policymaking contexts. These competencies are pivotal in mobilizing collective efforts, leveraging diverse expertise, and aligning various stakeholders towards common public health goals. This domain includes ten competencies and appears in 15 studies. The most frequently cited competencies are the ability to engage and collaborate with stakeholders—stressed in one study as crucial to “address key policy questions” ([25] (p2))—and the ability to build and leverage networks for evidence-informed policymaking. Other commonly mentioned skills include collaborating with interdisciplinary teams, identifying and engaging key actors, and applying interpersonal skills for collaboration across organizations. While competencies such as stakeholder management and network maintenance are less frequently noted, they underscore the operational depth required for sustained partnership building. Taken together, these point to the vital role of relational capacity in enabling implementation of collective policy efforts and knowledge exchange.

Political competencies comprise the capacity to navigate and effectively influence political contexts and dynamics relevant to public health policymaking. These competencies allow policymakers to build necessary relationships, leverage political resources, and effectively engage within complex political environments. This domain comprises eight competencies, referenced across 14 studies. The most frequently cited is the ability to assess and enhance political acceptability and support, with a study saying that this is “one of the first critical issues that must be taken into cognizance in policy development” ([41] (p7)). The ability to apply policy acumen involving knowledge about policy actors, positions, interests, resources, strategies is also relevant: “policy acumen, consisting of insights about positions, interests, resources and strategies of key players in the policy process, and the practical implications of policy actions, forms the basis for actors to make sound judgment on the desirability and feasibility of different policies” ([43] (p8)). Additional competencies point to the capacity to apply political knowledge effectively, identify policy champions, and build trust within political systems. These skills position policymakers to anticipate and respond to the shifting dynamics of political contexts, aligning policy objectives with political opportunity structures to enhance prospects.

Leadership and management competencies entail the abilities required to guide teams, manage resources effectively, and lead organizations strategically within public health policymaking. Competencies in this domain highlight their fundamental role in coordinating efforts and ensuring effective policy implementation. This domain includes nine distinct competencies, most prominently the ability to establish and manage teams and to prioritize competencies for policymaking staff referenced in four studies. Examples from the literature also include the ability to lead during public health emergencies and manage conflicts. Further emphasized were competencies like leading with strategic vision and managing resistance, and managing human, financial, and infrastructural resources effectively. These abilities are critical in ensuring continuity, motivation, and direction within policymaking institutions.

Communication competencies comprise the essential skills for clearly conveying information, persuading diverse audiences, and effectively facilitating dialogue and consensus in public health policymaking contexts. The six competencies identified in this domain were frequently identified as crucial for bridging knowledge gaps, aligning stakeholder perspectives, and ensuring successful policy advocacy and implementation. Notably, literature highlighted competencies such as the ability to craft concise and effective policy briefs, persuade through effective framing of evidence, and utilize targeted communications and evidence summaries to facilitate informed policymaking.

Resource mobilization, while less frequently cited than other domains, represent essential pillars of effective public health policymaking. The domain includes four competencies, most commonly the ability to manage and allocate financial resources and to mobilize support for policy implementation—each referenced in four studies. These skills ensure that policymakers can identify, secure, and deploy financial and material assets to operationalize policy goals. Technology readiness, comprising five competencies, is also among the least referenced domains. Nonetheless, studies underscored its rising relevance, particularly the ability to utilize new data technologies, such as AI and big data analytics, and to implement cybersecurity measures to protect policy infrastructure. These competencies are critical in an increasingly digital policy environment. Their limited presence likely reflects the novelty and ongoing evolution of technological applications in public health in general [70], as well as in policymaking.