Overcoming barriers in global nursing leadership development: participant experiences and a novel framework for equitable blended learning

Background The global nursing leadership deficit is acute, yet nursing leadership development remains underdeveloped in many countries. The State of the World's Nursing 2025 report revealed that while 66% of countries have leadership development initiatives, only 25% of low-income countries offer structured programs. The COVID-19 pandemic accelerated the shift to e-learning, creating both opportunities and inequities for nurses globally. This study explored barriers, enablers, and strategies for e-learning among participants of a nine-month hybrid leadership development program delivered through the Canvas Learning Management System at the University of Global Health Equity (UGHE) in Rwanda. Methods An exploratory qualitative study using 21 in-depth interviews (IDIs) was conducted with 19 purposively selected alumni and two of their coaches from the 2022–2024 cohort, drawn from Rwanda, Malawi, Botswana, Ethiopia, Sierra Leone, Lesotho, Haiti, and the USA. The transcripts were analyzed using latent content analysis. Trustworthiness was ensured through peer debriefing, member checking, reflexive journaling, and code saturation. Results Four overarching themes emerged: (1) technological barriers and digital inequities; (2) the dual burden of learning while working in resource-constrained settings; (3) language, communication, and pedagogical quality as determinants of learning; and (4) relational architecture, including coaching, peer networks, and institutional support, as pathways to completion. Learning enablers included active facilitation techniques, WhatsApp-based peer networks, transformative coaching, family support, and institutional pastoral care, while internet connectivity challenges, smartphone-only access, work–learning conflicts, and language barriers hindered learning. Conclusions E-learning in nurse leadership training in resource-limited contexts is feasible but requires deliberate structural investment. Programs must proactively address digital equity, workload integration, pedagogical quality, coaching standardization, and credential recognition. These findings were synthesized into the Digital Equity, Pedagogical Quality, Relational Support, and Credential Recognition (DPRC) Framework, an actionable guide for institutions designing e-learning programs for nurses.