Leading in a time of crisis: exploring early experiences of health facility leaders during the COVID-19 pandemic in Nigeria’s epicentre

Abstract

Purpose The COVID-19 pandemic has had a disruptive effect on the health system. Health facility leaders were at the forefront of maintaining service delivery and were exposed to varied stressors in the early phase of the pandemic. This study aims to explore the leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in Nigeria’s epicentre. Design/methodology/approach This study conducted an exploratory descriptive qualitative study. To achieve this, 33 health facility leaders of different cadres across primary, secondary, and tertiary levels of the public health care system in Lagos, Nigeria, were remotely interviewed. The key informant interviews were transcribed verbatim and were analysed by using thematic analysis. Findings The health facility leaders experienced heightened levels of fear, anxiety and stressors during the early phase of the pandemic. They also had genuine concerns about exposing their family members to the virus and had to manage some health-care workers who were afraid for their lives and reluctant. Coping mechanisms included psychological and social support, innovative hygiene measures at health facility and at home, training and staff welfare in more ways than usual. They were motivated to continue rendering services during the crisis because of their passion, their calling, the Hippocratic oath and support from the State government. Originality/value The experiences of health facility leaders from different parts of the world have been documented. However, to the best of the authors’ knowledge, this is one of the first studies that specifically report multi-layer leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in sub-Saharan Africa.

Evaluation of Covid-19 Impact on Maternal and Neonatal Health Services Continuity at the Cite-Verte Health District in Yaounde, Cameroon

“…Had it not been for external concerns such as distance, transport, the poor reception of certain staff, or even complications during treatment, the pandemic did not have a considerable impact according to MNHS users. The above problems mentioned by MNHS users in our study are similar to those revealed by Balogun et al ( 2021) [23] when they confirmed that 18.13% of women were unable to access services because they did not have means of transport.…”

Leading for High Reliability During the COVID-19 Pandemic: A Pilot Quality Improvement Initiative to Identify Challenges Faced and Lessons Learned

“…Strong, adaptive leadership at all levels of health care systems was needed to effectively address the immense crisis at hand. 36,37 Findings from this pilot QI initiative suggest that MCDs faced many new challenges, requiring them to perform unfamiliar tasks and manage numerous overlapping challenges (eg, staffing shortages and reassignments, safety concerns, changes to patient appointments, backlogs in essential services), all while also trying to continue with the journey to high reliability. Despite the challenges leaders faced, they recognized the need to manage competing priorities early and effectively.…”

“…Emerging research highlights how leaders had to modify their day-to-day responsibilities because of the wide disruptions caused by the COVID-19 pandemic, even when not on the journey to becoming an HRO. 36,37 Some participants felt compelled to stay committed to the HRO journey despite numerous competing demands. They stayed committed to looking for opportunities to progress by implementing HRO principles and practices to achieve safety, quality, and efficiency goals.…”

“…This dedication is noteworthy, especially in light of recently published research that demonstrates the vast number of patient safety issues that presented during the COVID-19 pandemic (eg, ineffective communication, poor teamwork, the absence of coordination) 1 as well as perceptions that patient safety and quality of care had significantly declined as a result of the crisis. 36,37 Participants also highlighted the need to be adaptive when responding to the complexity and unpredictability of the pandemic. Participants regularly sought ways to increase their knowledge, skills, and abilities by using the resources (eg, tools, experts) available to them.…”