Strengthening health system leadership for better governance: what does it take?

Abstract

This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On the other hand, they provide some evidence of the positive potential of new forms of participatory leadership, together with ideas about what forms of leadership development intervention can nurture new forms of leadership. Finally, the papers prompt reflection on the research needed to support the implementation of such interventions.

Leadership, governance and management for improving district capacity and performance: the case of USAID Transform: Primary Health Care

“…The study demonstrated that district health managers' performance is highly related to performance of other primary health care entities. This nding is consistent with other similar research in other settings where improving performance of district management improved the performance of primary health care functions (12) (13). The analysis of district management administrative capacity shows differences between LMG and non-LMG districts.…”

Managerial capacity among district health managers and its association with district performance: A comparative descriptive study of six districts in the Eastern Region of Ghana

“…In alignment, Seims et al found that strengthening leadership and management skills among DHMs in Kenya through a team-based approach led to significant increases in health-service delivery [24]. The importance of building abilities among DHMs to work effectively within teams has been confirmed by other studies as well [5,10,23,43,54], and an emphasis on this should thus be ensured in district level management strengthening efforts.…”

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“…Effective leadership has been recognised as crucial in shaping organisational culture and driving the implementation of reforms in the health care sector, evident in the growing interests in the concepts of health management and leadership across different countries (Ayeleke 2018). Already the 2000 WHO Report on Health Systems (WHO, 2000) brought new attention to the importance of 'stewardship' as a critical element of every health system, which has been relabelled 'leadership and governance', and recognized as a critical lever for health system development ( De Savigny,2009;Gilson, 2018). Indeed, a sudy showed that both poor leadership practices often impact negatively on staff motivation and patient care, and also provided some evidence of the positive potential of new forms of participatory leadership (Gilson, 2018).…”

“…Already the 2000 WHO Report on Health Systems (WHO, 2000) brought new attention to the importance of 'stewardship' as a critical element of every health system, which has been relabelled 'leadership and governance', and recognized as a critical lever for health system development ( De Savigny,2009;Gilson, 2018). Indeed, a sudy showed that both poor leadership practices often impact negatively on staff motivation and patient care, and also provided some evidence of the positive potential of new forms of participatory leadership (Gilson, 2018). This is so, not only as usual for high-level policy makers, but also for leadership roles undertaken by many actors during the lengthy process of policy initiation, selection, development, implementation, and evaluation (Chunharas et al, 2016).…”