The Influence of Leadership Styles on Health Workers Performance in Uganda: A Study of Kampala Capital City Authority Health Facilities

Abstract

The importance of leadership style as predictor of organizational citizenship behavior (OCB) has been well established in Western settings. Leadership is defined as the ability to set employees in motion to get works done. It reflects an influence relationship behavior between leaders and followers in a particular situation with the common intention to accomplish the organizations end results.

In order for health care workers to operate efficiently, they must have effective leadership, and the health care leaders of KCCA health facilities face challenges due to the increasing complexities aris¬ing both in the industry and the authority itself. These challenges will continue to evolve for years to come. Researchers are realizing that health worker commitment and loyalty are at their lowest especially in government owned health facilities in Uganda, and that health care executives, physicians, and patients in Uganda today are generally dissatisfied with the manage¬ment in the industry. Therefore this study sought to determine the influence of leadership styles on health workers performance in KCCA health facilities.

Cross sectional design combined with descriptive and analytical research design were adopted. The study population comprised of health care workers (doctors, clinical officers and professional nurses) from KCCA health facilities within the district (Kampala). In order to avoid bias and ensure representativeness, stratified random sampling was used to select the respondents. Stratification was done by parish, profession and leadership position. Using simple random sampling, health care workers were selected from each stratum based on the lists obtained from the district health offices. The study used in-depth interviews. The data was collected by already used modified Multifactor Leadership Questionnaire (MLQ). Health worker performance data was provided by the respective health facilities from their performance management system. Each performance appraisal factor was measured using a scale of 1-5 where 1 is regarded as low performance, 3 is the target (met performance standard) and 5 is high performance. These scores were averaged, to result into a total score.

From the analysis, 42% of the respondents their performance consistently met or was above acceptable performance levels while the other 2% was below the acceptable level. The most used leadership styles at the KCCA health facilities were authoritative (34%), transactional (32.7%) and (25.4%) transactional was the least used leadership style. Authoritative leadership was used by doctors, clinical offices followed by Laboratory technicians and a small number of Pharmacists

transactional leadership was used by Midwives, Doctors, and Nurses, while transformational leadership was used by Clinical officers followed by Midwives, Nurses, Doctors and Pharmacists.

Authoritative and transformational leadership style had significant relationship whereas transactional style had non-significant influence on health worker performance.

Recommendations

reduction on application of Authoritative leadership styles by KCCA is recommended, hence the District council should advocate for better leadership styles that match different situations. Authoritative leadership results but can be applied in only appropriate situations. KCCA should organize leadership workshops for health workers in leadership positions at all the health facilities under its jurisdictions. This will raise awareness among them in order to make informed choices upon which style.