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Importance of Medical Leadership Study in African States

Efficiency in a health care setting involves management skills and leadership abilities. Management and leadership have been developed in the business field, applying knowledge to the companies, aiming at financial profit. However, leadership in the medical field needs another perspective, which is different from the business one. Management in health services involves “decision-making for complex systems comprising both the hardware (finances, medicines, infrastructure) and software (ideas, trust, values) aspects” (Mathole, Lembani, Jackson, Zarowsky, Bijlmakers, & Sanders, 2018, p. ii6). In the reviewed article, written in 2018, the efficiency of maternal health services in two rural hospitals in South Africa was analyzed using quantitative methods. The under-studied topic of medical leadership in African states is highly significant to the current global health care environment, as research in the field can contribute to other low- and middle- income countries (LMICs).

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Concerning the authors’ position on the described topic, they defined two types of leadership (distributed and hierarchical), which led to different outcomes. Mathole et al. (2018) revealed apparent differences between medical workers’ organizational culture and leadership style in two analyzed hospitals. It was concluded that the leadership approach affects hospital results: with distributed type perinatal mortality rates were low (Chisomo hospital), while with hierarchical one, they were high (Tinyade hospital). Scholars stated that good performance in Chisomo hospital is driven by a few individuals, so “sustainability in health facilities still needs strong and well-developed systems” for the whole structure to demonstrate high efficiency despite workers’ characteristics (Mathole et al., 2018, p. ii15). Although high mortality rates in hospitals (even varying from place to place) in South Africa can be partly solved by distributed leadership approach, it is still a structural problem.

I support their view on the need to introduce well-developed systems in health facilities, as hospitals have different workers, territories, and specializations, so the structural change should be made. Scholars defined distributed type based on the workers’ teamwork, cooperation of departments, and management meetings as the most efficient kind of leadership (Mathole et al., 2018). From my perspective, the leadership theory which fits the conclusion is the transformational one. According to Mathole et al. (2018), a leader in a transformational approach “encourages teamwork, collaboration, empathy and the acceptance and use of innovativeness which results in improvement of outcomes” (p. ii14). Transformational type is not based on leader’s personal characteristics but on his skills to organize cooperation among workers; therefore, it can be achieved in each healthcare institution.

Provided that the leadership in health services in South Africa is a structural problem, some policies need to be implemented. Health policy involves actions to be made in society and medical organizations to achieve specific healthcare goals. To strengthen leadership in the medical structure, changes in health policy in South Africa and other LMICs need to be made. The current health policy in African states establishes equal access to the national health-care institutions for different socio-economic groups. So, the governmental focus is on broadening the opportunities of receiving medical aid for the population. However, the topic of leadership is relevant to the local hospitals even within current health policy, as it lets them improve the quality of provided treatment.

In conclusion, it is necessary to state that the under-studied topic of medical leadership in South Africa is relevant to the current care environment as some of the leadership types, such as distributed, may raise the quality of the provided services. Applying transformational leadership theory to medical organizations, the efficiency of hospitals’ workers may be increased. At the same time, providing sustainability to health facilities should become a new branch in current health policy in low- and middle- income countries.


Mathole, T., Lembani, M., Jackson, D., Zarowsky, C., Bijlmakers, L., & Sanders, D. (2018).

Leadership and the functioning of maternal health services in two rural district hospitals in South Africa. Health Policy and Planning, 33(2), ii5-ii15.

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