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Santos RS, Lousã EP, Sá MM, Cordeiro JA. First, Be a Good Citizen: Organizational Citizenship Behaviors, Well-Being at Work and the Moderating Role of Leadership Styles. Behav Sci (Basel) 2023; 13:811. [PMID: 37887461 PMCID: PMC10603912 DOI: 10.3390/bs13100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 10/28/2023] Open
Abstract
The study investigates the effect of organizational citizenship behavior (OCB) on well-being at work. The study further examines the moderating role of people and task-focused leadership styles between OCB on well-being at work. Individual-directed organizational citizenship behaviors (OCBI) and organizational-directed organizational citizenship behaviors (OCBO) will also be analyzed. A quantitative study was conducted and convenient sampling was adopted in selecting respondent workers (n = 200) in different Portuguese organizations. The results show that OCBs positively and significantly influence well-being at work. The strength of individual-directed organizational citizenship behaviors (OCBI) on well-being at work is stronger than that of organization-directed organizational citizenship behaviors (OCBO). Contrary to expectations, the relationship between leadership styles and well-being was not statistically significant, offering possibilities for discussion regarding the central importance usually attributed to leadership in the organizational context. However, leadership styles have a moderating effect between OCB and well-being at work, except when the employee adopts OCBO and the leadership style is people-oriented. The present study is innovative because it positions OCB as an antecedent in the relationship with well-being at work and investigates the moderating role of leadership styles in the relationship between organizational citizenship behavior and well-being.
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Affiliation(s)
- Reinaldo Sousa Santos
- Research Unit in Business Sciences and Sustainability (UNICES), University of Maia, 4475-690 Maia, Portugal; (E.P.L.); (M.M.S.)
| | - Eva Petiz Lousã
- Research Unit in Business Sciences and Sustainability (UNICES), University of Maia, 4475-690 Maia, Portugal; (E.P.L.); (M.M.S.)
- Centre for Organizational and Social Studies of Polytechnic of Porto (CEOS.PP), Polytechnic of Porto, 4465-004 Porto, Portugal
| | - Maria Manuel Sá
- Research Unit in Business Sciences and Sustainability (UNICES), University of Maia, 4475-690 Maia, Portugal; (E.P.L.); (M.M.S.)
- NECE-UBI, Research Centre for Business Sciences, 6200-209 Covilhã, Portugal
| | - João Alves Cordeiro
- Department of Business Sciences, University of Maia, 4475-690 Maia, Portugal;
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Restivo V, Minutolo G, Battaglini A, Carli A, Capraro M, Gaeta M, Odone A, Trucchi C, Favaretti C, Vitale F, Casuccio A. Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before-After Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10995. [PMID: 36078706 PMCID: PMC9518077 DOI: 10.3390/ijerph191710995] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/25/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
To work efficiently in healthcare organizations and optimize resources, team members should agree with their leader's decisions critically. However, nowadays, little evidence is available in the literature. This systematic review and meta-analysis has assessed the effectiveness of leadership interventions in improving healthcare outcomes such as performance and guidelines adherence. Overall, the search strategies retrieved 3,155 records, and 21 of them were included in the meta-analysis. Two databases were used for manuscript research: PubMed and Scopus. On 16th December 2019 the researchers searched for articles published in the English language from 2015 to 2019. Considering the study designs, the pooled leadership effectiveness was 14.0% (95%CI 10.0-18.0%) in before-after studies, whereas the correlation coefficient between leadership interventions and healthcare outcomes was 0.22 (95%CI 0.15-0.28) in the cross-sectional studies. The multi-regression analysis in the cross-sectional studies showed a higher leadership effectiveness in South America (β = 0.56; 95%CI 0.13, 0.99), in private hospitals (β = 0.60; 95%CI 0.14, 1.06), and in medical specialty (β = 0.28; 95%CI 0.02, 0.54). These results encourage the improvement of leadership culture to increase performance and guideline adherence in healthcare settings. To reach this purpose, it would be useful to introduce a leadership curriculum following undergraduate medical courses.
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Affiliation(s)
- Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alberto Battaglini
- Vaccines and Clinical Trials Unit, Department of Health Sciences, University of Genova, Via Antonio Pastore 1, 16132 Genova, Italy
| | - Alberto Carli
- Santa Chiara Hospital, Largo Medaglie d’oro 9, 38122 Trento, Italy
| | - Michele Capraro
- School of Public Health, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
| | - Cecilia Trucchi
- Planning, Epidemiology and Prevention Unit, Liguria Health Authority (A.Li.Sa.), IRCCS San Martino Hospital, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Carlo Favaretti
- Centre on Leadership in Medicine, Catholic University of the Sacred Heart, Largo F. Vito 1, 00168 Rome, Italy
| | - Francesco Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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Argaw MD, Desta BF, Muktar SA, Abera WS, Beshir IA, Otoro IA, Samuel A, Rogers D, Eifler K. Comparison of maternal and child health service performances following a leadership, management, and governance intervention in Ethiopia: a propensity score matched analysis. BMC Health Serv Res 2021; 21:862. [PMID: 34425808 PMCID: PMC8383359 DOI: 10.1186/s12913-021-06873-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing the work climate, and creating responsive health systems. Hence, the Ethiopian Ministry of Health with the support of the USAID Transform: Primary Health Care project has been implementing LMG interventions to improve performances of primary healthcare entities. The purpose of this evaluation was to compare maternal and child health service performances and overall health system strengthening measurement results of primary health care entities by LMG intervention exposed groups. Methods The study used a cross-sectional study design with a propensity matched score analysis, and was conducted from August 28, 2017, to September 30, 2018, in Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and Peoples’ (SNNP) regions. Data collection took place through interviewer and self-administered questionnaires among 227 LMG intervention exposed and 227 non-exposed health workers. Propensity score matched analysis was used to balance comparison groups with respect to measured covariates. Results The mean overall maternal and child health key performance indicator score with standard deviation (± SD) for the LMG intervention exposed group was 63.86 ± 13.16 and 57.02 ± 13.71 for the non-exposed group. The overall health system strengthening score for the LMG intervention exposed group (mean rank = 269.31) and non-exposed group (mean rank = 158.69) had statistically significant differences (U = 10.145, z = − 11.175, p = 0.001). In comparison with its counterpart, the LMG exposed group had higher average performances in 3.54, 3.51, 2.64, 3.00, 1.07, and 3.34 percentage-points for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. Conclusion There were evidences on the positive effects of the LMG intervention on increased maternal and child health services performances at primary healthcare entities. Moreover, health facilities with LMG intervention exposed health workers had higher and statistically significant differences in management systems, work climates, and readiness to face new challenges. Therefore, this study generated evidence for integrating LMG interventions to improve the performance of primary healthcare entities and maternal and child service uptake of community members, which contributes to the reduction of maternal and child deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06873-8.
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Affiliation(s)
- Mesele Damte Argaw
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc, Addis Ababa, Ethiopia.
| | - Binyam Fekadu Desta
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc, Addis Ababa, Ethiopia
| | - Sualiha Abdlkader Muktar
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc, Addis Ababa, Ethiopia
| | - Wondwosen Shiferaw Abera
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc, Addis Ababa, Ethiopia
| | - Ismael Ali Beshir
- USAID Transform: Primary Health Care, JSI Research & Training Institute, Inc, Addis Ababa, Ethiopia
| | - Israel Ataro Otoro
- Federal Ministry of Health, Health Extension and Primary Health Services Directorate, Addis Ababa, Ethiopia
| | - Asegid Samuel
- Federal Ministry of Health, Human Resource Development Directorate, Addis Ababa, Ethiopia
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The fertile grounds of reproductive activism in The Gambia: A qualitative study of local key stakeholders' understandings and heterogeneous actions related to infertility. PLoS One 2019; 14:e0226079. [PMID: 31800633 PMCID: PMC6892487 DOI: 10.1371/journal.pone.0226079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/19/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction While several studies have focussed on the experiences of women living with infertility, there is a paucity of information related to understandings, representations and actions of key stakeholders (i.e. organisations and individual actors involved in activities or professional care surrounding infertility) when it comes to infertility in Sub-Saharan Africa. This ethnographic study conducted in The Gambia, West Africa, focuses on how key stakeholders in the country understand infertility, and on their activities to improve the lives of people with infertility. Methodology This ethnographic study draws on primary and secondary data for thematic analysis. Primary qualitative data were collected using in-depth interviews, observations, informal conversations and group discussion with various stakeholders (i.e. health care providers and representatives of non-governmental, governmental and international organisations). Sources of secondary data included government and non-governmental reports and media outputs. Results Results illustrated that most key stakeholders had a good understanding of the cultural frameworks and social realities of women living with infertility, with less focus on, or awareness of, men’s experiences of infertility. We distinguished three different positions of these actors and organisations, first, the infertility supporters, i.e. those who despite political challenges and a lack of funding, initiated activities to raise awareness about the problems people with infertility are facing and aim to increase access to infertility services. The second are moderate supporters, i.e. those who recognise the problems infertility poses and whose organisations target some of the perceived causes of infertility (i.e. lack of health education and harmful cultural practices). A third group of neutral or moderate opponents consist mainly of formal health care providers who do not consider infertility a current priority, given many competing demands in the resource-constrained healthcare system. Conclusion While international donors still largely neglect the emotional and social implications of infertility in Sub-Saharan African countries, some local stakeholders are working to bring services closer to people with infertility. The efforts of these local stakeholders require support and integration, and should include engaging with different groups for widespread sensitisation to reduce stigma and promote attendance to health centres for reproductive health challenges.
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Phillips-White N, Motomoke E, Nkosi F, Crawford J, Magadzire BP, Larsen-Cooper E, Biayi F. Leading from all levels: building supply chain leadership capacity in Equateur Province, Democratic Republic of Congo. BMJ Glob Health 2019; 4:e001756. [PMID: 31544005 PMCID: PMC6730614 DOI: 10.1136/bmjgh-2019-001756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/24/2019] [Accepted: 07/27/2019] [Indexed: 12/02/2022] Open
Abstract
A well-functioning supply chain is a critical component of the health system to ensure high-quality medicines and health products are available when and where they are needed. However, because supply chains are complex systems, strong, competent leaders are needed to drive continuous improvement efforts. This paper documents the learnings from a supply chain leadership intervention in the Democratic Republic of Congo (DRC), which aimed to build leadership capacity in a cross-tier group of central/provincial/district-level leaders. The intervention, called the Leadership in Supply Chain Initiative, used an experiential learning curriculum to train 19 ‘champions’ in Equateur Province, DRC. Based on self-assessments and key informant interviews, participants reported that the intervention increased their ability to lead change in the supply chain. In particular, participants and stakeholders noted that empowering district managers as leaders in the supply chain was important to improve supply chain performance, since they oversee service delivery points and are responsible for operationalising changes in the supply chain. Moreover, this intervention adds to evidence that leadership capacity is most effectively gained through experiential learning coupled with mentorship and coaching. Additional research is needed to determine the optimal duration of leadership building interventions and to better understand how supply chain leaders can be supported and mentored within the public health system.
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Affiliation(s)
| | - Eomba Motomoke
- Democratic Republic of Congo Country Office, VillageReach, Kinshasa, Democratic Republic of Congo
| | - Freddy Nkosi
- Democratic Republic of Congo Country Office, VillageReach, Kinshasa, Democratic Republic of Congo
| | | | | | | | - Franck Biayi
- Programme National d'Approvisionement en Médicaments Essentiels (PNAM), Kinshasa, Democratic Republic of Congo
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Gilson L, Agyepong IA. Strengthening health system leadership for better governance: what does it take? Health Policy Plan 2018; 33:ii1-ii4. [PMID: 30053034 PMCID: PMC6037056 DOI: 10.1093/heapol/czy052] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 11/13/2022] Open
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.
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Affiliation(s)
- Lucy Gilson
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, South Africa
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Irene Akua Agyepong
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, South Africa
- Division of Research and Development, Dodowa Health Research Centre, Box DD1, Dodowa, Ghana
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Mutale W, Vardoy-Mutale AT, Kachemba A, Mukendi R, Clarke K, Mulenga D. Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia. PLoS One 2017; 12:e0174536. [PMID: 28742853 PMCID: PMC5526553 DOI: 10.1371/journal.pone.0174536] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/11/2017] [Indexed: 11/24/2022] Open
Abstract
Background Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012–2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. Methods This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. Results On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training. Conclusion Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services.
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Affiliation(s)
- Wilbroad Mutale
- University of Zambia School of Medicine, Department of Public Health, Lusaka, Zambia
- * E-mail:
| | | | - Arthur Kachemba
- Broachreach Institute for Training and Education (BRITE), Lusaka, Zambia
| | - Roman Mukendi
- Broachreach Institute for Training and Education (BRITE), Lusaka, Zambia
| | - Kupela Clarke
- Broachreach Institute for Training and Education (BRITE), Lusaka, Zambia
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