The Interactions of Public Health Organisational Leadership with its Environment: A Case Study of the Sally Mugabe Central Hospital in Harare, Zimbabwe

Abstract

Introduction and Background: This paper presents a case study from Sally Mugabe Central Hospital; that examines the interactions of public health organisational leadership with its environment, within the context of  Zimbabwe's unique social, economic and political circumstances.

Objective: To investigate how the local context and local environment of Zimbabwe's unique social, economic  and political situation have interacted with the leadership of Sally Mugabe Central Hospital as a Zimbabwean public health institution.

Methods: A combination of semi-structured interviews and document analysis were used to conduct the  research. Purposive sampling and expert sampling were used to select respondents for interviews. Content  analysis of relevant administrative and management documents kept at the participating institution was carried out. This research is located within the theoretical framework of Health Policy and Systems Research (HPSR);  and examines the institutional level or meso-level of the healthcare system.

Results and Discussion: Research findings are discussed under subheadings that correspond to the interactions of social, economic and political factors with public health institutional leadership.

Recommendations: Based on the research findings of this case study, recommendations are made on relevant and effective changes to practice, for the leadership of Zimbabwean public health institutions,  recommendations that may have some applicability elsewhere as well, on the basis of lessons learnt.

Conclusion: The problem of chronic underfunding; as well as the social, economic and political challenges that have been experienced at the institutional level in the Zimbabwean public health system; require innovative and adaptive public health leadership that can confront adversity in a complex environment.