The influence of prevailing managerial leadership style on employee engagement, job satisfaction and organisational commitment: a South African public health sector perspective.

Doctoral Degree. University of KwaZulu-Natal, Durban.There are many commonalities in public policy implementation areas. In South Africa there are many public policies which, though well developed, face challenges such as poor leadership, shortage of resources including human resources, inadequate finance, and poor infrastructure, specifically at implementation levels, in most of sectors including the public health sector. This study was conducted to explore the leadership styles of managers working at Public Hospitals in Vhembe District of the Limpopo Department of Health (LDoH) in South Africa. The study was conducted in support of the pilot implementation of the National Health Insurance (NHI) Public Policy which is being piloted in some districts (including Vhembe District) in South Africa, and also to prepare the South African public health sector, in particular the LDoH, for countrywide implementation of a NHI policy. The LDoH, like any other organisations in the world, is faced with the challenges of an ever-changing environment such as an increasing burden of disease, high attrition rates, difficulty to retain employees with scarce skills, and increased demand for health care services, to mention a few. These challenges necessitate the urgency to have good leaders in public hospitals to ensure the smooth running of the hospitals and achievement of the organisational goals. The study’s aim therefore was to investigate managerial leadership styles adopted by managers employed at public hospitals with the aim of identifying the dominant style of leadership and evaluate its influence on employee engagement, job satisfaction and organisational commitment. Additionally, the study was undertaken to identify challenges, obstacles and problems faced by managers working at public hospitals of the LDoH, particularly when executing their daily tasks or responsibilities. There have been limited studies on the influence of the managerial leadership style on employee engagement, job satisfaction, and organisational commitment, especially in the South African Public Health Sector. Both qualitative and quantitative methods (mixed methods) were employed to understand managerial leadership styles and answer the research questions. For quantitative data collection, the instrument used was a questionnaire and for qualitative data collection, a semi-structured interview was employed. Quantitative data were analysed using Excel spreadsheets and Statistical Package for Social Sciences (SPSS) software. Qualitative data were transcribed and analysed using narrative thematic analysis. To explore the influence of the prevailing managerial leadership style adopted by managers, the researcher used factor analysis regression analysis. The results of this study identified two leadership styles adopted by managers working at public hospitals in Vhembe district, autocratic, and participative or democratic leadership styles. This study showed that the prevailing managerial leadership style adopted by managers of public hospitals in Vhembe District is an autocratic leadership style. This predominant managerial leadership style was found to have a positive influence on employee engagement in clinical employees, and a negative influence on employee engagement in non-clinical employees. The study also revealed a negative influence of the prevailing leadership style on clinical employees’ job satisfaction, and a positive relationship between the prevailing managerial leadership style and non-clinical employees’ job satisfaction. Furthermore, the study findings indicated a negative correlation between clinical employees’ organisational commitment, and a positive relationship between non-clinical employees’ organisational commitment. With regard to challenges faced by managers working at public hospitals in Vhembe district, the findings revealed the greatest challenges as acting in higher posts, bad attitude by some employees, poor communication, absenteeism and lack of respect as key challenges faced by managers. In view of the NHI’s main objective which is Universal Health Coverage (UHC), this research recommends democratic or participative and transformational leadership styles as suitable leadership styles for managers working at public hospitals