Assessing Management and Leadership Quality Styles of Sub-district Leaders in Relation to Staff Performance in the Sub-districts: The Pursuit of Health System Strengthening, Fanteakwa District

Background: Sub-district leaders/managers are health care professionals appointed to lead or manage the sub-districts. A series of survey and monitoring reports have unearthed weak leadership and management at the sub-districts which has the potential of weakening the sub-district health systems and which contributes to the overall effect on resilient health systems. The objectives of the study were to: determine the leadership styles exhibited by sub-district leaders, analyze the association between the leadership/management styles of Sub-district leaders and performance of their subordinates, and analyze the relationship between Leadership Styles and performance of Sub-district leaders.

Methods: A cross-sectional survey design was employed. The average performance of the leaders was calculated based on the Ghana Health Service performance appraisals criteria. Principal Component and Exploratory Factor Analyses were used to determine the leadership styles exhibited whilst correlation and regression analyses were used to determine the association between: leadership styles and subordinates performance, and leadership styles and leaders performance.

Results: The results showed that transformational and supportive are the leadership styles exhibited by the leaders and both are positively related to the performance of their subordinates. However, transformational leadership style tends to add more to the subordinates performance than the supportive style leaders. Both leadership styles are each significantly associated to the performance of the leaders. Additionally, a higher overall leader’s performance is associated with a higher subordinate’s performance. Also a higher leadership ability rating is associated with higher leaders’ performance.

Conclusion: Sub-district leaders or managers` leadership styles have a tremendous influence on the performance of their subordinates and the leaders themselves. The transformational and supportive leadership styles are positively related to the performance of the subordinates. A qualitative research is needed to obtain in-depth information about the leadership quality styles of sub-district leaders.