Elements of management and leadership strengthening in health systems: a qualitative study from Iran

Abstract

PurposeThe importance of management capacity in the health sector has been increasingly recognized. The World Health Organization (WHO) (2008) has claimed that limited “management capacity” in low-income countries is one of the main obstacles toward achieving health-related goals. The aim of this study is to answer the research question: “What are the elements of management and leadership capacity of senior managers from the perspective of senior managers.”Design/methodology/approachSemi-structured individual interviews were conducted with 20 senior health managers. Sampling method was purposive. Data were collected using a researcher-made interview guide. The transcribed text was analyzed using framework analysis.FindingsFive main themes emerged from the analysis are: (1) competencies required for managers; (2) selection and appointment of managers; (3) establishment of managers' database; (4) deployment of functional support system; and (5) environmental sensitivity. Each of these themes contains sub-themes.Research limitations/implicationsDue to the COVID-19 pandemic, the interviews were conducted virtually. This may have had an impact on obtaining wealthy data because in a face-to-face interview, it is possible to question and answer, get additional explanations and understand the interviewee's mentality.Practical implicationsExtracting elements of management and leadership capacity helps managers to assess management capacity and leadership comprehensively and effectively. In addition, effective and useful operations can be done to strengthen the management and leadership capacity.Originality/valueThis is the first study that has identified the main elements of management and leadership capacity from the perspective of senior health managers in Iran. This article provides the components of the health system management and leadership capacity that can be used at top management level.