Increasing access to primary health care through distributed leadership

Abstract

ABSTRACT Background: Primary health care is a vital component of an effective health-care system. However, there are challenges in access to primary health care. The leadership approach adopted in primary health-care delivery has been called a key determinant of access to care. Objectives: In this study, the researcher examines the adoption of distributed leadership in primary health-care delivery and how it affects access to primary health care. The researcher seeks to establish the features of distributed leadership in primary health care, adoption of said leadership, and the impact of leadership approach on barriers to access. Methods: The study is based on a quantitative analysis of 12 studies from various countries globally that were retrieved from seven electronic databases. Results: It is noted that the main features of distributed leadership in primary health care include leadership coalitions among members of primary health care teams, a collective approach to decision-making, and shared accountability. The adoption of distributed leadership is seen to significantly reduce communication barriers (P = 0.01) and knowledge barriers (P = 0.028) while enhancing continuity of care in primary health-care delivery (P = 0.03). The researcher also reports a statistically significant difference in health-care access, depending on the different features of distributed leadership (χ 2(2) = 6.003, P = 0.014). Conclusions: The evidence presented could equip primary health-care leaders and policy makers with insights and knowledge regarding the enhancement of primary health-care access through the adoption of a distributed leadership approach.