Abstract
Leadership in public health is necessary, relevant, and important as it enables the engagement, management, and transformation of complex public health challenges at a national level, as well as collaborating with internal stakeholders to address global public health threats. The research literature recommends exploring the journey of public health leaders and the factors influencing leadership development, especially in developing countries. Thus, we aimed to develop a grounded theory on individual leadership development in the Nepalese context. For this, we adopted constructivist grounded theory, and conducted 46 intensive interviews with 22 public health officials working under the Ministry of Health, Nepal. Data were analysed by adopting the principles of Charmaz's constructivist grounded theory. The theory developed from this study illustrates four phases of leadership development within an individual-initiation, identification, development, and expansion. The 'initial phase' is about an individual's wishes to be a leader without a formal role or acknowledgement, where family environment, social environment and individual characteristics play a role in influencing the actualisation of leadership behaviours. The 'identification phase' involves being identified as a public health official after having formal position in health-related organisations. The 'development' phase is about developing core leadership capabilities mostly through exposure and experiences. The 'expansion' phase describes expanding leadership capabilities and recognition mostly by continuous self-directed learning. The grounded theory provides insights into the meaning and actions of participants' professional experiences and highlighted the role of individual characteristics, family and socio-cultural environment, and workplace settings in the development of leadership capabilities. It has implications for academia to fulfill the absence of leadership theory in public health and is significant to fulfill the need of leadership models grounded in the local context of Asian countries.
Highlights
Leadership is one of the most observed phenomena but least understood [1]
Public health reaches beyond health issues/problems or health services/system, and leadership is required to respond the social and political factors that impact the health of the population
The research question guided this study was ’how does someone become a leader in public health in context of Nepal?’ We explored the journey of public health officials and investigated the socio-cultural factors that support the progress of leadership development among them
Summary
Despite numerous research and studies, leadership lacks universal definition because of its personalized application and different ways to influence people To understand it leadership is ’a process whereby an individual influence a group of individuals to achieve a common goal’ [2]. A better understanding of public health leadership is needed to enable leaders to deal with contemporary public health issues [37], and to bring desirable changes in the organisation. In most of the developing countries like Nepal, the senior officials in health organisations are technical staff (doctors, nurses, and allied health workers) who are in-charge of managing people and programs These officials are not formally employed as leaders with the responsibility to bring changes in the organization. It is necessary to understand the perspectives of leadership among public health professionals from varied backgrounds to explore the way they lead public health services
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