Leadership and health organisations

The 2008 World Health Organization (WHO) Health Report highlighted leadership reforms as one of the four strategies of the New Primary Health Care approach. Leadership reforms were described as reforms to make health authorities more reliable and accountable. Health authorities can do a much better job of formulating and implementing Primary Health Care reforms adapted to local contexts. ¹ At government level, leadership reforms in health systems will involve several paradigm shifts. First is a shift from ‘reactionary’ to ‘activist’ government, whereby visionary government leaders develop realistic and sustainable change agendas, restrain the pace of change and prevent radical excess. Second, governments need to reinvest in leadership and human resources capacity in the health sector. Such investments should be guided by training needs for health leaders, and the aims of high quality and high coverage of public health programmes. Third, government leaders need to adapt to the rising influence of civil society as a facilitator of health reforms, while ensuring that health technocrats are adequately skilled to navigate the murky but ultimately rewarding pathway of intersectoral collaboration with diverse groups of stakeholders. To paraphrase Warren Bennis, health managers are people who do things right, while health leaders are people who do the right thing. Doing the ‘right thing’ entails a thorough understanding of core organisational leadership domains (Figure 6.2).