Date of Conferral

2023

Degree

Ph.D.

School

Health Services

Advisor

Kenneth Feldman

Abstract

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines to understand leadership guided the study. The findings indicate that the combination of management and leadership practices that promote accountability results are motivated and sustained by the leaders’ ethical and moral values, character and soft skills; majorly driven by task, relations, change, and externally-oriented leadership behavior; aligned with the leaders’ perceived primary management and leadership roles and responsibilities; and focus on enabling others to identify the right problem to address, recognize and navigate the eclectic ecosystem-wide interests, and mandates. These findings add to knowledge on managing and leading accountability in low-income settings. Implications for positive social change included understanding how to identify, select, develop, promote, and retain managers and staff with the relevant skills, enduring positive intrapersonal accountability motives and practices; this results in building effective organization systems that shape, strengthen, and sustain a culture of accountability for results.

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