Strategic leadership and change management imperatives in a volatile era: a case study of Prince Mshiyeni Memorial Hospital.
Authors:   , Zungu Knowledge Lungisani 
Published: January 2024

The South African public healthcare system plays a critical role in rendering care to the majority of the population. Public healthcare is one of the democratic government’s key priorities, reflected in the constitutional commitment to providing accessible and quality healthcare efficiently and sustainably to all citizens. To realise this commitment, leadership and management of public healthcare facilities play a significant role as they can influence the success or failure of delivering quality and efficient healthcare services. Primarily because it is the responsibility of leaders to render healthcare sector demands efficiently and effectively. Strategic leadership is one of the effective tools for efficient management. Its effect on managing complexities, shocks, and various forms of turbulence and its efficiency is well documented in the literature. As a country heavily burdened by socio-economic development challenges such as the increasing poverty and unemployment rate, the number of people relying on public healthcare continually increases. With increasing healthcare demands and the burden of disease, public hospitals and clinics as institutions operate in challenging, complex and dynamic environments. Additional to an already turbulent environment prone to change and instability, public healthcare institutions in South Africa operate under the globally experienced volatile, uncertain, complex and ambiguous business environment. Therefore, the assessment of leadership styles, practices, and their impact is of performance in of great importance. Given such a state, the literature points to the importance of strategic leadership being a vital requirement for healthcare management and leadership. The wide range of strategic leadership competencies enables leaders to adapt continuously to change and the fast speed of innovation. This is because strategic leaders are visionary; they have the capacity to innovatively and creatively navigate organisations through volatility to improve performance. This study aimed to investigate the role of strategic leadership and change management at Prince Mshiyeni Memorial Hospital. Through a qualitative inquiry, an interview schedule of sixteen questions was administered to fifteen participants in leadership positions within the hospital. Questions probed to unearth the strategic activities and successfully captured experiences and viewpoints on the impact of strategic leadership in managing change and the hospital's performance in this era of unpredictable constant change. The findings of this study pointed out that Mshiyeni hospital operates in a complex and demanding environment with constrained human and financial resources. The hospital tackles extensive responsibilities of regional and district hospital services in an overly populated location dominated by socio-economically challenged communities. Results further showed that keeping the hospital operational at a satisfactory level has been achieved through strategic leadership approaches designed and actioned by the leaders at the hospital level. As access and delivery of quality healthcare is a constitutional mandate in SA, the commitment to deliver efficient and effective healthcare service is cited as one of the main priority objectives of the department of health. However, the financial provisions for public healthcare facilities seem not to match the service demands in a manner that can enable public hospitals to deliver their service sufficiently. It is recommended that future research probe into this matter at an executive level within the health department. This recommendation will aid in getting an idea of how the health department idealises its public institutions to execute its services in the context of the existing constrained resources state.