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Leadership from ‘below’? Clinical staff and public hospitals in South Africa


This paper identifies the possibilities and challenges related to involving clinical staff in the leadership and management of district hospitals in South Africa. It couches findings and recommendations in terms that are applicable to other service sectors. This is because strengthening the leadership capacity of practitioners (as opposed to simply their line managers’), and facilitating participation in their organizations’ decision-making processes, might be one mechanism to restore responsiveness and quality in public services in general. The study also speaks to how to strengthen the public sector along lines that preserve its ‘publicness’ and enable it to meet its social objectives more effectively, as an alternative to more market-based approaches.

Jane Doherty
Publication Information: 
Briefing Note No. 4
Publication Date: 
Publication Type: 
Briefing Note