From hierarchy to collaborative authentic leadership: attributes and lessons from primary health care implementation in west bengal, india

This commentary argues that primary health care in marginalized settings improves when leadership shifts from hierarchical to collaborative-that is, authentic leadership. By "collaborative authentic leadership," we mean a practice that combines the honesty and self-awareness of authentic leadership with the shared decision-making of collaborative leadership so that those closest to the community help shape the care it receives.Drawing on three JBI-informed projects in West Bengal-diabetes screening and diarrhea care via mobile medical units in Jalpaiguri, and antenatal care in Howrah sub-centers-this analysis shows how empowering frontline providers and using the JBI evidence implementation model bridges a baseline gap between remote service delivery and community alignment.This gap reflected a structural tension: top-down leadership silences the informal providers and accredited social health activists, who know communities best, leaving them present but powerless. Collaborative authentic leadership addresses this tension directly by distributing authority to those closest to the community, appointing diabetes ambassadors, mentoring younger mothers through experienced peers, training informal health care providers in evidence-based practice, and creating shared spaces for data review and decision-making. In each case, the shift to collaborative and authentic leadership was modest in resources but substantial in the redistribution of accountability and voice.This commentary explains a shift into practical, field-grounded, day-to-day leadership style, aligned with collaborative and authentic leadership, presenting transferable lessons for primary health care in similar low- and middle-income settings. SPANISH ABSTRACT: https://links.lww.com/IJEBH/A670.