Leadership and management competencies and practices among health managers in Wakiso District, Uganda

INTRODUCTION: Leadership and management are of great importance for health service delivery, yet they are understudied in Uganda. We therefore conducted a study that assessed the leadership and management competencies and practices among health managers in Wakiso District, Uganda. MATERIALS AND METHODS: A cross-sectional study that employed a structured questionnaire was conducted among 60 health managers. The health managers were in-charges of government lower-level health facilities (health centre II, III, and IV). The questionnaire had questions on leadership and management competencies including cognitive, interpersonal, organisation and supervision, as well as human resource management skills. Data was analysed descriptively in Stata version 14. RESULTS: Most health managers were female 37 (61.7%), a significant proportion 43 (71.7%) were not inducted into their roles, and 37 (61.7%) lacked motivation to perform their duties. Overall, only 15 (25.0%) and 20 (33.3%) demonstrated good leadership and management competencies respectively. In addition, means for leadership and management competencies ranged from 20.9 to 37.0 and 7.8 to 36.5 respectively. According to the health managers, monitoring 39 (65.0%), speaking 36 (60.0%) and active listening 35 (58.3%) were the most important cognitive skills; while coordination 27 (45.0%), instructing 25 (41.7%), and social perceptiveness 25 (41.7%) were mentioned as the most important interpersonal skills. In addition, management of financial 38 (63.3%), logistic 34 (56.7%), and human resources 31 (52.5%) were the most important business analysis skills. Health managers frequently engaged in promoting good working relationships among subordinates 32 (53.3%), holding self and others accountable for health facility organisational goal attainment 28 (46.7%), and creating an effective work environment for subordinates 27 (45.0%). CONCLUSIONS: Leadership and management competencies among health managers were generally lacking. There is need for induction and routine refresher training on leadership and management among health managers to enhance their performance.