Strategic Leadership Practices and Organizational Performance in Public Healthcare Institutions in Bauchi State, Nigeria: A Cross-Sectional Study

Healthcare institutions operate in complex environments characterised by resource constraints, workforce challenges, technological change, and increasing expectations for quality care. This study examined the association between strategic leadership practices and organisational performance in selected public healthcare institutions in Bauchi State, Nigeria. A quantitative cross-sectional survey was conducted among management and senior professional personnel across five public healthcare institutions representing primary, secondary, and tertiary levels of care. Of 130 questionnaires distributed, 112 were completed, yielding an 86.2% response rate. Strategic vision, communication, employee empowerment, strategic decision-making, change management, and organisational performance were assessed using a five-point Likert scale. Data were analysed using descriptive statistics, Pearson correlation, and multiple linear regression at a 5% significance level. Strategic vision (mean = 3.59), decision-making (mean = 3.57), and communication (mean = 3.52) were rated more favourably than employee empowerment (mean = 3.31) and change management (mean = 3.12). All leadership dimensions correlated positively with organisational performance (r = 0.286–0.612). The regression model was significant, F(5,106) = 39.42, p < .001, explaining 65.9% of performance variance (R² = 0.659). Strategic decision-making was the strongest predictor (β = 0.312, p < .001), followed by communication, vision, and empowerment, while change management was not independently significant. Strengthening strategic decision-making, communication, vision-setting, employee empowerment, and structured change-management processes may improve organisational performance in public healthcare institutions.