Unit Six

Leading health care

By: Nejib Sufian(BSc, MA, MPHN)

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Learning Objectives
At the end of this session you will be able to:
• Define leadership
• Describe the leadership practices.
 Discuss different leadership theories, types & styles.

• Explain the differences between leader and manager.

• Describe on different types of power

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 Leadership

“I am more afraid of an army

of 100 sheep led by a lion than
an army of 100 lions led by a
sheep”
Talleyrand

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 What is Leadership?
• Multidimensional concept that can be
defined in different ways,
• The ability to influence a group toward
the achievement of goals.
• leadership is Enabling Groups to Make
Progress in Complex Conditions.
Management sciences for health (2006)
• Leadership is not domination, but the art
of persuading people to work toward a
common goal. Goleman and Daniel,1995.

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 Leadership…
• Leadership is always exercised in relationsh
ip with others.

• The true test of effective leadership is the

visible progress towards the realization o
f vision,
inspire others to follow.

• Leadership involves unequal distribution of

power between the leader and group
members.
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 Leadership…
• The leader must win the willingness of the
workers to accept directions

• Leaders are agents of change, persons

whose acts affect other people more
than other people’s acts affect them

• Leadership is an activity that takes place at

all levels, not a position of authority

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 Leadership is
about:
» Influencing
» Motivating
» Inspiring
» Taking people to greater heights
» Working with participants on the how and
helping them figure out the what and why
» Encouraging them to push themselves to
achieve the highest possible performance
» Action
» Enabling, not telling

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 Who is a leader?
• A leader is an individual in a team influencing
group activities towards goal formulation
and achievement.

• In other words, a leader is someone who has

a vision, and the ability to make it a
reality

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 Who is a leader?
To achieve
objectives

Influence
followers
behavior

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 Dimensions of leadership
• Leadership involves not just “doing” but “being”

• Leadership is exercised with others

• Leadership is responsibility, not rank, title, privilege, or

money

• Leadership and management are both necessary.

• Leadership is about enabling people to face challe

nges.
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Some of the Great leaders

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Leading Practices
Four Leadership
Practices

1. Scanning
2. Focusing
3. Aligning/Mobilizing
4. Inspiring

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 Leadership Practice: Scanning
 Leaders encourage their teams to scan their internal
& external environments, organizations, teams, and
themselves.
 Identify client & stakeholder need & priorities

 Recognize trends, opportunities, & risks that affect

organizations.
 Identify staff capacities & constraints.

 Know yourself, your staff, & your organization

values, strengths, & weakness.

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 Leadership Practice: Focusing
• Using information from scanning, focus on a
response.

• Leaders focus their limited time,

energy, and resources on the people
and things that are most important.
•Articulate the organization’s mission &
strategy
• Identify critical challenges
• Link goals with the overall organizational
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 Leadership Practice:
Aligning/Mobilizing
• A leader aligns and mobilizes others to achieve
objectives.

• This means seeking out other groups or people

whose objectives are in line with yours and getting
them to work alongside you.

• You should align and mobilize stakeholders’ and

staff time and energies as well as the material
and financial resources to support
organizational goals and priorities.

• Facilitate teamwork
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 Leadership Practice: Inspiring
• Helps staff to face challenges creatively.
• They are the people whose example moves us
to follow in their footsteps.

Inspiring involves demonstrating:

 Values through actions as role model &
supporting staff
 “Walking the talk” - matching deeds with
words
 Trust & confidence in staff, acknowledging
their contribution
 Be a model of creativity,
innovation ,learning& supporting staff.
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 Manager Vs Leader

• Sometimes used interchangeably.

• A person emerges as a leader

• A manager is put in to his position by

appointment.
• If a manager cannot influence others he is not
a good leader; though he is a manager.
• There are good leaders who are not managers.

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 Managers  Leaders

 Cope with system  Seeks change

complexity  Set direction and shared values
 Plan and budget  Motivate people
 Control and solve problem
 Administers  Innovates
 A copy  An original
 Maintains  Develops
 Focuses on systems  Focuses on people
&structure  Inspires trust
 Relies on control  Long-range perspective
 Short- range view  Asks what and why
 Asks how and when  Eye on the horizon
 Eye on the bottom line  Originates
 Imitates  Does the right thing
 Does things right
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 Approaches to leadership

1. The trait approach(Theory):

• It was assumed that some people are set apart
from others by virtue of their possession of
some quality or qualities of ‘greatness’ and that
it is these people who become leaders.

• This approach to leadership suggests that it is

personal characteristics, or traits, that differentiate
leaders from those they lead.
• “Leaders are born but not made”

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 The trait approach…

• These leadership traits include

– Personality characteristics (adaptability,

dominance, self-confidence),

– Physical characteristics (above-average

height, medium weight, attractive appearance),
and

– Ability (intelligence, task expertise, sensitivity in

dealing with others).

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 2. The behavioral approach(Theory):

Assumptions:

- Leaders can be made, rather than are born

- Successful leadership is based in definable, learnable

behavior

Description:
 Behavioral theories of leadership do not seek inborn traits
or capabilities. Rather, they look at what leaders actually do.

• Studied behavioral characteristics of leaders;

• What they do and how they interact with the subordinates;

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 3. The contingency approach:

• Leadership could vary with the situation or

circumstances
• Focuses on task requirements

• No single trait has been shown to be common to

all effective leaders and no single style has been
found to be effective in improving staff performance
in all situations.
• The management technique that best contributes to
the attainment of organizational goals might vary
in different types of situations or circumstances

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 Types of leaders
1. Transactional leaders

• Identify the expectations of their followers

• Act managerially by establishing a close link

between effort and reward.
• They evaluate, correct and train staff whenever
staff performance needs to be improved, and they
reward appropriately when the required
outcomes are achieved.

• Power is given to the leader to evaluate and reward

the followers. 24
 2. Transformational leaders

• Transformational leaders, as defined by Bass

(1985) support their staff and encourage them
to ‘do more than they originally expected to
do’.
• Transformational leaders motivate staff to do
better

• Transformational leaders provide encouragement

and support to followers.

• show trust and respect for them as individuals

• They build self-confidence and heighten

personal development
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 Types of Leaders…
3. Charismatic leaders
• Max Weber, a sociologist, defined charisma (from the
Greek for “gift”) more than a century ago as “a certain
quality of an individual personality, by virtue of
which he or she is set apart from ordinary people.”
• Charismatic leaders rely on their personality, their
inspirational qualities and their aura/ characteristic

Key Characteristics of a Charismatic Leader

• Vision and articulation

• Willing to take on high personal risk

• Sensitive to follower needs 26

 Types of Leaders

4. Situational leaders

• Is one who can adopt different leadership

styles depending on the situation

• Effective leaders are versatile/Adapt in

being able to move between the styles
according to the situation, so there is no one
right style

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 Leadership styles
 It is the typical pattern of behavior that a leader uses to
influence their employees to achieve organizational goals.

1. Autocratic Leaders:
• Make decisions and announce them

• There is also a clear division between the leader and the

followers.
• “ Do just what I say” or “ Don’t touch the hot iron”.

• Subordinates carry out orders

• Believe that money is the only reward that will motiv

ate staffs. 28
Autocratic Leader

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 Styles of
Leadership
2. Democratic /participative Leaders:
• Democratic leaders, also known as participative
leaders, encourage group members to
participate.
• Democratic leaders keep staff informed about
everything that affects their work and share
decision-making and problem-solving
responsibilities.
• Group members feel engaged in the process
and thus are more motivated and creative
• Permit subordinates to make decisions
• Ideas are bilaterally proposed
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Democratic Leader

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 Democratic /participative
Leaders…
• This style is most successful
– when used with highly skilled or
experienced staff or
– when implementing operational
changes or resolving individual or
group problems

• This is a popular style because when it is

done well it creates a harmonious,
productive and developing work force

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 Styles Leadership….
3. Laissez – faire Leaders:
• Laissez-faire leadership is a style where the leader
provides little or no direction and gives staff
as much freedom as possible.
• All authority or power is given to the staff and
they determine goals, make decisions, and resolve
problems on their own.
• The laissez-faire leader promotes a strong sense
of competence and expertise in team members
and allows others to rise to their performance
potential.
• This style can lack accountability for team
failures
Type I
• Leaders have little or no confidence in their abi 33
Laissez – faire Leaders

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 Laissez – faire Leaders ….

Type II:

• Leaders are extremely confident about their staff

s
• Subordinates may be high in their academic
position.
• Every staff knows the objectives of his / her orga
nization.
• Able to plan and implement independently

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Leadership Styles

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 Leadership use of power and
authority
• Leaders influence people to do things
through the use of power and authority.

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 Leadership use of power and
authority…

• ‘Authority’ is the formal right to get people to do

things or the formal right to control resources

• Factors within a person, such as talent or charm,

help them achieve power.

• Power is the ability to influence decisions and

control resources.

• Powerful people have the potential to exercise

influence, and they exercise it frequently.

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• Only the organization can confer authority.
 Five types of power

1. Legitimate power
• It is a result of the position a person holds
in the organization hierarchy.

• It is the easiest type of influence for most

staff to accept.

• For example, virtually all employees accept

the manager’s authority to conduct a
performance evaluation.

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 types of power…

2. Reward power
• Emanates/issue from the leaders ability to
reward desirable behavior
• It stems partly from the legitimate power.
• Reward includes pay increase,
promotions, work schedule,
recognitions of accomplishment, etc

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 3. Coercive power
• is the opposite of reward power

• based on the leader’s ability to punish or

prevent them from obtaining desired
rewards.
• Organizational punishments include
assignment to undesirable working
hours, demotion, and firing

• Effective leaders generally avoid heavy

reliance on coercive power.

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 4. Expert power
• It derives from a leader’s job-related
knowledge as perceived by group
members.

• This type of power stems from having

specialized skills, knowledge, or
talent

• Expert power can be exercised even

when a person does not occupy a 44
 5. Referent power
• It refers to control based on loyalty to
the leader and the group members’
desire to please that person.

• Having referent power contributes to

being perceived as charismatic, but
expert power also enhances charisma

• Part of the loyalty to the leader is

based on identification with the
leader’s personal characteristics.
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 Thank
you!!

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