Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study

Abstract Background The importance of strong and transformative leadership is recognised as essential to the building of resilient and responsive health systems. In this regard, Sustainable Development Goals (SDG) 5 prioritises a current gap, by calling for women’s full and effective participation a...

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Main Authors: Maylene Shung-King, Lucy Gilson, Chinyere Mbachu, Sassy Molyneux, Kelly W. Muraya, Nkoli Uguru, Veloshnee Govender
Format: Article
Language:English
Published: BMC 2018-09-01
Series:International Journal for Equity in Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12939-018-0859-0
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author Maylene Shung-King
Lucy Gilson
Chinyere Mbachu
Sassy Molyneux
Kelly W. Muraya
Nkoli Uguru
Veloshnee Govender
author_facet Maylene Shung-King
Lucy Gilson
Chinyere Mbachu
Sassy Molyneux
Kelly W. Muraya
Nkoli Uguru
Veloshnee Govender
author_sort Maylene Shung-King
collection DOAJ
description Abstract Background The importance of strong and transformative leadership is recognised as essential to the building of resilient and responsive health systems. In this regard, Sustainable Development Goals (SDG) 5 prioritises a current gap, by calling for women’s full and effective participation and equal opportunities for leadership, including in the health system. In South Africa, pre-democracy repressive race-based policies, coupled with strong patriarchy, led to women and especially black women, being ‘left behind’ in terms of career development and progression into senior health leadership positions. Methods Given limited prior inquiry into this subject, we conducted a qualitative exploratory study employing case study design, with the individual managers as the cases, to examine the influence of gender on career progression and leadership perceptions and experiences of senior managers in South Africa in five geographical districts, located in two provinces. We explored this through in-depth interviews, including life histories, career pathway mapping and critical incident analysis. The study sample selection was purposive and included 14 female and 5 male senior-managers in district and provincial health departments. Results Our findings suggest that women considerably lag behind their male counterparts in advancing into management- and senior positions. We also found that race strongly intersected with gender in the lived experiences and career pathways of black female managers and in part for some black male managers. Professional hierarchy further compounded the influence of gender and race for black women managers, as doctors, who were frequently male, advanced more rapidly into management and senior management positions, than their female counterparts. Although not widespread, other minority groups, such as male managers in predominantly female departments, also experienced prejudice and marginalisation. Affirmative employment policies, introduced in the new democratic dispensation, addressed this discriminatory legacy and contributed to a number of women being the ‘first’ to occupy senior management positions. In one of the provinces, these pioneering female managers assumed role-modelling and mentoring roles and built strong networks of support for emerging managers. This was aided by an enabling, value-based, organisational culture. Conclusion This study has implications for institutionalising personal and organisational development that recognise and appropriately advances women managers, paying attention to the intersections of gender, race and professional hierarchy. It is important in the context of national and global goals, in particular SDG 5, that women and in particular black women, are prioritised for training and capacity development and ensuring that transformative health system policies and practices recognise and adapt, supporting the multiple social and work roles that managers, in particular women, play.
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spelling doaj.art-035df6628cf04f13be7da36584e7d4682022-12-22T01:14:54ZengBMCInternational Journal for Equity in Health1475-92762018-09-0117111210.1186/s12939-018-0859-0Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory studyMaylene Shung-King0Lucy Gilson1Chinyere Mbachu2Sassy Molyneux3Kelly W. Muraya4Nkoli Uguru5Veloshnee Govender6Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape TownHealth Policy and Systems Division, School of Public Health and Family Medicine, University of Cape TownCollege of Medicine, University of Nigeria Enugu CampusKEMRI-Wellcome Trust Research ProgrammeKEMRI-Wellcome Trust Research ProgrammeCollege of Medicine, University of Nigeria Enugu CampusAlliance for Health Policy and Systems, World Health OrganizationAbstract Background The importance of strong and transformative leadership is recognised as essential to the building of resilient and responsive health systems. In this regard, Sustainable Development Goals (SDG) 5 prioritises a current gap, by calling for women’s full and effective participation and equal opportunities for leadership, including in the health system. In South Africa, pre-democracy repressive race-based policies, coupled with strong patriarchy, led to women and especially black women, being ‘left behind’ in terms of career development and progression into senior health leadership positions. Methods Given limited prior inquiry into this subject, we conducted a qualitative exploratory study employing case study design, with the individual managers as the cases, to examine the influence of gender on career progression and leadership perceptions and experiences of senior managers in South Africa in five geographical districts, located in two provinces. We explored this through in-depth interviews, including life histories, career pathway mapping and critical incident analysis. The study sample selection was purposive and included 14 female and 5 male senior-managers in district and provincial health departments. Results Our findings suggest that women considerably lag behind their male counterparts in advancing into management- and senior positions. We also found that race strongly intersected with gender in the lived experiences and career pathways of black female managers and in part for some black male managers. Professional hierarchy further compounded the influence of gender and race for black women managers, as doctors, who were frequently male, advanced more rapidly into management and senior management positions, than their female counterparts. Although not widespread, other minority groups, such as male managers in predominantly female departments, also experienced prejudice and marginalisation. Affirmative employment policies, introduced in the new democratic dispensation, addressed this discriminatory legacy and contributed to a number of women being the ‘first’ to occupy senior management positions. In one of the provinces, these pioneering female managers assumed role-modelling and mentoring roles and built strong networks of support for emerging managers. This was aided by an enabling, value-based, organisational culture. Conclusion This study has implications for institutionalising personal and organisational development that recognise and appropriately advances women managers, paying attention to the intersections of gender, race and professional hierarchy. It is important in the context of national and global goals, in particular SDG 5, that women and in particular black women, are prioritised for training and capacity development and ensuring that transformative health system policies and practices recognise and adapt, supporting the multiple social and work roles that managers, in particular women, play.http://link.springer.com/article/10.1186/s12939-018-0859-0Gender and leadership in healthGender, race and professional hierarchy and health leadershipSouth African health leaders and genderIntersectional social identities and health leadership
spellingShingle Maylene Shung-King
Lucy Gilson
Chinyere Mbachu
Sassy Molyneux
Kelly W. Muraya
Nkoli Uguru
Veloshnee Govender
Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
International Journal for Equity in Health
Gender and leadership in health
Gender, race and professional hierarchy and health leadership
South African health leaders and gender
Intersectional social identities and health leadership
title Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
title_full Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
title_fullStr Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
title_full_unstemmed Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
title_short Leadership experiences and practices of South African health managers: what is the influence of gender? -a qualitative, exploratory study
title_sort leadership experiences and practices of south african health managers what is the influence of gender a qualitative exploratory study
topic Gender and leadership in health
Gender, race and professional hierarchy and health leadership
South African health leaders and gender
Intersectional social identities and health leadership
url http://link.springer.com/article/10.1186/s12939-018-0859-0
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