• Conrad Musinguzi, Leticia Namale, Elizeus Rutebemberwa, Aruna Dahal, Patricia Nahirya-Ntege, and Adeodata Kekitiinwa.
• Directorate of Health Systems Strengthening, Baylor College of Medicine Children's Foundation, Kampala, Uganda.
• J Healthc Leadersh. 2018 Jan 1; 10: 21-32.

BackgroundLeadership is key to strengthening performance of Health Systems. Leadership styles are important organizational antecedents, especially in influencing employee's motivation, job satisfaction, and teamwork. There is limited research exploring this relationship among health workers in resource-limited settings such as Uganda. The aim of this study was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and motivation, job satisfaction, and teamwork of health workers in Uganda.MethodWe conducted a cross-sectional study in 3 geographic regions of Uganda in November 2015, using self-administered questionnaires with 564 health workers from 228 health facilities. Data were collected on health workers' perception of leadership styles displayed by their facility leaders, their level of motivation, job satisfaction, and team work. Using Pearson correlation, relationships among variables were identified and associations of the components of leadership styles with motivation, job satisfaction, and teamwork was found using multivariable logistic regression.ResultsHealth workers in Uganda preferred leaders who were transformational (62%) compared with being transactional (42%) or laissez-faire (14%). Transformational leadership was positively correlated with motivation (r=0.32), job satisfaction (r=0.38), and team work (r=0.48), while transactional leadership was positively correlated with job satisfaction (r=0.21) and teamwork (r=0.18). Motivation was positively associated with leaders who displayed idealized influence-behavior (odds ratio [OR]=3.7; 95% CI, 1.33-10.48) and intellectual stimulation (OR=2.4; 95% CI, 1.13-5.15) but negatively associated with management by exception (OR=0.4; 95% CI, 0.19-0.82). Job satisfaction was positively associated with intellectual stimulation (OR=5.7; 95% CI, 1.83-17.79). Teamwork was positively associated with idealized influence-behavior (OR=1.07-8.57), idealized influence-attributed (OR=3.9; 95% CI, 1.24-12.36), and contingent reward (OR=5.6; 95% CI, 1.87-17.01).ConclusionTransformational styles had a positive impact on stimulating motivation, assuring job satisfaction, and consolidating teamwork among health workers compared with those who demonstrated transactional skills or laissez-faire styles.RecommendationSupporting transformational leadership skills development in health facility leaders could encourage health worker motivation, strengthen job satisfaction, and maintain cohesion among health workers for better service delivery.

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