Primary Healthcare Leaders' Perceptions of Relational Leadership: An Action Learning Research Approach

In complex healthcare settings, such as primary healthcare, effective leadership is critical for fostering an environment that prioritizes patient-centered care and strengthened team functioning. Effective leadership requires approaches that emphasize meaningful relationships, collaboration, and communication. It is different from conventional leadership, which deals with delegating authority and tasks. Little is known about how PHC leaders in under-resourced South African settings perceive and enact relational leadership (RL) in their daily practice.

This study explored PHC leaders' perceptions of RL within a South African primary healthcare setting in Gauteng Province, using a qualitative action learning research approach.

A qualitative action learning research approach was used in this study. The data were collected from April 2024 to September 2024.

Ten leaders participated in monthly action learning group sessions, reflective journaling, and collaborative discussions over 6 months, during which the primary researcher observed interactions. Data from transcripts, journals, and the observational notes were thematically analyzed.

Ethical approval was obtained from the North-West University Health Research Ethics Committee (NWU-00041-23-A1). All participants signed a written informed consent form before forming part of the action learning group.

Five themes emerged: understanding and implementing RL; benefits of RL; challenges while implementing RL; connection between RL and patient care; and strategies to enhance the practice and implementation of RL.

Participants perceived RL as fostering trust, team cohesion, and open communication, and as supporting patient-centered care, although heavy workloads, limited resources, and hierarchical norms constrained its practice. These reflections represent subjective perceptions rather than objectively measured outcomes, but they highlight RL's potential value for leadership development in PHC settings.