A win-win for health care: promoting co-leadership and increasing women’s representation at the top

Purpose This paper aims to contribute to the growing body of research on health-care leadership by demonstrating the value of dyads and triads in strengthening capabilities of health-care settings and providing action pathways to accelerate gender parity in senior health-care positions. Design/methodology/approach The paper reviews the evidence that when single-leadership models are used and women are under-represented in leadership, the health-care industry may miss out on opportunities to increase efficiency and quality of care. Next, the paper describes a co-leadership model with distinct and overlapping roles, which promotes women’s participation and inspires administrative and clinical leaders to collaborate and achieve optimal performance. Findings The dyad as the enabling track for women in health-care leadership creates opportunities for health-care systems to bridge the gender gap in senior positions as well as improve the delivery of cost-effective quality care. Practical implications The inclusive co-leadership model with distinct and overlapping roles is a promising pathway for increasing health-care system efficiency and for promoting women to senior roles by tapping into the leadership skills and expertise that women bring to these roles. Originality/value The current paper demonstrates the dual effects of using co-leadership in senior health-care positions and fixing the gender imbalance. It has significant implications for advancing similar pathways in other industries as a means for accelerating gender parity in senior management.

Serving two masters? Shared corporate leadership and conflict of interest

In order to reduce costs and inefficiencies, break down silos, and create smoother transitions of care, health organizations are starting to share senior leadership roles with their regional partners. While these are laudable goals, having individuals share responsibilities among two or more organizations can pose significant ethical challenges such as divided loyalties and create a conflict of interest. The risks of conflict of interest among senior health leaders who share roles within multiple health organizations have largely been ignored. This article will explore the ethical challenges of this issue and offer suggestions on how senior health leaders who are put in this uncomfortable position can identify and respond to a potential conflict of interest.

Preferences of healthcare providers for capitation payment in Kenya: a discrete choice experiment

Provider payment mechanisms (PPMs) are important to the universal health coverage (UHC) agenda as they can influence healthcare provider behaviour and create incentives for health service delivery, quality and efficiency. Therefore, when designing PPMs, it is important to consider providers’ preferences for PPM characteristics. We set out to uncover senior health facility managers’ preferences for the attributes of a capitation payment mechanism in Kenya. We use a discrete choice experiment and focus on four capitation attributes, namely, payment schedule, timeliness of payments, capitation rate per individual per year and services to be paid by the capitation rate. Using a Bayesian efficient experimental design, choice data were collected from 233 senior health facility managers across 98 health facilities in seven Kenyan counties. Panel mixed multinomial logit and latent class models were used in the analysis. We found that capitation arrangements with frequent payment schedules, timelier disbursements, higher payment rates per individual per year and those that paid for a limited set of health services were preferred. The capitation rate per individual per year was the most important attribute. Respondents were willing to accept an increase in the capitation rate to compensate for bundling a broader set of health services under the capitation payment. In addition, we found preference heterogeneity across respondents and latent classes. In conclusion, these attributes can be used as potential targets for interventions aimed at configuring capitation to achieve UHC.