Thesis:

Influence of leadership styles on employee performance in selected healthcare facilities in Dadaab subcounty Garissa county

Employee performance was recognized as a fundamental determinant of service quality and operational efficiency in healthcare settings. This study investigated the influence of leadership styles—transformational, transactional, autocratic, and participative—on employee performance within selected healthcare facilities in Dadaab Subcounty, Garissa County, Kenya. Guided by four specific objectives, the study sought to examine the influence of transformational leadership; assess the role of transactional leadership; analyze the effects of autocratic leadership; and evaluate the impact of participative leadership on employee performance. The study was underpinned by Transformational Leadership Theory and the Path-Goal Theory of Leadership, which provided a theoretical lens for understanding how leadership behaviors influenced subordinate outcomes within complex operational environments. A descriptive survey research design was adopted to collect quantitative data reflective of the prevailing experiences and practices in the healthcare sector. The target population comprised 161 employees, including medical officers, nurses, clinical officers, laboratory technicians, public health officers, and administrators from both public and private healthcare institutions. Given the manageable population size, the study employed a census sampling method, involving all 161 individuals to ensure comprehensive coverage and minimize sampling bias. Data were collected using semi-structured questionnaires comprising both closed and open ended items, organized according to the study variables and measured using a 5-point Likert scale. To ensure validity and reliability, the instruments were pilot-tested in a neighboring subcounty (Lagdera), and their internal consistency assessed using Cronbach’s Alpha, with a threshold of 0.7 considered acceptable. Data analysis was conducted using SPSS Version 23.0 and Microsoft Excel, applying both descriptive (means, standard deviations, frequencies) and inferential statistics (Pearson correlation and multiple linear regression). The results were presented in the form of tables, graphs, and charts. Findings revealed that transformational (β = 0.402, p < .001), participative (β = 0.346, p < .001), and transactional leadership (β = 0.298, p = .001) significantly and positively influenced employee performance. Autocratic leadership showed a negative and statistically insignificant effect (β = -0.129, p = .060). The model explained 64.3% of variance in employee performance (R² = 0.643) with a statistically significant ANOVA result (F = 69.74, p < .001). Employees reported high levels of motivation (mean = 4.12), collaboration (mean = 4.22), and productivity (mean = 4.12), affirming the positive influence of inclusive leadership. The study concludes that transformational and participative leadership are most effective in enhancing performance, while autocratic leadership hinders engagement. It recommends institutionalizing leadership training programs, promoting participative decision-making, and phasing out rigid autocratic practices.