The Influence of Leadership Styles on Employee Performance in the Zambian Public Health Sector

Leadership effectiveness is a critical determinant of employee performance in public health institutions, particularly in resource-constrained contexts such as Zambia, where challenges in staff motivation, accountability, and service delivery persist. This study examined the influence of leadership styles on employee performance in the Zambian public health sector, focusing on the Lusaka District Health Office (LDHO), with specific emphasis on transformational, transactional, and participative leadership styles and the mediating role of employee motivation. Guided by a positivist philosophy, the study adopted a quantitative, cross-sectional, descriptive, and correlational design, with data collected through a structured questionnaire grounded in the Full Range Leadership Theory and Herzberg’s Two-Factor Theory. Using stratified random sampling, 314 valid responses were obtained from a target of 378 employees across clinical, administrative, managerial, and support staff. Data were analysed using SPSS version 26 through descriptive statistics, Pearson correlation, hierarchical multiple regression, and mediation analysis based on the Baron and Kenny framework supported by the Sobel test. The findings revealed that participative and transactional leadership styles had significant positive effects on employee performance, while transformational leadership did not exhibit a statistically significant direct influence in the final model. Leadership styles collectively explained 41.1% of the variance in employee performance (R² = 0.411, p < 0.001), indicating moderate explanatory power. Employee motivation emerged as the strongest predictor of performance and significantly mediated the relationship between leadership styles and employee performance, confirming both direct and indirect pathways of influence. The study concludes that leadership approaches emphasising employee involvement, shared decision-making, and structured accountability are more effective in enhancing performance in the LDHO context than purely inspirational approaches. It contributes to theory by providing context-specific evidence on leadership–motivation–performance dynamics within Zambia’s decentralised public health system and offers practical implications for strengthening leadership development and performance management. However, the cross-sectional design limits causal inference, and the findings should be interpreted as associative rather than causal.