Health Sector Succession Planning and Management Practices in Sierra Leone: A Situation Analysis to Inform Health System Strengthening
DOI:
https://doi.org/10.47604/ijlg.3501Keywords:
Succession Planning, Succession Management, Leadership, Public Health, Public SectorAbstract
Purpose: This study aimed to evaluate succession planning and management (SPM) practices as part of health system strengthening initiatives to optimize performance and impact on population health outcomes
Methodology: A Mixed-method cross-sectional study design was used with both qualitative data and quantitative data collected simultaneously. The target population is middle and senior leaders within the civil service between Grade 9 and Grade 14 in the MoH, comprising healthcare professionals and administrative staff at national and district levels. For the quantitative survey, a total of 402 respondents completed the survey, representing 32% of the study population (n=1,264). For the qualitative interview, a purposive sample of twenty (20) participants was targeted among the eligible MoH personnel for this study, with a 90% (n=18) response rate. A semi-structured guide was used for the interviews, which were conducted largely in English. All interviews were audio-recorded with the participants’ consent. For the survey analysis, all 402 cases were considered, and the data analysis procedure involved both descriptive and inferential analyses, using SPSS version 25. For the analysis, Braun and Clarke’s (2006) step-by-step framework for performing thematic analysis was followed. The MAXQDA 22 software was used for the text coding and storage.
Findings: The study findings revealed SPM practices are lacking or inadequate in the public health sector. The study also found that women are inadequately considered for top management positions. There is a significant relationship between gender and perceptions about women being considered for leadership positions, X2 (3, N = 402) = 8.88, p < .05. However, the relationship between gender and the other variables (occupational roles, professional cadres, and grade) shows no statistically significant difference (p > 0.05).
Unique Contribution to Theory, Practice and Policy: Utilizing the Human Capital Theory and the Signaling Theory, this study evaluated the current SPM practices in the public health sector of a post-conflict setting. This study was significant to policy and practice for providing awareness of the use of effective succession planning strategies for achieving sustainability by retaining talented staff and developing future leaders to benefit the continuity of healthcare services for all Sierra Leoneans. It is recommended that the MoH, with the support of public sector oversight institutions should explore the possibility of forming a succession management committee to streamline succession issues in the health sector, with attention given to addressing workplace barriers to facilitate women’s advancement in their careers within the public health sector.
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References
Abate, G. B., & Woldie, A. T. (2022). Breaking barriers to women’s advancement in the public sector in Sub-Saharan Africa. Canadian Bureau for International Education.
Adam, T., & De Savigny, D. (2012). Systems thinking for strengthening health systems in LMICs: Need for a paradigm shift. Health Policy Planning; 27 (4):iv1-iv3.
Ager, A., Saleh, S.,Wurie, H., & Witter, S. (2019). Health in situations of fragility: A systems for health approach. WHO Bulletin;97:378-378A
Ahluwalia, S.C., Damberg, C.L., Silverman, M., Motala, A., & Shekelle, P.G. (2017). What defines a high-performing health care delivery system: a systematic review. Joint Commission Journal on Quality and Patient Safety; 43:450–9
Ali, Z., Mahmood, B., & Mehreen, A. (2019). Linking succession planning to employee performance: The mediating roles of career development and performance appraisal. Australian Journal of Career Development, 28(2), 112–121.
Al Hilali, K. S., Al Mughairi, B. M., Kian, M. W., & Karim, A. M. (2020). Coaching and mentoring. Concepts and practices in development of competencies: A theoretical perspective. International Journal of Academic Research in Accounting, Finance and Management Sciences, 10(1), 41-54.
Alter, S. (2013). Building a blueprint for success. Journal of Property Management, 78, 16-20. Retrieved from http://www.irem.org/jpm
Arimie, C. J., Eghaghe, A., & Osaluwe, E. O. (2022). Management Development and Succession Planning: Challenges and Prospects for Nigerian Public Service. Nigerian Journal of Political & Administrative Studies Vol. 6.1, 134-153
Biesma, R.G., Brugha, R., Harmer, A., Walsh, A., Spicer, N., & Walt, G. (2009). The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control. Health Policy & Planning; 24(4):239–52.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https:// doi.org/10.1191/1478088706qp063oa
Carriere, B., Cummings, G., Muise, M., & Newburn-Cook, C. (2009). Healthcare succession planning: An integrative review. Journal of Nursing Administration, 39, 548–555. doi:10.1097/NNA.0b013e3181c18010
Chee, G., PIelemeier, N., Lion, A., & Gonnor, C. (2013). Why differentiating between health system support and health systemstrengthening is needed. International Journal of Health Planning & Management;28(1):85-94.
Ciccone, D. K., Vian, T., Maurer, L., & Bradley, E.H.(2014). Linking governance mechanisms to health outcomes: a review of the literature in low- and middle-income countries. Social Science & Medicine;117:86-95
Clark, D., & Martorell, P. (2014). The signaling value of a high school diploma. Journal of Political Economy, 122, 282-318. Retrieved from http://www.journals.uchicago.edu/loi/jpe
Darvish, H., & Temelie, Z. N. (2014). A study on the relationship between succession planning and strategic planning. Case study: Payame Noor University of Aleshtar. Economic Insights-Trends & Challenges, 66(1), 11-24. Retrieved from http://www.upg-bulletin-se.ro
De Vos, A., & Dries, N. (2013). Applying a talent management lens to career management: The role of human capital composition and continuity. International Journal of Human Resource Management, 24, 1816-1831. doi:10.1080/09585192. 2013.777537
Dodd, K., & Simons, C. (2005). Succession Planning - Securing your Organization’s Future. Home Health Care Management & Practice, 17(5), 401–402. https://doi.org/10.1177/1084822305275604
Durst, S., & Bruns, G. (2016). Sustaining the future of the public sector: insights into a Swedish municipality’s dealing with knowledge management and succession planning. Journal of Information & Knowledge Management, 15(02), 1650012.
Guest, D. E., Sanders, K., Rodrigues, R., & Oliveira, T. (2021). Signalling theory as a framework for analysing human resource management processes and integrating human resource attribution theories: A conceptual analysis and empirical exploration. Human resource management journal, 31(3), 796-818.
Granados, N., & Gupta, A. (2013). Transparency strategy: Competing with information in a digital world. MIS Quarterly, 37, 637-641. Retrieved from www.misq.org
Gray, D. (2014). Succession planning 101. Professional Safety, 59, 35-35. Retrieved from http://www.asse.org/professional-safety/
Groves, K. S. (2018). Succession management capabilities: planning for the inevitable transition of executive talent. Academy of Management Proceedings;1, p. 15773. doi.org/10.5465/AMBPP.2018.15773
Harper, E., Leider, J.P., Coronado, F., & Beck, A.J. (2018). Succession Planning in State Health Agencies in the United States: A Brief Report. Journal of Public Health Management and Practice 24(5):p 473-478, DOI: 10.1097/PHH.0000000000000700
Harris, C. M., Pattie, M. W., & McMahan, G. C. (2015). Advancement along a career path: The influence of human capital and performance. Human Resource Management Journal, 25, 102-115. doi:10.1111/1748-8583.12047
Health Labour Market Analysis in Sierra Leone (2019)
Hussain, A.T. and Binti, M, S. (2023). Reviewing the relation between Human Resources Practices, Talent Management and Succession Planning in UAE Public Sector. Information Sciences Letters; 12 (4) . Available at: https://digitalcommons.aaru.edu.jo/isl/vol12/iss4/42
Ingale, A. (2024). Succession planning and leadership development are important in creating a talent pipeline within human resource management. Available at SSRN 5031223.
Ismail, A., Adnan, N. H., & Bakar, R. A. (2014). Perceived career development support in workplace career program. Ekonomski Anali/Economic Annals 59, 151-175. doi:10.2298/EKA14011571
Keerio, N., Ahmad, A. R., & Abbas, Z. (2022). Integrated model of organisational culture and succession planning in the context of higher education institutions: a brief review. International Journal of Services and Operations Management, 42(2), 281-293.
Khwela, B. C., Derera, E., & Kubheka, Z. (2020). Women in leadership and the glass ceiling effect: A comparative study of the private and public sectors in KwaZulu-Natal, South Africa. International Journal of Social Sciences and Humanity Studies, 12(2), 368-383.
Klein, M. F., & Salk, R. J. (2013). Presidential succession planning: A qualitative study in private higher education. Journal of Leadership & Organizational Studies, 20, 335-345. doi:10.1177/1548051813483836
Kulshrestha, S. (2024). A Study to Explore the Impact of Performance Appraisal and Rewards on Employees Attrition Level. Open Access Journal of Behavioural Science & Psychology, 7(2), 1-5.
Lembani, M., de Pinho, H., Delobelle, P., Zarowsky, C., Mathole, T., & Ager, A. (2015). Health systems resilience: a systems analysis. A case study of maternal health service provision in OR Tambo District, Eastern Cape, in the context of chronic poor health performance. ReBUILD Consortium. https://assets. publishing.service.gov.uk/media/57a08985e5274a31e0000110/healthsystems-resilience_eastern-cape-case-study_final-report.pdf. Accessed 20 July 2025
Lin, C. T., & Chang, T. T. (2018). Who Is My Successor? Creating a Mentor–Protégé Selection and Evaluation Model Based on the Views of Mentors. Journal of Testing and Evaluation, 46(3), 1158-1167.
Marginson, S. (2019). Limitations of human capital theory. Studies in highereducation, 44(2), 287-301.
Mateso, P. E. E. (2010). Understanding Succession Planning and Management Efforts at Midwestern University: A Mixed Methods Study [Doctoral dissertation, Bowling Green State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1276203234
McConnell CR, Brue SL, Macpherson DA (2009). Contemporary labor economics. New York: McGrew-Hill.
Mehrtak, M., Vatankhah, S., Delgoshaei, B., and Gholipour, A. (2014). Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education. Global Journal of Health Science; 6(5); doi:10.5539/gjhs.v6n5p174
Mishra, S., & Mishra, D. (2013). Review of literature on factors influencing attrition and retention. International Journal of Organizational Behaviour & Management Perspectives, 2(3), 435.
Mitalo, R., & Aleu, D. A. A. (2025). Impact of Succession Planning Practices on Employee Performance of the Ministry of Public Service in Juba, South Sudan. East African Scholars Journal of Economics, Business and Management; 8(7):237-247. DOI: https://doi.org/10.36349/easjebm.2025.v08i07.004
Mutale, W., Bond, V., Mwanamwenge, M.T., Mlewa, S., Balabanova, D., Spicer, N., et al. (2013). Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study. BMC Health Services Research;13:291.
Mutale,W., Vardoy-Mutale, A.T., Kachemba, A., Mukendi, R., Clarke, K., & Mulenga, D. (2017). Leadership and management training as a catalyst to health system strengthening in low-income settings: evidence from implementation of the Zambia Man-agement and Leadership course for district health managers in Zambia. PLoS One. ;12(7):e0174536
Mwisongo, A., & Nabyonga-Orem J. (2016). Global health initiatives in Africa - governance, priorities, harmonisation and alignment. BMC Health Services Research;16(4):212.
Osituyo, Oladapo O. (2018). Deliberate Ceiling for Career Progress of Female Public Service Employees: A Contemporary Transformation Trend in South Africa. Journal of International Women's Studies, 19(3), 172-186. Available at: http://vc.bridgew.edu/jiws/vol19/iss3/13
Pelan, V. (2012). The difference between mentoring and coaching. Talent Management Magazine, 34-37.
Pila, M. M., Schultz, C., & Dachapalli, L. A. (2016). Factors related to succession planning in a government department in Gauteng. Problems and Perspectives in Management, 14(4), 145-153.
Rothwell, W. J. (2005). Effective succession planning: Ensuring leadership continuity and building talent from within (3rd ed.). New York, NY: American Management Association
Rothwell, W. J. (2011). Replacement planning: A starting point for succession planning and talent management. International Journal of Training and Development, 15(1), 87-99.
Rowold, J. (2014). Instrumental leadership: Extending the transformational-transactional leadership paradigm. Zeitschrift Für Personalforschung, 28, 367-390. doi:10.1688/ZfP-2014-03-Rowold
Samuels, F., Amaya, A.B., & Balabanova, D. (2017). Drivers of health system strengthening: Learning from implementation of mater-nal and child health programmes in Mozambique, Nepal and Rwanda. Health Policy & Planning;32(7):1015-1031
Shuey, D., & Dodd, R. (2012). Country health systems and global health partnerships: what are the challenges, how to think about them and what to do differently. In: Low-Beer D, editor. Innovative health partnerships. The diplomacy of diversity. New Jersey: World Scientific Publishing; 151 –74.
Titzer, J., Phillips, T., Tooley, S., Hall, N., & Shirey, M. (2013). Nurse manager succession planning: Synthesis of the evidence. Journal of Nursing Management, 21, 971-979. doi:10.1111/jonm.12179
Titzer, J. L., Shirey, M. R., & Hauk, S. (2014). A nurse manager succession planning model with associated empirical outcomes. Journal of Nursing Administration, 44, 37-46. doi:10.1097/NNA.0000000000000019
Trepanier, S., & Crenshaw, J. T. (2013). Succession planning: A call to action for nurse executives. Journal of Nursing Management, 21, 980-985. doi:10.1111 /jonm.12177
Trickel, M. M. (2015). The exploration of executive leadership succession planning strategies in New Jersey community colleges. (Doctoral dissertation). Retrieved from ProQuest Digital Dissertations and Theses database. (UMI No.3731183)
Vyas-Doorgapersad, S., & Bangani, A. (2020). The implementation of gender equality within the South African Public Service (1994–2019). Africa’s Public Service Delivery and Performance Review, 8(1), 1-10.
Walton-Roberts, M., Runnels, V., Rajan, I, Sood, A., Nair, S. et al. (2017). Causes, consequences, and policy responses to the migration of health workers: key findings from India. Human Resources for Health; 15:28 doi:10.1186/s12960-017-0199-y
Wiesman, J. M.; Babich, S.M.; Umble, K.; & Baker, E.L., (2016). Succession Planning and Management Practice in Washington State Local Public Health Agencies. Journal of Public Health Management and Practice; 22(6):512-519, DOI: 10.1097/PHH.0000000000000397
Witter, S., Palmer, N., Balabanova, D., et al. (2019). Health system strengthening—Reflectionson its meaning, assessment, and our state of knowledge. International Journal of Health Planning & Management; 34:e1980–e1989. https://doi.org/10.1002/hpm.2882
World Health Organization (2007). Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes: WHO’s Framework for Action. World Health Organization: Geneva
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