Matandela Mirriam, Chisale Goitsemang Lucy, Matahela Vhothusa Edward
National Department of Health, Pretoria, South Africa.
Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa.
Front Health Serv. 2025 Aug 20;5:1634563. doi: 10.3389/frhs.2025.1634563. eCollection 2025.
Nurses are central to South Africa's healthcare system, yet the sector faces ongoing challenges, including workforce shortages, high workloads, limited career progression, and weak institutional support. These issues are exacerbated by the absence of a structured leadership development framework. In response, the national Department of Health, through the South African Nursing Leadership Initiative, launched a pilot study to explore nurse leaders' perceptions of leadership development needs prior to the development of a national Nursing Leadership Competency Framework. This study explored nurse leaders' perceptions of the leadership capacity required to strengthen the nursing workforce and support national health priorities.
A qualitative, exploratory study was conducted between May and July 2024, involving 153 purposively selected nurse leaders from four provinces. Data were collected through structured group narrative sessions, using semi-structured questionnaires aligned with global frameworks. A deductive thematic narrative analysis guided by Braun and Clarke's six-phase framework (2006) was employed to identify themes.
Three central themes emerged consistently across the pilot provinces. (1) revealed persistent nursing shortages and limited opportunities for career advancement. (2) highlighted the need for structured in-service education and leadership training to address skills gaps. (3) underscored high workloads, inadequate institutional support and the absence of psychological safety, all contributing to poor retention and morale.
This pilot study provides contextual insights into the leadership development needs of a limited group of nurse leaders, which will inform the refinement of data collection tools and the design of a larger, national study. The findings are not generalisable but offer valuable direction for developing a contextually grounded Nursing Leadership Competency Framework and supporting strategic leadership capacity-building aligned with South Africa's health system strengthening goals.
护士在南非医疗体系中至关重要，但该行业面临持续挑战，包括劳动力短缺、工作量大、职业发展受限以及机构支持薄弱。由于缺乏结构化的领导力发展框架，这些问题更加严重。作为回应，国家卫生部通过南非护理领导力倡议开展了一项试点研究，以在制定国家护理领导力能力框架之前，探索护士领导者对领导力发展需求的看法。本研究探讨了护士领导者对加强护理劳动力和支持国家卫生重点所需领导能力的看法。
2024年5月至7月进行了一项定性探索性研究，涉及从四个省份有目的地挑选的153名护士领导者。通过结构化小组叙述会议收集数据，使用与全球框架一致的半结构化问卷。采用由布劳恩和克拉克的六阶段框架（2006年）指导的演绎主题叙述分析来确定主题。
在试点省份中始终出现了三个核心主题。（1）显示护理人员持续短缺且职业晋升机会有限。（2）强调需要结构化的在职教育和领导力培训以解决技能差距。（3）强调工作量大、机构支持不足以及缺乏心理安全感，所有这些都导致留用率低和士气低落。
这项试点研究提供了对有限数量护士领导者领导力发展需求的背景见解，这将为完善数据收集工具和设计更大规模的全国性研究提供信息。这些发现不具有普遍性，但为制定基于具体情况的护理领导力能力框架以及支持与南非卫生系统加强目标相一致的战略领导力能力建设提供了有价值的方向。
