WE LED THROUGH THE STORM: A COMPARATIVE ANALYSIS OF LEADERSHIP STYLES AND STRATEGIES DURING THE COVID-19 PANDEMIC IN SOUTH AFRICA AND SIERRA LEONE
1
Faculty of Health Sciences, School of Public Health, University of Pretoria, Pretoria, South Africa
2
Health, Ministry of Health, Freetown, Sierra Leone
Popul. Med. 2026;8(Supplement Supplement 1):A3124
ABSTRACT
BACKGROUND:
COVID-19, the pandemic, exposed systemic vulnerabilities within many healthcare systems, illustrating the critical role of resilient leadership in managing and navigating unprecedented global crises. This study employed a multiple comparative case study approach to compare South Africa, an upper-middle-income country, with Sierra Leone, a resource-poor setting with prior experience with Ebola. During 2024-2025, semi-structured interviews were conducted with health leaders and policymakers in both countries.
METHODS:
The data was analysed thematically to identify similarities and differences in leadership crisis management and strategies implemented during the pandemic. Nine themes emerged: (1) leadership and coordination structures; (2) border health, surveillance, and preparedness; (3) human resources, training, and workforce support; (4) continuity of essential health services; (5) risk communication, community engagement, and infodemic management; (6) resource mobilisation and logistics; (7) collaboration and multi-sectoral approaches; (8) challenges, failures, and gaps; and (9) lessons learned and recommendations.
RESULTS:
Sierra Leone demonstrated absorptive and adaptive capacities by leveraging community structures and lessons learned from the Ebola outbreak to sustain services and mobilise rapid responses despite severe resource constraints. South Africa, in contrast, emphasised centralised decision-making and socioeconomic relief, demonstrating adaptive and transformative capacities through large-scale vaccination rollouts but facing political contestations and challenges in maintaining public trust.
CONCLUSIONS:
Leadership resilience during health crises is not determined by resources. Strengthening leadership frameworks that integrate absorptive, adaptive and transformative (restructuring systems for long-term resilience) capacities is necessary to build pandemic preparedness. Embedding community engagement, transparent communication, and multi-sectoral collaboration into preparedness strategies will be critical for ensuring equitable and effective responses to future pandemics.
COVID-19, the pandemic, exposed systemic vulnerabilities within many healthcare systems, illustrating the critical role of resilient leadership in managing and navigating unprecedented global crises. This study employed a multiple comparative case study approach to compare South Africa, an upper-middle-income country, with Sierra Leone, a resource-poor setting with prior experience with Ebola. During 2024-2025, semi-structured interviews were conducted with health leaders and policymakers in both countries.
METHODS:
The data was analysed thematically to identify similarities and differences in leadership crisis management and strategies implemented during the pandemic. Nine themes emerged: (1) leadership and coordination structures; (2) border health, surveillance, and preparedness; (3) human resources, training, and workforce support; (4) continuity of essential health services; (5) risk communication, community engagement, and infodemic management; (6) resource mobilisation and logistics; (7) collaboration and multi-sectoral approaches; (8) challenges, failures, and gaps; and (9) lessons learned and recommendations.
RESULTS:
Sierra Leone demonstrated absorptive and adaptive capacities by leveraging community structures and lessons learned from the Ebola outbreak to sustain services and mobilise rapid responses despite severe resource constraints. South Africa, in contrast, emphasised centralised decision-making and socioeconomic relief, demonstrating adaptive and transformative capacities through large-scale vaccination rollouts but facing political contestations and challenges in maintaining public trust.
CONCLUSIONS:
Leadership resilience during health crises is not determined by resources. Strengthening leadership frameworks that integrate absorptive, adaptive and transformative (restructuring systems for long-term resilience) capacities is necessary to build pandemic preparedness. Embedding community engagement, transparent communication, and multi-sectoral collaboration into preparedness strategies will be critical for ensuring equitable and effective responses to future pandemics.
| eISSN: | 2654-1459 |
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