An Exploration of Leadership Challenges in Government Hospitals in India during Health Crisis - Confab 360 Degree Annual Conference in Dubai, 2025

Abstract

Introduction: Leadership in Indian government hospitals faces serious challenges during health crises like the COVID-19 pandemic, including bureaucratic delays, resource constraints, and ethical dilemmas in resource usage. These issues are further worsened by federal-state tension, inadequate adaptive competency, and systemic inequities, usually resulting in suboptimal crisis response and burnout. This paper includes a systematic literature review (SLR) for exploring these challenges and dynamics to inform practice and policy. By critically reviewing existing literature, the study focuses on bridging the gap in understanding crisis-specific stressors and general healthcare management problems, highlighting the need for a transformative approach in resource-deficient settings.

Method: The SLR method follows PRISMA guidelines, searching databases such as Scopus, PubMed, and Google Scholar. 17 articles were finally selected to be included in the study following the inclusion and exclusion criteria specified. Major themes were identified from the extensive review of the selected articles.

Results: Three interconnected themes emerged: systemic operational challenges covering sub-themes of resource scarcity and governance delays; leadership styles and competencies, including adaptive deficits and mental health gaps; and policy reforms, which covered decentralisation and training as sub-themes. Sub-themes revealed crisis-specific aggravated challenges, such as rural inequities and burnout, with regional successes like Kerala's (Indian State) adaptive strategies contrasting national hierarchical failures.

Conclusion: The review reveals the importance and need for an evolutionary leadership shift to develop resilience in Indian hospitals. Recommendations include adaptive training, decentralisation, mental health support, global partnerships, and post-crisis evaluations.