{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T05:48:11Z","timestamp":1747201691969,"version":"3.37.3"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009497","name":"African Population and Health Research Center","doi-asserted-by":"publisher","award":["Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [reference no. 107768\/Z\/15\/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training, and Science in Africa (DELTAS Africa) programme."],"award-info":[{"award-number":["Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [reference no. 107768\/Z\/15\/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training, and Science in Africa (DELTAS Africa) programme."]}],"id":[{"id":"10.13039\/501100009497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nClinical leaders in health systems play critical roles in making decisions that impact patient care and health system performance. Current literature has focused on the importance of clinical leaders\u2019 roles in healthcare settings and has not addressed the leadership aspect that clinical leaders engage in day-to-day decision-making in HIV facilities while providing HIV patient care. Therefore, identifying the leadership roles that wclinical leaders perform at HIV primary facilities is of critical importance.<\/jats:p>\n<\/jats:sec>\n\nPurpose<\/jats:title>\nThe study explored the views of healthcare providers working in AMPATH-MTRH HIV facility on what they perceived as the roles of clinical leaders at the HIV primary care facility.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nWe conducted a qualitative exploratory study between December 2019 to May 2020, involving in-depth interviews with (n = 22) healthcare providers working in AMPATH-MTRH HIV facility, who were purposively and conveniently sampled to participate in in-depth interviews to explore perceptions regarding the leadership roles of clinical leaders. The collected data were analyzed thematically and Nvivo vs.12 software was used for data management.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe following themes were identified from the analysis regarding perceived clinical leaders\u2019 roles in an HIV primary care facility: 1) Strategic roles:<\/jats:bold> providing direction and guidance, ensuring goals and objectives of the department are achieved within the set timelines, planning, and budgeting for adequate resources to support patient HIV care 2)<\/jats:bold> Interconnecting health systems levels and supervisory oversight roles: a link between management, staff, and patients, solving problems, organizing and attending departmental meetings, facilitate staff training, accountable, collaborating with other departments and leaders, defines and assigns responsibilities, ensure quality patient service, coordination, and management of daily activities 3) Research roles<\/jats:bold>: data collation, analysis, generation, review and reporting to the management.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nClinical leaders in the HIV care system perform leadership roles that are characterized by strategic, middle-level, supervisorial and research which reflects the model of the leadership and management style of the HIV care system. The understanding of these roles contributes valuable insights to HIV leaders and managers to recognize the important contribution of clinical leaders and consider reviewing Standard Operating Procedures to include these leadership roles and strengthen their capacity to maximize clinicians\u2019 contribution to improve HIV care and enhance responsive health systems.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302066","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T19:42:20Z","timestamp":1717184540000},"page":"e0302066","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Leading from the bottom: The clinical leaders roles in an HIV primary care facility in Eldoret, Kenya"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5599-0839","authenticated-orcid":true,"given":"Felishana","family":"Cherop","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juddy","family":"Wachira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Bagire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Korir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"issue":"Suppl.2","key":"pone.0302066.ref001","doi-asserted-by":"crossref","first-page":"ii27","DOI":"10.1093\/heapol\/czx167","article-title":"Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens","volume":"33","author":"J. Nzinga","year":"2018","journal-title":"Health Policy Plan."},{"issue":"5","key":"pone.0302066.ref002","doi-asserted-by":"crossref","first-page":"32","DOI":"10.7748\/phc2013.06.23.5.32.e795","article-title":"Clinical leadership in primary care","volume":"23","author":"R. Taylor","year":"2013","journal-title":"Prim. Heal. Care"},{"issue":"0","key":"pone.0302066.ref003","first-page":"1","article-title":"Clinical Leadership\u2013An Important Precondition for the Success of Proactive and Interdisciplinary Follow-up of Frail Older Recipients of Home Healthcare","volume":"00","author":"G. N\u00e6ss","year":"2023","journal-title":"Home Heal. Care Manag. Pract."},{"key":"pone.0302066.ref004","first-page":"1","article-title":"Attributes, skills and actions of clinical leadership in nursing as reported by hospital nurses: a cross-sectional study","volume":"0","author":"M. T. Mrayyan","year":"2023","journal-title":"BMJ Lead."},{"key":"pone.0302066.ref005","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2147\/JHL.S46161","article-title":"The importance of clinical leadership in the hospital setting","volume":"6","author":"J. Daly","year":"2014","journal-title":"J. Healthc. Leadersh."},{"issue":"Suppl 2, no. 169","key":"pone.0302066.ref006","first-page":"86","article-title":"Clinical leadership and hospital performance: assessing the evidence base","volume":"16","author":"F. Sarto","year":"2016","journal-title":"BMC Health Serv. Res."},{"issue":"1","key":"pone.0302066.ref007","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.socscimed.2012.11.019","article-title":"Clinicians on the board: What difference does it make?","volume":"77","author":"G. Veronesi","year":"2013","journal-title":"Soc. Sci. Med."},{"issue":"11","key":"pone.0302066.ref008","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1111\/jan.14092","article-title":"An integrative review of leadership competencies and attributes in advanced nursing practice","volume":"75","author":"M. Heinen","year":"2019","journal-title":"J. Adv. Nurs."},{"issue":"4","key":"pone.0302066.ref009","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/j.1365-2834.2009.01015.x","article-title":"Public health nurses perception of clinical leadership in Ireland: Narrative descriptions","volume":"17","author":"M. Carney","year":"2009","journal-title":"J. Nurs. Manag."},{"issue":"1","key":"pone.0302066.ref010","first-page":"1","article-title":"A scoping review of mentorship of health personnel to improve the quality of health care in low and middle-income countries","volume":"13","author":"P. Schwerdtle","year":"2017","journal-title":"Global. Health"},{"issue":"10","key":"pone.0302066.ref011","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1111\/j.1365-2702.2007.01823.x","article-title":"The core role of the nurse practitioner: Practice, professionalism and clinical leadership","volume":"16","author":"J. Carryer","year":"2007","journal-title":"J. Clin. Nurs."},{"key":"pone.0302066.ref012","first-page":"1","article-title":"Nurse managers\u2019 leadership roles in mining primary healthcare settings in Gauteng","volume":"27","author":"S. E. Nene","year":"2022","journal-title":"Heal. SA Gesondheid"},{"issue":"2","key":"pone.0302066.ref013","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/1744987112464630","article-title":"Clinical leadership characteristics confirmed","volume":"19","author":"D. Stanley","year":"2014","journal-title":"J. Res. Nurs."},{"key":"pone.0302066.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/1797014","article-title":"The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses\u2019 Perceptions","volume":"2016","author":"I. E. Larsson","year":"2016","journal-title":"Nurs. Res. Pract."},{"issue":"1","key":"pone.0302066.ref015","first-page":"1","article-title":"Towards improved health service quality in Tanzania: Contribution of a supportive supervision approach to increased quality of primary healthcare","volume":"19","author":"S. Renggli","year":"2019","journal-title":"BMC Health Serv. Res."},{"issue":"1","key":"pone.0302066.ref016","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ijgo.2015.10.004","article-title":"A systematic review of supportive supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa","volume":"132","author":"C. Bailey","year":"2016","journal-title":"Int. J. Gynecol. Obstet."},{"issue":"04","key":"pone.0302066.ref017","first-page":"1","article-title":"Exploring Supportive Supervision of Nurses in the Health Care Facilities in Volta Region, Ghana","volume":"03","author":"C. Sah","year":"2023","journal-title":"J. Nurs. Res. Patient Saf. Pract."},{"issue":"1","key":"pone.0302066.ref018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-022-08637-4","article-title":"Health services supervision in a protracted crisis: a qualitative study into supportive supervision practices in South Sudan","volume":"22","author":"G. W. Lutwama","year":"2022","journal-title":"BMC Health Serv. Res."},{"key":"pone.0302066.ref019","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/JMDH.S151534","article-title":"Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa","volume":"11","author":"S. Govender","year":"2018","journal-title":"J. Multidiscip. Healthc."},{"key":"pone.0302066.ref020","unstructured":"\u201cHistory\u2014AMPATH Kenya.\u201d https:\/\/www.ampathkenya.org\/history (accessed Jun. 08, 2022)."},{"issue":"7","key":"pone.0302066.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pmed.1002355","article-title":"Leveraging peer-based support to facilitate HIV care in Kenya","volume":"14","author":"R. Karwa","year":"2017","journal-title":"PLoS Med."},{"issue":"426\u2013432","key":"pone.0302066.ref022","article-title":"Sample size for qualitative research. Qualitative Market Research","volume":"19","author":"B. C R","year":"2016","journal-title":"An Int. Journal."},{"key":"pone.0302066.ref023","doi-asserted-by":"crossref","first-page":"170","DOI":"10.4135\/9781446282243.n12","article-title":"Qualitative Content Analysis","author":"M. Schreier","year":"2014","journal-title":"SAGE Handb. Qual. Data Anal."},{"issue":"1","key":"pone.0302066.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12905-022-01810-1","article-title":"Adaptive leadership in clinical encounters with women living with HIV","volume":"22","author":"S. D. Randolph","year":"2022","journal-title":"BMC Womens. Health"},{"key":"pone.0302066.ref025","doi-asserted-by":"crossref","DOI":"10.4135\/9781529682571","author":"M. Schreier","year":"2012","journal-title":"Qualitative Content Analysis in Practice"},{"key":"pone.0302066.ref026","article-title":"Patient Experiences of Decentralized HIV Treatment and Care in Plateau State, North Central Nigeria: A Qualitative Study","volume":"2017","author":"G. O. Kolawole","year":"2017"},{"key":"pone.0302066.ref027","first-page":"355","article-title":"Reliability and Validity in Qualitative Research","author":"C. S. Franklin","year":"2019","journal-title":"Handb. Soc. Work Res. Methods"},{"issue":"12","key":"pone.0302066.ref028","first-page":"1","article-title":"Marking out the clinical expert \/ clinical leader \/ clinical scholar: perspectives from nurses in the clinical arena","volume":"12","author":"J. Mannix","year":"2013","journal-title":"BMC Nurs."},{"issue":"4","key":"pone.0302066.ref029","first-page":"1","article-title":"Challenges of academic healthcare leaders in a higher education context in South Africa","volume":"46","author":"K. Jooste","year":"2017","journal-title":"Educ. Manag. Adm. Leadersh."},{"key":"pone.0302066.ref030","article-title":"Clinical Leadership Competency Framework.","author":"NHS Leadership Academy","year":"2011","journal-title":"Self assessment tool"},{"issue":"12","key":"pone.0302066.ref031","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1080\/09593985.2018.1474984","article-title":"How does leadership manifest in the patient\u2013therapist interaction among physiotherapists in primary health care? A qualitative study","volume":"35","author":"E. Rasmussen-barr","year":"2019","journal-title":"Physiother. Theory Pract."},{"issue":"1","key":"pone.0302066.ref032","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-018-3561-4","article-title":"Developing and evaluating clinical leadership interventions for frontline healthcare providers: a review of the literature","volume":"18","author":"S. Mianda","year":"2018","journal-title":"BMC Health Serv. Res."},{"issue":"402","key":"pone.0302066.ref033","first-page":"1","article-title":"A health system framework for perinatal care in South African district hospitals: a Delphi technique","volume":"19","author":"N. M. Nkwanyana","year":"2019","journal-title":"BMC Health Serv. Res."},{"issue":"1","key":"pone.0302066.ref034","first-page":"1","article-title":"The Challenges of Leading Healthcare Organizations","volume":"3","author":"J. Conbere","year":"2018","journal-title":"Theory Pract. Socio-Economic Manag."},{"issue":"0","key":"pone.0302066.ref035","first-page":"1","article-title":"The approachable team leader: Front line perspectives on leadership in critical care","volume":"0","author":"J. Swani","year":"2019","journal-title":"J. Patient Saf. Risk Manag."},{"issue":"2","key":"pone.0302066.ref036","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1108\/LHS-08-2017-0046","article-title":"The resident physician as leader within the healthcare team: An exploratory inquiry into the perspectives of interprofessional clinicians","volume":"31","author":"L. K. Sonnenberg","year":"2018","journal-title":"Leadersh. Heal. Serv."},{"issue":"6","key":"pone.0302066.ref037","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1111\/j.1440-1754.2012.02478.x","article-title":"The new clinical leader","volume":"48","author":"K. Oates","year":"2012","journal-title":"Journal of Paediatrics and Child Health"},{"issue":"02","key":"pone.0302066.ref038","first-page":"1","article-title":"Perceptions Of Clinical Leadership In An Aged Care Residential Facility In Perth, Western Australia","volume":"02","author":"D. Stanley","year":"2017","journal-title":"Heal. Care Curr. Rev."},{"issue":"2","key":"pone.0302066.ref039","article-title":"Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH","volume":"33","author":"I. A. Agyepong","year":"2017","journal-title":"Health Policy Plan."},{"issue":"0","key":"pone.0302066.ref040","first-page":"1","article-title":"Linking Nurses \u2018 Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment","volume":"0","author":"S. Boamah","year":"2017","journal-title":"Can. J. Nurs. Res."},{"key":"pone.0302066.ref041","doi-asserted-by":"crossref","first-page":"79","DOI":"10.2147\/JHL.S143639","article-title":"Conceptualizations of clinical leadership: A review of the literature","volume":"9","author":"S. Mianda","year":"2017","journal-title":"Journal of Healthcare Leadership"},{"issue":"1","key":"pone.0302066.ref042","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1177\/0844562117732490","article-title":"Linking Nurses\u2019 Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment","volume":"50","author":"S. Boamah","year":"2018","journal-title":"Can. J. Nurs. Res."},{"issue":"4","key":"pone.0302066.ref043","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.carage.2022.04.011","article-title":"The Role of Clinical Leaders in Workforce Development and Retention in Post-Acute and Long-Term Care","volume":"23","author":"E. Galik","year":"2022","journal-title":"Caring Ages"},{"issue":"1","key":"pone.0302066.ref044","first-page":"9","article-title":"Clinical Leadership: A Call to Action","volume":"25","author":"C. Gatson Grindel","year":"2016","journal-title":"MedSurg Nurs."},{"key":"pone.0302066.ref045","doi-asserted-by":"crossref","first-page":"ii27\u2013ii34","DOI":"10.1093\/heapol\/czx167","article-title":"Examining clinical leadership in Kenyan public hospitals through the distributed leadership lens","volume":"33","author":"J. Nzinga","year":"2018","journal-title":"Health Policy Plan."},{"issue":"8","key":"pone.0302066.ref046","first-page":"26","article-title":"Role of clinical nurse leadership in improving patient care.","volume":"16","author":"J. Murphy","year":"2009","journal-title":"Nurs. Manag(Harrow)."},{"key":"pone.0302066.ref047","first-page":"1","volume-title":"in ABC of Clinical Leadership","author":"S. Jonas","year":"2011"},{"issue":"2","key":"pone.0302066.ref048","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1213\/ANE.0000000000005845","article-title":"Anesthesiologists as Health System Leaders: Why It Works","volume":"134","author":"J. M. Conroy","year":"2022","journal-title":"Anesth. Analg."},{"issue":"8","key":"pone.0302066.ref049","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/jpm.12221","article-title":"Enabling professional development in mental health nursing: The role of clinical leadership","volume":"22","author":"G. Ennis","year":"2015","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"issue":"1","key":"pone.0302066.ref050","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12912-015-0075-9","article-title":"The role of a clinical nurse consultant in an Australian Health District: A quantitative survey","volume":"14","author":"L. Wilkes","year":"2015","journal-title":"BMC Nurs."},{"issue":"1","key":"pone.0302066.ref051","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1080\/13814788.2018.1515907","article-title":"Clinical leadership and integrated primary care: A systematic literature review","volume":"25","author":"M. S. Nieuwboer","year":"2019","journal-title":"Eur. J. Gen. Pract."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T19:43:18Z","timestamp":1717184598000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302066"}},"subtitle":[],"editor":[{"given":"Edward","family":"Nicol","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":51,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0302066","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,5,31]]}}}