Building Resilient Health Systems for SDG 3 in Emerging Economies: Understanding how E-Leadership and E-Skills Shape E-Performance in Post-COVID Digital Healthcare- A Strategic Review
Résumé
In this review, we critically examine how e-leadership and workforce digital skills interact to enhance healthcare performance in post-COVID settings within emerging economies, addressing a knowledge gap concerning the joint influence of leadership behaviours and employee competencies on organisational outcomes in resource-constrained contexts. We anchored this review on the Upper Echelons Theory, which emphasises that leaders’ characteristics and cognitive frames shape strategic decisions, and the Technology-Organisation-Environment framework, which highlights the interplay of technological, organisational, and environmental factors in digital adoption. Employing a qualitative thematic review of empirical studies published between 2020 and 2025 and sourced from databases including Scopus, Web of Science, PubMed, and Google Scholar, our review synthesises evidence on effective digital transformation strategies in healthcare. Our findings indicate that strategic e-leadership combined with workforce digital competence significantly improves efficiency, quality of care, innovation, remote collaboration, and organisational resilience. Successful interventions identified include digital dashboards, telehealth platforms, cloud-based patient management systems, and structured training programs, demonstrating the importance of aligning leadership vision, staff capability, and organisational resources. Persistent challenges encompass uneven distribution of digital skills among healthcare staff, limited assessment of leadership competence, infrastructural constraints, and insufficient longitudinal evidence on the sustainability and scalability of digital initiatives. Our review concludes that coordinated integration of leadership, workforce skills, and supportive organisational and technological infrastructures is essential for achieving resilient healthcare services. Policy implications involve institutionalising digital leadership frameworks, promoting continuous professional development, and investing in interoperable digital systems. Theoretical contributions reinforce the combined application of Upper Echelons and Technology-Organisation-Environment frameworks in explaining digital performance, while empirical contributions provide contextualised evidence of effective strategies and interventions. This review offers guidance for healthcare organisations, policymakers, and researchers seeking to enhance post-pandemic digital healthcare performance in emerging economies, emphasising the critical role of leadership, workforce capability, and organisational readiness in achieving sustainable outcomes.
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