Abstract:
The global healthcare sector is undergoing a rapid digital transformation, yet its success in
resource-constrained settings like Tanzania is hindered by significant gaps in the digital
competencies of healthcare workers. This study assessed the influence of digital leadership
on digital competencies among healthcare workers at Benjamin Mkapa Zonal Hospital and
Dodoma Regional Referral Hospital in Tanzania. Guided by Hensellek's Digital
Leadership Framework and Transformational Leadership Theory, the research employed
a pragmatic, convergent parallel mixed-methods design. Data was collected from 93
participants (79 surveys and 14 in-depth interviews) and analyzed using simple linear
regression and thematic analysis. The study found that strategic vision setting was the
strongest statistically significant predictor of digital competencies (β = 0.380, p < 0.001),
explaining 14.4% of the variance. However, qualitative data revealed a critical
"implementation gap," where top-down, compliance-oriented communication undermined
staff ownership. Resource allocation did not show a significant direct relationship with
competencies (p = 0.108), not due to irrelevance, but because of systemic dysfunction in
governance, including donor dependency and reactive allocation, which nullified its
variable power. Continuous learning promotion was a significant but secondary predictor
(β = 0.313, p = 0.006), yet its potential was unrealized due to a heavy, unsupported reliance
on informal peer-learning networks like WhatsApp groups, as formal training was
inadequate. The study concludes that digital leadership effectiveness in this context
depends not on excellence in any single dimension, but on the synergistic alignment of a
co-created strategic vision, strategically governed resources, and institutionalized
continuous learning. It contributes to knowledge by empirically validating and
contextualizing Hensellek's framework, revealing that the interdependencies between its
dimensions are the primary drivers of digital competency development in resource constrained healthcare environments. The findings offer actionable recommendations for
policy, management practice, and future research to strengthen Tanzania's digital health
ecosystem.
