Servant Leadership, Leader–Member Exchange and Proactive Behavior in the Public Health Sector

• Author: Ahmed Mohammed Sayed Mostafa,Eman Aly Abed El-Motalib
• Published date: 01 September 2019
• DOI: 10.1177/0091026018816340
• Date: 01 September 2019
• Subject Matter: Articles

https://doi.org/10.1177/0091026018816340

Public Personnel Management

2019, Vol. 48(3) 309 –324

© The Author(s) 2018

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0091026018816340

journals.sagepub.com/home/ppm

Article

Servant Leadership, Leader–

Member Exchange and

Proactive Behavior in the

Public Health Sector

Ahmed Mohammed Sayed Mostafa1

and Eman Aly Abed El-Motalib1

Abstract

Very limited attention has been given by scholars to the relationship between servant

leadership and employee behaviors in the public sector and not much is known about

the mechanisms through which this relationship may take place. This study examines

the relationship between servant leadership and proactive behaviors in the Egyptian

public health sector and investigates the role of leader–member exchange (LMX) as a

mediator. Using a sample of Egyptian public hospital nurses, the results of structural

equation modeling (SEM) indicate that servant leadership was positively related to

LMX which, in turn, had a significant positive association with proactive behavior.

Thus, servant leaders encourage employees to engage in proactive behavior through

enhancing the quality of their exchange relationship with their supervisors.

Keywords

servant leadership, leader–member exchange, proactive behavior, Egyptian public

hospital nurses

Introduction

Servant leadership has received considerable attention from scholars in the past few

years. Servant leadership is generally viewed as a leadership style that “stresses per-

sonal integrity and focuses on promoting the interests of others” (Wu, Tse, Fu, Kwan,

& Liu, 2013, p. 384). Servant leaders are service-oriented leaders who strive unselfishly

to help and support others before themselves (Greenleaf, 1977). Such leaders bring out

1Assiut University, Assiut, Egypt

Corresponding Author:

Ahmed Mohammed Sayed Mostafa, Faculty of Commerce, Assiut University, Assiut, Egypt.

Email: Ahmedmsmostafa@gmail.com

816340PPMXXX10.1177/0091026018816340Public Personnel ManagementMostafa and Abed El-Motalib

research-article2018

310 Public Personnel Management 48(3)

the best among their followers and assist them in achieving their potential. Besides fol-

lowers, they also serve other stakeholders, including the community and society as a

whole (Graham, 1991).

There is now enough evidence of the effectiveness of servant leadership in produc-

ing desirable employee behaviors in private sector organizations (e.g., Ling, Lin, &

Wu, 2016; Wu et al., 2013). However, very limited attention has been given by schol-

ars to the relationship between servant leadership and employee behaviors in the pub-

lic sector and not much is known about the mechanisms through would this relationship

may take place (Miao, Newman, Schwarz, & Xu, 2014; Newman, Schwarz, Cooper,

& Sendjaya, 2017; Parris & Peachey, 2013; Shim, Park, & Eom, 2016). This study

seeks to address these gaps by examining the relationship between servant leadership

and proactive behaviors in the Egyptian public health sector and investigating the role

of leader–member exchange (LMX) as a mediator.

This study makes three main contributions to the literature. First, it contributes to

the proactivity literature. Proactive behavior is defined as “taking initiative in improv-

ing current circumstances; it involves challenging the status quo rather than passively

adapting present conditions” (Crant, 2000, p. 436). Such behavior has been found to

be linked to desirable employee and organizational outcomes (Parker, Williams, &

Turner, 2006; Strauss, Griffin, & Rafferty, 2009; Thomas, Whitman, & Viswesvaran,

2010). Therefore, it has become a “necessity” in many organizations (Thomas et al.,

2010, p. 275) and is viewed as “crucial to organizational success” (Strauss et al., 2009,

p. 279). However, in spite of its importance, the antecedents of proactive behavior are

“not well understood” (Parker et al., 2006). This study, therefore, contributes to the

literature by examining the role of servant leadership in promoting proactive behaviors

among public sector employees. By so doing, the study also responds to calls for more

research on the role of leadership in enhancing such behaviors (Strauss et al., 2009;

Den Hartog & Belschak, 2017) where, as recently stated by Den Hartog and Belschak

(2017, p. 412), “empirical work on how leaders affect proactivity is still relatively

limited.”

Second, very limited attention has been devoted by scholars to the psychological

processes underlying the relationship between servant leadership and employee behav-

iors (Newman et al., 2017). Therefore, this study also contributes to the literature by

examining the mediating role of LMX on the relationship between servant leadership

and proactive behaviors. LMX refers to the quality of the relationship between leaders

and their followers (Graen, Uhl-Bien, 1995). LMX theory specifically suggests that

leaders use different styles in dealing with followers and develop a different type of

exchange or relationship with each follower (Liden & Maslyn, 1998). This theory is

the “most closely tied” leadership approach to social exchange theory (Liden, Wayne,

Zhao, & Henderson, 2008, p. 163). Therefore, examining the role of LMX as a media-

tor will also help assess the prominence of social exchange theory, which has been

widely used to explain the influence of leadership on positive employee behaviors

(Miao et al., 2014; Newman et al., 2017).

Finally, this study extends prior research on the relationship between servant

leadership and employee outcomes by examining the proposed relationships in the