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Item Effect of Democratic Leadership on Organizational Performance of Level Four and Five Public Hospitals in Isiolo County, Kenya(Journal of Strategic Management, 2025-07) Abdi, Wario; Nancy, Rintari; Paul, KirigiaThe purpose of the study is to determine the effect of democratic leadership on organizational performance of level four and five public hospitals in Isiolo County, Kenya. The study adopted correlational research and targeted Isiolo County referral hospital, Garbatulla hospital and Merti hospital in Isiolo County. The respondents included 3 medical superintendents, 29 departmental heads, 62 health care staff, and 38 operations staff. The medical superintendents and departmental heads were sampled using purposive sampling method, whereas the staff were sampled using simple random method. The questionnaires were administered to the staff, while interviews were conducted on the management. A pilot study was conducted in Marsabit county hospital and reliability tested through Cronbach Alpha coefficient. Complete questionnaire’s data were coded into SPSS version 25 for the analysis of both descriptive and inferential statistics. It is thus noted that with regards to democratic leadership, public hospitals had ensured that there were strong systems that were supported by employee innovations and collaborations between the management and staff. However, the communication pattern between the management and other stakeholders was found to be limited. The study recommends that the county government leadership, should develop strategic policies that will guide on the interactions of hospital’s management with internal and external stakeholders more effectively. This could be informed by the constitution and existing MOH guidelines.