Aims: This study examined the influence of leadership in multi-stakeholder partnerships. Four W.K. Kellogg-funded community partnerships in South Africa were evaluated. Participants included community, academic and health service partners. The partnerships aimed to achieve interprofessional community-sensitive health professions education. Methods: We undertook: 1) quantitative assessment (survey, N = 529) of whether leadership skills were systematically associated with three partnership factors (satisfaction, sense of ownership and commitment); and the individual contributions of these factors to the partnerships' outcomes; and 2) qualitative assessment (semi structured interviews, N = 46) of the extent of coalition members' ratings of their leadership, the likelihood of concerns about their leaders; and the nature of these concerns. Results: Quantitatively, partner's positive ratings of their leadership were consistently and significantly attended by better sense of ownership, commitment to and satisfaction with the partnerships. Variance in partnership outcomes was accounted for by leadership skills (26%), ownership (21%), commitment (20%) and satisfaction (11%). Partnership members who rated their leadership highly expressed fewer concerns (qualitatively) about their leaders. These concerns were: leadership visibility, openness and legitimacy; leadership features, styles and characteristics; the consequences of lack of appropriate leadership; and management procedures that were lacking. Conclusions: Coalition efforts would benefit from focusing on factors that are conducive to effective leadership.
