Background Healthcare institutions strive for better healthcare systems with clinical leaders to provide excellent patient care. However, there is paucity in the literature on what strategic leader attributes should clinical leaders have to perform clinical and leadership functions in an HIV health system. Methods We explored healthcare providers' perceptions regarding the strategic leader attributes of clinical leaders in AMPATH-Moi Teaching and Referral Hospital in Eldoret Kenya. We conducted (n = 22) in-depth interviews with healthcare providers including clinical officers, nurses, social workers, counselors, retention officers, and, pharmacists who were purposively sampled from the AMPATH-MTRH HIV facility between September 2019 to May 2020. Data were analyzed using a thematic approach. Results The findings identified 4 domains of strategic clinical leader attributes. Training and expertise: clinical competence, informed, and knowledgeable. Personality traits: team leader, trustworthy, honest and integrity, flexible and swift, impartial and mentor. Interpersonal skills: approachable, good listener and understanding, good communication skills, good relationship, interaction, and respect. Managerial traits: good planner, accountable, disciplined, dedicated and hardworking, innovative, problem-solver, organized, and vocal. Conclusion Clinical leaders require strategic leader attributes to lead HIV health systems, manage patient dynamics and provide excellent HIV care. The leadership and management of the HIV facility should develop the capacities of the clinical leaders to a more strategic leadership approach so that they become dynamic and responsive in their leadership and clinical roles.

Patient loyalty is the continuous commitment and engagement in care where patients can improve and sustain quality of life through continuous use of medical care. Identifying strengths and weaknesses in providing excellent quality care is a key measure of success of healthcare professionals and hospital management. However, few studies have examined patient loyalty from a strategic leadership perspective within HIV health care systems. The purpose of this study is to determine how patient loyalty to HIV care is influenced by multiple factors in a healthcare system environment. The study employs a mixed-methods approach guided by the complexity theory and the theory of planned behavior. A total of 444 surveys with (50 healthcare providers and 394 adult HIV-infected patients) currently on antiretroviral drugs, as well as 22 in-depth interviews with healthcare providers will be conducted. The study will be done at AMPATH Eldoret Kenya. We will use stratified proportionate and census sampling methods to select study participants for the survey while purposive and convenient sampling techniques will be used for in-depth interviews. Structured questionnaires and interviewer guides will guide data collection. Quantitative data analysis will entail hierarchical regression to test direct effects while multiple regression will test the mediation effects using the Hayes PROCESS Model No.6 in SPSS. Qualitative data analysis will be conducted using a thematic analytical method.

Patient loyalty is the continuous commitment and engagement in care where patients can improve and sustain quality of life through continuous use of medical care. Identifying strengths and weaknesses in providing excellent quality care is a key measure of success of healthcare professionals and hospital management. However, few studies have examined patient loyalty from a strategic leadership perspective within HIV health care systems. The purpose of this study is to determine how patient loyalty to HIV care is influenced by multiple factors in a healthcare system environment. The study employs a mixed-methods approach guided by the complexity theory and the theory of planned behavior. A total of 444 surveys with (50 healthcare providers and 394 adult HIV-infected patients) currently on antiretroviral drugs, as well as 22 in-depth interviews with healthcare providers will be conducted. The study will be done at AMPATH Eldoret Kenya. We will use stratified proportionate and census sampling methods to select study participants for the survey while purposive and convenient sampling techniques will be used for in-depth interviews. Structured questionnaires and interviewer guides will guide data collection. Quantitative data analysis will entail hierarchical regression to test direct effects while multiple regression will test the mediation effects using the Hayes PROCESS Model No.6 in SPSS. Qualitative data analysis will be conducted using a thematic analytical method.