Procurement practices, leadership style and employee-perceived service quality towards the perceived public health sector performance in Zimbabwe

Abstract The public sector performance can be judged through the ability to deliver expected service to residents within the community. The purpose of this study was to examine the influence of leadership style and employee-perceived service quality on perceived public health sector performance. Also, the study sought to understand whether procurement practices mediate the effect of leadership style on perceived service quality. A cross-sectional survey of 380 public health sector employees was conducted in Mashonaland central Province in Zimbabwe between September and October 2022. Structural equation modelling (SEM) in AMOS Version 25 was employed to test research hypotheses. The study established that both leadership style and perceived service quality influence public health sector performance. The study further concluded that procurement practices partially mediate the influence of leadership style on perceived service quality. Also, the study established that employee-perceived service quality partially mediate the influence of procurement practices on perceived public health sector performance. Finally, the study found out that employee-perceived service quality partially mediate the influence of leadership style on perceived public health sector performance.


PUBLIC INTEREST STATEMENT
The public sector performance can be judged through the ability to deliver expected service to residents within the community. The study examined the influence of leadership style and employee-perceived service quality on perceived public health sector performance. Also, the study sought to understand whether procurement practices mediate the effect of leadership style on perceived service quality. The study established that both leadership style and perceived service quality influence public health sector performance. Further study concluded that procurement practices partially mediate the effect of leadership style on perceived service quality. Also, the study established that employeeperceived service quality partially mediate the effect of procurement practices on perceived public health sector performance. Finally, the study found out that employee-perceived service quality partially mediate the effect of leadership style on perceived public health sector performance.

Introduction
The success of public sectors can be judged by the ability to deliver service that satisfies residents within the community (Boselie et al., 2021;Kaondera et al., 2023). When the public sector achieves high levels of services satisfaction, it can improve its performance (Trammell et al., 2020). Generally, public sectors within developed nations are doing well in public management (Aladwan & Alshami, 2021). Thus, the performance of most public sectors is determined by their ability to offer services, which satisfies the community (Criado & Villodre, 2021;Koba & Koumproglou, 2020). However, developing countries still lag behind in delivering expected service, especially within the public health sector (Javidi et al., 2020). Most health centres are not performing to the expected levels, especially in developing nations. Underperforming health centres are characterized by understaffing, demoralized personnel, shortages of drugs and medicines among other challenges. Kaufmann et al. (2019) add that patients in most public health centres cry about lack of care by workers.
Some of the problems faced within the public health sector in developing nations are attributed to delays in procuring medicines (Chikwere et al., 2022), leadership style, poor management strategies procurement practices and lack of funding (Criado & Villodre, 2021). Procurement practice involves locating and agreeing on conditions for acquiring products, services or works through tendering or competitive bidding. Most business operations would not be able to run without proper procurement practice. For projects and procedures to move forward successfully, procurement management makes sure that all goods and services are correctly procured. If not properly done, procurement practices compromise the quality of service in that staff connive to purchase substandard products or very expensive products in return for bribes (Lee, 2021), and the public sector performance is thus affected.
Management style involve bureaucracy which is most common among public institutions in developing nations like Zimbabwe. Leadership style is described as the individual's ability to persuade, motivate and enable others to actively participate in and contribute to an organization's success. The leadership style and quality impact organizational performance. Failure in having a proper management style affect decision-making process and results in delayed payment suppliers. Leadership styles like bureaucracy involve too much consultation which delays drug purchases within the public health sector, which contribute to poor service quality (Huragu & Chuma, 2019). Hence, service quality must not be compromised, especially within the health sector. Also, high-quality health care should be safe, effective, patient-centred, timely, efficient and equitable.
Most emerging countries are recognized for incompetent procurement practices, hopelessly bureaucratic public health sectors leading to poor service delivery and Zimbabwe is not an exception. The public health sector in Zimbabwe is not performing to expected standard (Chikwere et al., 2022). Most public health centres (clinic and hospitals) are struggling to provide the expected service to residents within their respective communities. The majority of Zimbabwe's public clinics and hospitals are faced with problems which include malfunctioning equipment, shortage of drugs and absence of skilled workforce personnel. Some of the health centres do not have ambulances to assist patients in case of emergencies. Also, the public health sector continues to experience the exodus of trained personnel (nurses and doctors) who are migrating to greener pastures. Despite having appealing infrastructure within the country's public health sector, the service delivery remains poor such that most patients are seeking medical assistance from neighbouring countries like South Africa, Botswana and Zambia and the rich go as far as Singapore and India among other developed nations. If the current situation within the public health centres persists, Zimbabwe's public health sector could face total collapse and all citizens might end up seeking medical attention from outside the country.
Several studies have been carried out worldwide in trying to address the related problems within the public sector (Adamopoulos, 2022;Ahbabi et al., 2018;Eckelman et al., 2020;Guarnieri & Gomes, 2019;Holbert et al., 2021;Mutembei, 2019;Parashakti et al., 2020;Purwanto et al., 2020;Raghupathi & Raghupathi, 2020). However, none of these studies assessed the performance of the public health sector through leadership style and employee-perceived service quality. Moreover, none of the earlier studies included procurement practices as a mediator on the effect of leadership style on employee-perceived service quality. Thus, the current study sought to close this knowledge gap by addressing these objectives -to establish the effect of leadership style on employee-perceived service quality, procurement practices and perceived public health sector performance, to establish how procurement practices contribute to the public health sector performance and to examine the mediating role of procurement practices on the effect of leadership style on employee-perceived service quality. The mediating role of employee-perceived service quality on the relationship between procurement practices and perceived public health sector performance was one of the objectives. Lastly, the study sought to test the mediation role of employee-perceived service quality on the influence of leadership style on perceived public health sector performance. Special attention was on district clinics and hospitals in Mashonaland Central province where most Zimbabwe's public health centres are represented. SERVQUAL by Parasuraman et al. (1985) is one of the models underpinning the current study. Managers in a range of sectors can use the SERVQUAL service quality gap approach model to measure service quality. The main objective of this model is to pinpoint the discrepancies between consumer expectations and the actual services provided. In that, it emphasizes the appearance of physical facilities, equipment, personnel and communication materials, the ability to deliver the promised service dependably and accurately, the eagerness to assist customers and provide prompt service, the knowledge and courtesy of employees and their ability to convey trust and confidence, and the caring, individualized attention the organization provides its customers, SERVQUAL is relevant to the current study.

Theories underpinning the study
The current analysis is based on the Stewardship Theory. According to the theory, managers should take good care of the resources they are in charge of if left to manage their own departments. It also states that there is a significant link between satisfaction and organizational success. Accordingly, management for the public health sector have the mandate to take care of their departments to ensure community satisfaction and departmental success. Thus, the Stewardship Theory is relevant to the current study because management for public health institutions are responsible for ensuring the sectors' performance through good leadership style and competent procurement practices.

Perceived public health sector performance
The ability of a public sector to meet its goals is often referred to as public sector performance and is normally linked to non-financial performance (Pang & Lu, 2018;Parashakti et al., 2020). Additionally, Kaufmann et al. (2019) define public sector performance as a key measure that is established for creating improved decisions within a sector. The current study understands perceived public health sector performance as the ability by management of public health institutions like public clinics and hospitals to assess their own service delivery levels.
Accessibility, quality and efficiency are some of the dimensions of health system performance (Purwanto et al., 2020). These factors work together to decide how far health care goals can be achieved. Accessibility refers to how easily patients can obtain the care they require at the appropriate time (Adamopoulos, 2022). The degree to which the proper care is provided in the proper manner is referred to as quality (Eckelman et al., 2020). Efficiency is the measure of how well accessibility and effectiveness are achieved given the available resources. Measuring these values, comprehending the variables that affect them, and finding and assessing methods of improvement are all part of health system performance (Raghupathi & Raghupathi, 2020).

Perceived service quality
Various authors have researched on the concept of service quality but there is no agreement on its proper definition. However, Chikazhe et al. (2023) define service quality as the difference between customer expectations of service and perceived service. Kaufmann et al. (2019) assert that if expectations and perceptions of a customer are surpassed it can then be described as service quality. Additionally, Koba and Koumproglou (2020) describe service quality as an assessment of the overall quality of services that are given to customers, from this it can be noted that the quality of service delivery is the variation between what the customer perceived and expected of the services provided by the organization. Simply said, it is the customer's assessment of the service received and how it is compared to their expectations. In this study, perceived service quality is regarded as the ability of the public health sector departments in meeting residents' (customers') expectations in terms of providing superior service quality.
There are different ways of checking the quality provided to customers; one way of checking quality of service delivery is through determining its fitness for use by users (consumers) (Aladwan & Alshami, 2021). Javidi et al. (2020) further add that the quality of the service delivered is just dependent on the needs and expectations of the community. Public-sector departments have also realized that customer service and quality assessment are essential strategic problems in assuring performance (Trammell et al., 2020). Agbeko et al. (2021) defines procurement as the process of locating and agreeing on conditions for acquiring products, services or works through tendering or competitive bidding. Procurement practices include local sourcing, multiple sourcing and electronic procurement, to mention but a few (Huragu & Chuma, 2019). Javidi et al. (2020) add that the drafting and processing of a demand, as well as the final receipt and approval of payment, are all part of the procurement process. Purchase planning, standards, specifications determination, supplier research, selection, financing, pricing negotiation and inventory control are all examples of the procurement process (Huragu & Chuma, 2019).

Procurement practices
Procurement process involves local sourcing, multiple sourcing and electronic procurement. Etse et al. (2021) define local sourcing as an agile supply chain strategy that is used by many organizations in response to global supply chain disruptions. Local sourcing signifies a prospect intended for companies to make sure a quick provision of supplies and facilities whilst constructing an additional nearby as well as reliable source of materials, goods and services. Van de Walle (2009) defines electronic procurement as an organizational purchasing system that depends upon a certain information technology which is well thought-out as the contribution side of the supply chains and their management. Multiple sourcing is a concept of working with many suppliers (Leal Filho et al., 2019). Multiple sourcing is a procurement practice that can be implemented by an organization as a proactive approach to avoid the risks that are associated with dealing with a single supplier (Agbeko et al., 2021). Guarnieri and Gomes (2019) added that multiple sourcing is a purchasing strategy that can be used by procuring organizations in circumstances where there are a lot of supply disruptions. Thus, this study understands procurement practice as an act involving activities like initiation of procurement negotiation for prices and discounts, awarding tenders for any big supplies, competitive bidding, negotiation of contract terms with selected supplier, practicing multiple sourcing and local sourcing as well as electronic procurement practices.

Leadership style
Scholars have offered a plethora of leadership definitions, each delving into their own dimension, beliefs and principles to arrive at their own appropriate description. To this end, Donkor et al. (2021) describe leadership as an individual's ability to persuade, motivate and enable others to actively participate in and contribute to an organization's success. Also, according to Singh and Slack (2022) leadership is the process by which a person sets the goals for one or more other employees and persuades them to work together with him or her and with each other to attain those goals with competence and full dedication. Jekelle (2021) argues that leadership is a process by which one individual affects a group of others to achieve an organization's fundamental goal. Additionally, Holbert et al. (2021) asserted that leadership is the practice through which a manager assumes sole accountability for a wide range of responsibilities that are primarily accomplished via the efforts of others. In this study, leadership style is viewed as a leader's approach and behaviour in directing, inspiring and managing others to ensure the performance of public health sector departments. It also includes the way the departmental head makes quick decisions, strategies and executes plans while taking into account the expectations of stakeholders and the welfare of their team.
Overall, the majority of scholars and practitioners agree that the style and quality of leadership in any business have a significant impact on employee performance, commitment and organizational performance (Donkor et al., 2021). Also, in this competitive age, organizations require leaders that are flexible and innovative who connect the organization with competitive challenges and push employees to go above and beyond to achieve organizational objectives (Essel, 2020). Leadership styles include democratic leadership, autocratic leadership and bureaucratic leadership among others (Jekelle, 2021). Under democratic leadership, people being led are active and is also known as participative management (Donkor et al., 2021). Democratic leaders frequently ask their employees for advice and input. They promote discussion and involvement in the decision-making process. As opposed to democratic leadership, autocratic or authoritarian leaders are generally regarded as individuals with ultimate control and influence over others (Singh & Slack, 2022). The management style known as bureaucratic leadership is characterized by a hierarchy and established official responsibilities (Chikwere et al., 2022). With this style of management, staff members are required to abide by the rules and regulations set forth by their superiors and this mostly used in public sectors.

Research hypotheses development
Literature confirms a positive relationship between leadership style and service quality (Ahbabi et al., 2018;Donkor et al., 2021;Holbert et al., 2021;Mahdikhani & Yazdani, 2020;Mansoor & Hussain, 2022;Pang & Lu, 2018;Qiu et al., 2020). Also, a study by Mahdikhani and Yazdani (2020) examined how leadership style affects the quality service offered by an organization. According to the findings, leadership style has a beneficial impact on service quality and team performance. Likewise, Chang et al. (2021) investigated whether leadership style influences service quality. A positive relationship among leadership style and service quality was established. Also, a study by Mansoor and Hussain (2022) investigated the effect of leadership style on the long-term service quality of higher education institutions. The findings show that leadership style has a positive impact on long-term service quality. However, none of the preceding studies considered the relationship between leadership style and employee-perceived service quality in a public sector set-up, which makes this study unique. Hence, there is need to hypothesize that H 1 : Leadership style has a positive influence on employee-perceived service quality.
Evidence in literature shows that service quality influences organizational performance (Ahbabi et al., 2018;Aladwan & Alshami, 2021;Chikazhe et al., 2021;Koba & Koumproglou, 2020;Lee, 2021;Singh & Slack, 2022). Additionally, Trivellas and Santouridis (2016) investigated the influence of service quality and institutional success within the higher education sector. The study results indicate that service quality affects the institutional performance. Similarly, Tomic et al. (2018) examined the relationship between service quality and business achievements. Service quality was found to influence how businesses perform. The relationship between quality practices, service innovation and organizational performance was investigated in a study by Khan and Naeem (2018). According to the study's finding, quality practices increase service innovation and organizational performance. The preceding literature and empirical studies investigated the relationship between service quality and how firms perform using several indicators. The current study opted for further investigation on perceived public health sector performance using employee-perceived service quality. Thus, it is possible to propose that H 2 : Employee-perceived service quality positively affect perceived public health sector performance.
Existent literature confirms that leadership style affects procurement practices within many sectors of an economy (Boselie et al., 2021;Essel, 2020;Etse et al., 2021;Leal Filho et al., 2019;Mungai, 2019). Moreover, a study by Leal Filho et al. (2019) investigated drivers for sustainable procurement within public institutions. The study results show that management style is among drivers for procurement. Also, Khadija and Kibet (2015) examined factors that influence public procurement procedures and practices. The study concluded that the possession of the requisite managerial technical skills affects public procurement procedures and practices. Empirical studies tested these hypotheses in other sectors of the economy different from the public health sector where procurement practices are more critical as they determine the life of patients. Therefore, it is plausible to suggest that H 3 : Leadership style has a positive impact on procurement practices.
Existing literature ratifies a positive relationship between procurement practice and service delivery improvement (Essel, 2020;Guarnieri & Gomes, 2019;John, 2019;Mungai, 2019;Mutembei, 2019). Empirical study by Mutembei (2019) investigated the effect of procumbent delays on service delivery improvement within the Ministry of National Treasury and Planning. The study concluded that procurement delays negatively impact on service delivery. In a related study carried out in Uganda, John (2019) conducted a study to establish the relationship between procurement strategies and service delivery. The study discovered a beneficial association between procurement strategy and service delivery. Likewise, Mungai (2019) investigated the effect of procurement practices on the performance of a firm. According to the findings of the study, strategic procurement processes act as strategic tools for providing better service. However, none of the previous studies considered employee perceptions in establishing the relationship between procurement practices within the health sector and service quality performance. Thus, it can be hypothesized that H 4 : Procurement practices positively influence employee-perceived service quality.
There is contentment in literature that resource procurement and business performance are correlated (Agbeko et al., 2021;Guarnieri & Gomes, 2019;Leal Filho et al., 2019;Trammell et al., 2020;Van de Walle, 2009). In addition, a study by Quesada et al. (2010) tested the impact of procurement technologies on procurement practices. The findings suggest that procurement technologies usage positively affects the performance of firms. A related study by Ezeanyim et al. (2020) studied whether procurement has an effect on the performance of tertiary institutions. It was established that resource procurement has a significant effect on the performance of tertiary institutions. Nonetheless, evidence from literature and prior studies ignore the effect of procurement practices in a critical public health sector where procurement system has to be efficient. As a result, it can be hypothesized that H 5 : Procurement practices have a positive influence on perceived public health sector performance.
The relationship between Leadership style and organizational performance is confirmed in the current literature (Boselie et al., 2021;Donkor et al., 2021;Guterresa et al., 2020;Holbert et al., 2021). Likewise, Holbert et al. (2021) studied the relationship between the role of leadership and organizational performance. The results of the study demonstrate that leadership positively impacts on firm performance. Moreover, Guterresa et al. (2020) examined the effect of leadership style on institutional performance. Results indicate that leadership style has a positive influence on firm performance. Also, Suprapti et al. (2020) tested the effect of transformational leadership and organizational performance in Indonesia. The result was that transformational leadership influences organizational performance. Taking into consideration that earlier studies focussed on different leadership styles affecting other sectors of the economy, the current study sought to further understand how the public health sector performance is affected by leadership styles that include the bureaucratic style common in most developing economies like Zimbabwe. Thus, it can be hypothesized that H 6 : Leadership style positively affects perceived public health sector performance.
Procurement practices are key to the performance of the public sectors (Guarnieri & Gomes, 2019;Trammell et al., 2020). Moreover, public sectors consider procurement exercise seriously since it can influence the level of service delivery within the sector (Agbeko et al., 2021). Several studies have confirmed a direct relationship between procurement practices and service quality (Essel, 2020;Guarnieri & Gomes, 2019;John (2019);Leal Filho et al., 2019;Mungai, 2019;Mutembei, 2019). This extant empirical literature tells us that leadership style, procurement practices, service quality and firm performance directly influence each other. However, none of the earlier studies investigated the mediating effect of procurement practices on the relationship between leadership style and employee-perceived service quality, the mediation role of employee-perceived service quality on the relationship between procurement practices perceived public health sector performance and lastly, employee-perceived service quality as a mediator of the effect of leadership on perceived public health sector performance. As such, it is plausible to assume that H 7 : Procurement practices mediate the influence of leadership style on employee-perceived service quality.
H 8 : Employee-perceived service quality mediates the relationship between procurement practices and perceived public health sector performance.
H 9 : Employee-perceived service quality mediates of the influence of leadership style on perceived public health sector performance.
Considering the preceding debate, it was necessary to propose the research model in Figure 1.

The research context
The study took place in Zimbabwe, a Sub-Saharan African country. Zimbabwe was chosen because it is one of the African countries with deteriorating public health sector. Thus, this study sought to examine if procurement practices, management style and employee-perceived service quality could be improved and save the public health sector from total collapse.
A cross-sectional survey of 380 public health sector employees was conducted between September and October 2022 in Mashonaland central Province in Zimbabwe. Questionnaires were distributed to respondents at their workplaces during working hours, especially during tea breaks and lunch hours to avoid too much work disturbances. The study used a 5-point Likert scale questionnaire to gather data, thus respondents were requested to choose from given responses. In an effort to maintain anonymity, respondents were advised not to include any identification details on the questionnaire. Purposive sampling method was adopted since the study targeted respondents with required information on the quality of service on offer, leadership styles that were being used, procurement practices which were in place and the knowledge of how their public sector departments were performing. Purposive sampling was adopted since the researcher was able to consider population members with specific traits or experiences in the area under study. In this manner, the researcher chose participants that were relevant to the current investigation and concentrating on a small sample.
Items used under each variable of the research instrument were borrowed from related studies and modified to suit this study. Table 1 shows constructs, items and sources.
A pilot test was conducted using part of the targeted population and the instrument was improved basing on shortcomings which arose from pilot test responses. The questionnaire was physically distributed to public health sector employees within provincial district clinics and hospitals after permission was sought from relevant authorities. Purposive sampling method was used to select respondents who participated in the study. Respondents were allowed up to five working days before completed questionnaires were collected. Some of the questionnaires were electronically distributed to those respondents who had access to the internet. Out of the 380 distributed questionnaires, 340 were returned and usable. Table 2 shows the respondents' demography. Table 2 show that the majority of respondents (82.9%) were aged between 30 and 49 years, meaning that this is the common age range for most employees working for the public health sector in Zimbabwe. There was gender balance on public health sector employees as indicated by almost equal representation of respondents who participated in the study. The number of respondents from the selected public sector departments was almost balanced (between 11% and 17%). However, the sample was dominated by employees engaged on permanent basis (72.9%) and these had vast work experience ranging from 5 to 15 years with the public sector. thus, data were collected from a rich source of information.

Scale validation
Before testing the research hypotheses, scale validation was ensured through confirmatory factor analysis (CFA). CFA's goal is to determine whether the results conform with the proposed measurement model. It is employed to determine whether construct measures are in line with a researcher's knowledge of the nature of the construct (or factor). Sampling adequacy was first conducted before conducting CFA. The results of the sampling adequacy test are presented in Table 3. Field et al. (2012) recommended that KMO be more than 0.5 and that Bartlet's Test of Sphericity be significant at p > 0.05 for a sample were adequate. The results for the sample adequacy met minimum requirements. Varimax Rotation was used for factor analysis, and it converged in 26 iterations with 71.058% being the total variance explained by the data and way beyond commended boundary of 60% (Tavakol & Dennick, 2011). The solution had four components namely perceived public health sector performance (PPHSP), employee-perceived service quality (EPSQ), procurement practices (PP) and leadership style (LS). No item was deleted due to low or double factor loadings.
Also, the study considered common method variance test to ensure that the common method bias does not significantly interfere with the study results. The solution gave a factor with a variance explained of 42.16%. This implies that common method bias was not a threat to this study as recommended by Kim et al. (2013) who suggested that the presence of a single factor with a variance explained greater than 50% suggests that there is common method bias.
Therefore, it was necessary to continue with scale validation. Convergent and discriminant validity were therefore examined.

Convergent validity
Measurement model fit indices, reliability, standardized factor loadings, critical ratios and average variance extracted (AVE) were all taken into account while assessing convergent validity. The measurement model was created using Maximum Likelihood Estimation (MLE) (Field, 2009). The measurement model fit indices met the minimal convergent validity conditions (CMIN/DF-3.118, GFI-0.919, AGFI-0.922, NFI-0.941, TLI-0.932, CFI-0.908 and RMSEA-0.059). Table 4 shows that the minimum conditions for convergent validity were met since all standardized factor loadings were greater than the recommended 0.6 cut-off point (Thompson, 2009). Individual item reliabilities, composite reliabilities and Cronbach's alpha values were all above 0.6 (Hair et al., 2014). Critical ratios were sufficiently large and significant at p < 0.001. The extracted average variance for all constructs was more than 0.5 (Tavakol & Dennick, 2011). Table 5 shows that minimum conditions for discriminant validity were met. All extracted average variance (diagonal elements) were greater than the squared inter-construct correlations.

Hypotheses test results
Structural equation modelling (SEM) in AMOS Version 25 was employed to test hypotheses H 1 -H 6 . Model fit indices were acceptable (2/DF -3.22; GFI -0.911; AGFI -0.925; NFI -0.0.931; TLI-0.927; CFI -0.940; RMSEA -0.39). Results for H I -H 6 are presented in Table 6.   Leaders strive to attain set goals with competence and full dedication Leaders assume sole accountability Leaders go above and beyond to achieve objectives Leaders inspire subordinates to achieve goals and solve problems Leaders make quick decisions to ensure smooth service delivery Leaders are flexible in decisionmaking to improve service delivery H 1 results indicate that leadership style has a positive influence on employee-perceived service quality. Furthermore, H 2 results confirmed a direct and positive relationship between employeeperceived service quality and perceived public health sector performance. Results for H 3 proved that leadership style influences procurement practices. Likewise, results for H 4 show that procurement practices have a direct and positive impact on employee-perceived service quality. H 5 results confirmed that procurement practices have a positive effect on perceived public health sector performance. Similarly, H 6 results indicate that leadership style influences perceived public health sector performance. Thus, H 1 -H 6 were all supported.
Results for H 7 show that the path LS → PP → EPSQ was significant (path coefficient = 0.291, p = 0.000). This suggests that procurement practices partially mediate the relationship between leadership style on perceived service quality. Therefore, H 7 was supported.   Table 7 indicate that the path PP→ EPSQ→PPHSP was also significant (path coefficient = 0.352, p-0.000). Thus, H 8 was supported. As expected, the path LS→EPSQ→ PPHSP was also significant (path coefficient 0.298, p = 0.000). Hence H 9 was supported.

Theoretical implications
In the public administration and management literature, despite the call for flexible leadership style to improve service quality and public sector performance (Donkor et al., 2021;Holbert et al., 2021;Lee, 2021;Singh & Slack, 2022), there is need to incorporate other variables like procurement practices to further cement the relationships (Guarnieri & Gomes, 2019;Trammell et al., 2020;Van de Walle, 2009).
In the current literature, there is minimal evidence of studies that have looked at the mediating effect of procurement practices on the leadership style, employee-perceived service quality relationship. As a result, the current research was conducted to fill a knowledge vacuum in the field of public administration and management. The study results show that leadership style, employeeperceived service quality and procurement practices are critical factors that influence perceived public health sector performance. Hence, the study results corroborate the Stewardship Theory proposed by Donaldson and Davis (1989), which stresses that there is a significant link between satisfaction and organizational success.
As expected, the study concluded that leadership style positively affects employee-perceived service quality, perceived public health sector performance and procurement practices. This discovery adds to the corpus of knowledge about this phenomenon (Agbeko et al., Agbeko et al., 2021;Ahbabi et al., 2018;Boselie et al., 2021;Essel, 2020;Etse et al., 2021;Leal Filho et al., 2019;Mungai, 2019;Qiu et al., 2020). Also, the study established that employee-perceived service quality influences perceived public health sector performance. This finding validates extant literature (Aladwan & Alshami, 2021;Lee, 2021;Singh & Slack, 2022). The study results are also in tandem with the SERVQUAL model that pinpoint the discrepancies between consumer expectations and the actual services provided. Moreover, procurement practices were found to influence both employee-perceived service quality and perceived public sector performance. Likewise, these results corroborate existent literature as they support prior findings (Essel, 2020;Guarnieri & Gomes, 2019;Mungai, 2019;Mutembei, 2019;Trammell et al., 2020).
The study further settled that procurement practices partially mediate the influence of leadership style on employee-perceived service quality. Results imply that procurement practices play  This suggests that when predicting perceived service quality and public sector performance, both leadership style and procurement practices must be taken into consideration. It was also among the study findings that employee-perceived service quality mediates the relationship between procurement practices and perceived public health sector performance. This means that when predicting public health sector performance, firms should also consider employee-perceived service quality and procurement practices. Lastly, the findings show that employee-perceived service quality mediates on the influence of leadership style on perceived public health sector performance. Thus, performance and leadership style maybe predicted by involving leadership style and perceived public health sector. These finding on the mediation effect of procurement practices and employee-perceived service quality add to the growing body of knowledge about the relationship among leadership style, employee-perceived service quality and perceived public sector performance.

Practical implications
To improve the public health sector performance, management is encouraged to pay attention to issues to do with procurement practices. Thus, management within the public health sector is recommended to consider proper tendering process, outsourcing, multiple sourcing and electronic sourcing among others instead of considering leadership style, perceived service quality in isolation.
It is also recommended that the Government should appoint competent and flexible leaders to manage district hospitals and clinics so that service delivery within the public sector could be improved. Bureaucratic management style is delaying managerial decisions like drug purchases which compromises the quality of service and negatively affect performance of the public health sector. Thus, bureaucratic leadership styles should be avoided to allow smooth flow of service within the public health sector.
Moreover, management for public health sector departments ought to be responsive to change, especially on technological issues. This will allow the public health sector to move away from traditional sourcing of drugs and medicines from suppliers. Electronic sourcing and tendering is the way to go and this does not to delay the process, thereby promoting superior service quality and improved performance. Also, management for the public health sector need to consider consulting other employees and stakeholders so as to generate different and creative ideas during the decision-making process. Service delivery activities within the public health sector which must be offered regularly in Zimbabwe include emergency care, planned procedures, labour and delivery services, diagnostic testing, lab work and patient education. Patients may receive inpatient or outpatient care from a hospital, depending on their health state.

Conclusion
The purpose of the study was to examine the effect of leadership style and perceived service quality on public health sector performance. Also, the study sought to understand whether procurement practices mediate the effect of leadership style on perceived service quality. The study established that both leadership style and perceived service quality influence public health sector performance. Furthermore, the study concluded that procurement practices partially mediate the effect of leadership style on perceived service quality.
The study has shortcomings that provide justification for additional research. For example, the survey was only conducted in one province within a single industry in Zimbabwe only. Moreover, only employees served as respondents and this makes generalizing the findings more challenging. As a result, it is suggested that additional research should be undertaken in other sectors with residents as respondents and in other marketplaces to improve the generalizability of the findings.