Influence of Ethical Leadership Practices on Employee Performance in Nigerian Healthcare Institutions: Evidence from the Federal Medical Centre Abuja

Employee performance remains a crucial determinant of healthcare quality, service efficiency, and organisational effectiveness. Ethical leadership has increasingly gained scholarly attention as a leadership approach capable of enhancing employee commitment, trust, motivation, and productivity through fairness, transparency, accountability, and integrity. This study examined the influence of ethical leadership practices on employee performance at the Federal Medical Centre (FMC), Abuja, Nigeria. The study was guided by Social Exchange Theory and LeaderMember Exchange Theory and adopted a convergent parallel mixed-methods design. A sample of 328 employees was selected from a target population of 1,830 staff members using purposive and simple random sampling techniques. Quantitative data were collected through structured questionnaires, while qualitative data were gathered through interviews with members of senior management. Quantitative data were analyzed using descriptive statistics, Pearson correlation, regression analysis, and analysis of variance (ANOVA), while qualitative data were analyzed using thematic analysis. The findings revealed that ethical leadership practices were moderately prevalent within the institution, particularly with respect to fairness, accountability, integrity, and transparency. Regression analysis demonstrated that ethical leadership significantly predicted employee performance, accounting for 94.9% of the variance in employee performance (R² = .949, p < .001). Furthermore, Pearson correlation analysis indicated a strong positive relationship between ethical leadership and employee performance, r(300) = .974, p < .001. Qualitative findings revealed that ethical leadership enhanced trust, motivation, teamwork, organisational commitment, and job satisfaction. However, favouritism, inconsistent policy implementation, and selective enforcement of ethical standards weakened employee morale and trust in leadership. The study concludes that ethical leadership is a significant predictor of employee performance in healthcare institutions. The study recommends integrating ethical leadership indicators into performance appraisal systems, establishing structured mentorship programmes, strengthening ethical leadership development initiatives, and institutionalizing accountability mechanisms to enhance healthcare performance outcomes. Keywords: Ethical Leadership; Employee Performance; Healthcare Institution; Organizational Commitment; Job Satisfaction