Leadership to manage mission drift: the case of health charities working in Africa

Healthcare organisations exposed to stakeholder pressures can experience ‘mission drift’. Their behaviour becomes inconsistent as they gradually change their practices to contradict their goals. Previous research has focused on the influence of external stakeholders such as donors, partners, civil society and beneficiaries, and responses to those influences. There is, however, little research dealing with the influence of internal stakeholders, such as executive directors. This chapter draws on findings from a study of UK charities supporting Africa’s public health programmes to understand the influence of senior executives. It shows how executives use their power over information to disrupt organisational performance and identifies gatekeeping and canvassing as ultimate response mechanisms demonstrated by boards. These response mechanisms advance a theoretical framework for managing mission drift and has implications for the governance of healthcare organisations that operate internationally.