When the leader carries your career: a serial mediation testing on the role of servant leadership in career competencies and career adaptability of followers

Purpose – The literature on leadership is quite extensive; however, this study explains the impact of leadership styles on career success, career competence and career adaptability in the health sector. It explains theimpactofservantleadershiponcareercompetenceandcareeradaptabilitywithaserialmediatingimpactofpsychologicalsafetyandproactivebehavioraswellasself-efficacyandproactivebehavior. Design/methodology/approach – Itisaquantitativestudy,andittestedthesuggestedmodelinhospitalsin Pakistan. The data were collected from 310 health practitioners from the hospitals


Introduction
When we look into the next century, 'leaders are those who inspire others,' and that is what service-oriented leaders are providing, a clear vision of self-sacrificing leaders who emphasize the need for others more than their own needs and develop individuals growth culture in their workplace (Liu, 2019), which also helps in cultivating effectiveness and efficiency in individuals. Literature is replete with a sharp distinction between servant leadership and other theories of leadership, such as transformational leadership (Ehrhart, 2004;Graham, 1991;Gregory Stone, Russell, & Patterson, 2004;Thao & Kang, 2018). For example, there is a difference between the focuses of transformational leaders and servant leaders, the former focus on organizational development while the latter help an employee to grow themselves (Gregory Stone et al., 2004;Thao & Kang, 2018). The organizational role is very important for the betterment of every country, and every country could get success only when its individuals are capable enough to deal with circumstances and how they are developing themselves (Beheshtifar, 2011;Moaeri, 2002). They can adapt to environmental factors accordingly, establish sustainable management and develop career competencies (Beheshtifar, 2011;Eisakhani, 2008). If the strategies and innovations of the organization are complex, their main success depends on humans, and for the development of an individual, it is necessary to look out for some factors. One of the most important factors is career competency. Moreover, due to reoccurring changes in the workplace environment, new career realities have emerged, which focus on individuals and allow them to start taking responsibility for the development of their careers (Beheshtifar, 2011;Haase, 2007). It has become significant for individuals to become competent and get adjusted according to the culture of the workplace. To be a successful employee, an individual must be able to acquire skills that are new to them to become competent for their career-related tasks. Since the leader, in an organization, is an influencer, it is the sole responsibility of the leader towards the followers that they become able to get opportunities to manage their careers. Career adaptability and career competencies are both fundamental concepts for employees to get all of them (Tien & Wang, 2017). The career of employees is somehow linked with their confidence of employees whereas confidence creates self-efficacy in employees. Self-efficacy, derived from social learning theory and social cognitive theory, is the belief that an individual can perform a specific task effectively (Bandura, 1978). Self-efficacy is considered a kind of confidence in an individual or another category of self-esteem (Kanter, 2005). There are three dimensions of self-efficacy: magnitude, the difficulty level of a person's tasks; strength, the prosecution as weak or strong about magnitude and generality, the degree of generality of standards in circumstances, and an individual's ability influences their performance, perception and motivation. We rarely try to accomplish a task if we expect to fail (Bayramo glu et al., 2013). New career realities are with fewer boundaries; therefore, employees must be proactive in their behaviors (Jackson, 1996;Mirvis & Hall, 1994;Seibert, Kraimer, & Crant, 2001) and proactive behavior in turn related to a successful career. It is therefore important to learn how people with proactive behavior succeed more in their careers. In addition to it, today, the broader concept of career is illustrated, which involves a wide range of activities throughout the entire life cycle of people. Individuals need to be concerned about their future, should be open to new experiences, believe in what they could do and should have ability to manage their future growth (Tien & Wang, 2017). In this busy era, it is necessary to work on career success, and this can happen if leaders carry the careers of individuals. Although research has explored the impact of leadership styles on career success, there seems to be a need to test different organizational paths through which a leader may impact the career of the followers. In this regard, this study has used serial mediation of psychological safety and proactive behavior between servant leadership and career adaptability or career competency and serial mediation of self-efficacy and proactive behavior between servant leadership and career competency and adaptability. This study AGJSR develops comprehensive understanding of how servant leaders of health department impact on the career competency and adaptability of individuals through different paths.
The theory of servant leadership (Greenleaf, 1979;Panaccio et al., 2015) is distinctive in how leaders ' behaviors are committed to giving priority to serving others beyond the influence of employees in their employment relations (Barbuto and Wheeler, 2006;Ehrhart, 2004;Graham, 1991;Liden et al., 2014;Neubert et al., 2008;Panaccio et al., 2015;Russell and Gregory Stone, 2002). Servant leadership was slow at first to attract the scholars' attention, but the scientific interest increased in this theory thereon. Reviews have been carried out for the literature on servant leadership (Panaccio et al., 2015;Parris & Peachey, 2013;Van Dierendonck et al., 2014), models have been suggested (Liden et al., 2014;Panaccio et al., 2015) and measures also have been created for behaviors of servant leadership (Panaccio et al., 2015;Van Dierendonck et al., 2014). Studies have also explored that there is a positive impact of servant leadership on significant outcomes. Servant leadership demonstrates the process of competence empowerment by recognizing the abilities of followers and realizing the potential growth of followers (Graham, 1991;Thao & Kang, 2018). Servant leaders posit a positive impact on followers' career competencies (Crant, 2000;Spreitzer, 2008). Career competencies relate to the assessment of followers about their capabilities to carry out work activities efficiently and also have opportunities to execute their work and become professional in their abilities and skills (Spreitzer, 1995). In this context, leaders, as strong relationship constituents and crucial aspects in constructing an understanding of the workplace environment for followers, are deemed to be pertinent factors in ascertaining the competencies of followers (Baard, Deci, & Ryan, 2004). Acts of honest love, generosity and creativity allow servant leaders to understand what suits them best and to provide a supportive and beneficial atmosphere for followers to learn new skills, improve their expertise, reach new high standards and achieve their goals (Chen & Bliese, 2002).
Social learning theory suggests that people imitate others in learning new and existing behaviors to be used in their benefits socially. Albert Bandura's concept provides a justifiable process through which it is deduced that subordinates are more prone to follow their leaders and learn from them in the behaviors in organizations (Bandura & Cervone, 1986). Since servant leaders are considered to be more concerned about the welfare and growth of employees working around them, it is believed that servant leaders are depicts more influence on followers in imparting learning of the behaviors (Wu, Liden, Liao, & Wayne, 2021). Therefore, social learning theory augments the concept of servant leadership theory, and it, in a way, justifies the impacts of servant leadership on career oriented outcomes for followers.
Recent research shows that servant leadership impacts more on career satisfaction and adaptive performance through work engagement as compared to authentic leadership (Kaya & Karatepe, 2020). This fosters the notion that organizations must not only use authentic leadership, but they should boost servant leadership to augment satisfaction and performance with the career of the employees. Another study reveals that servant leadership not only impacts work-related outcomes but nonwork-related outcomes as well, when processed through work engagement and subordinates' self-care, servant leadership brings subordinates' work-family balance (Rofcanin et al., 2021). The recent meta-analysis and systematic reviews on servant leadership enrich our understanding of the concept, theory and empirical testing of servant leadership, especially in comparison with other valueladen leadership styles. It has been found that servant leadership has more predictive validity on organizational outcomes, as compared with transformational, authentic and ethical leadership styles (Lee, Lyubovnikova, Tian, & Knight, 2020). The recent literature suggests ongoing pursuit to understand different dimensions in the definition of servant leadership, and it finds it more a discursive phenomenon and also suggests studying servant leadership with situational strength and self-determination theories to understand organizational outcomes in a better way (Eva, Robin, Sendjaya, van Dierendonck, & Liden, 2019).
Consequently, followers trust that they are sufficiently expert to be competent enough in their career-related activities. In compliance with this given reasoning, it has been suggested by Walumbwa et al. (2010) that servant leaders direct and improve the competencies of followers through knowledge sharing and experience, so that they can efficiently solve their career-related issues. We claim that the career competency of the followers is improved under the leadership of servant leaders because servant leaders are recognized for explaining their goals to followers. Furthermore, servant leaders motivate followers to seek new tasks and address the difficult challenges themselves while leaders focus on ensuring that followers are fully aware of what expectations are ahead and provide practical responses to their achievements constantly (Thao & Kang, 2018;Van Dierendonck et al., 2014).
Therefore, we hypothesize that H1. Servant leadership impacts the career competencies of followers.
As research into servant leadership and career competency confirm their interrelatedness (Nilforooshan & Salimi, 2016), the relationship between servant leadership and employee career adaptability has also been discussed in the literature. Career adaptability is found as one of the core components in the theory of career construction (Savickas, 2005). It relates to psychological and social resources that are used by individuals to effectively deal with changing and uncertain environments and to resolve the issues caused by routine tasks, transitions and work hardships. Career ability has been defined as the competencies and attitudes that employees use to adjust themselves according to the situation and they can adapt to changes in their future (Savickas, 1997). Career adaptability is based on mainly four dimensions: career concern, career confidence, career control and career curiosity (Savickas et al., 2009). The first and crucial dimensions of career adaptability are concern, which means how oriented and likely an individual is to prepare for their future moves related to a career. Career confidence relates to the point to which an individual trusts himself to make wise decisions regarding their career and make practical work choices. The level at which an employee feels responsible for developing a career and trying to negotiate workplace changes is indicated by career control. Career curiosity is defined as how much a person promotes exploring the workplace and to seek information about work and its requirements (Nilforooshan & Salimi, 2016). Moreover, the connection that leaders promote with all of their followers can significantly impact the chances of having a substantial level of career success among the followers (Williams et al., 2017). Therefore, we hypothesize that H2. Servant leadership impacts the career adaptability of followers. AGJSR Psychological safety relates to the level at which people believe that they will not be punished for taking a quite well-intentioned personal and social risk, like looking for feedback, acknowledging mistakes or raising concerns (Edmondson et al., 2001). In this study, servant leadership is speculated to substantially increase the understanding of psychological safety in employees. Employees conclude that their team and organization provide a secure psychological environment if the leadership is obliging, coach-oriented and demonstrates an anti-defensive reaction to queries and challenges (Edmondson, 1999). Prior research has demonstrated that servant leaders encourage an individual to exhibit these traits, and it is, therefore, realistic to suppose that these leaders play a crucial role in boosting the feeling of psychological safety in employees (Chughtai, 2016;Liden, Wayne, Zhao, & Henderson, 2008). Empirically, servant leadership is positively linked to psychological safety (Schaubroeck et al., 2011).
The perspective of psychological safety shows that helpful nature enriches proactive behaviors (Ohly & Fritz, 2007). Hence, it is fair to believe that besides its other benefits, psychological safety may enhance employees' proactivity by creating an environment according to the leadership of servant leaders. Proactive behavior is described as "making efforts to enhance current conditions; it means questioning to status quo instead of just adapting passively to existing conditions" (Crant, 2000). Instead of accomplishing narrowly described tasks (career success), it is expected that employees engage in diverse work tasks (Parker, 2000). Prior research has identified the reasons for proactive behavior (Axtell et al., 2000), such as psychological safety. Psychological safety encourages proactive behaviors, like doing experiments and making career developments.
Additionally, leadership is a crucial indicator of efficacy as leaders better explain roles as well as provide employees with all the support they need (Chen & Bliese, 2002). Servant leaders are therefore keen to give followers the possibility of developing skills and helping them in their careers (Walumbwa et al., 2010) have also proposed that leaders continue providing followers with developmental encouragement and support, prioritizing the satisfaction and potential of the followers. This helps and encouragement means that employees leaders are much more inclined to feel competent and to be able to perform proficiently in certain tasks, which ultimately increases self-efficacy in employees (Tierney & Farmer, 2011;Walumbwa et al., 2010;Yang, Liu, & Gu, 2017).
The proactive model of motivation proposed that a can-do behavior has a direct influence on the proactivity of individuals (Parker, Bindl, & Strauss, 2010). Social psychological theories suggest that individuals are motivated to exhibit certain activities through their understanding of ability and their perception of the effect of their behavior (Bandura, 1986). Those with a good sense of self-efficacy believe in their abilities and appear to be taking more interest than others in carrying out their roles. Self-efficacy promotes proactive behaviors of employees (Avey, Luthans, & Jensen, 2009;Huang, 2017). Therefore, we propose the following hypotheses: H3. Psychological safety mediates the relationship between servant leadership and proactive behavior.
H4. Self-efficacy mediates the relationship between servant leadership and proactive behavior.
Particularly individuals having proactive behaviors are in a better position to hold their career well-being actively "Proactive personality and job performance: the role of job crafting and work engagement" (Bakker, Tims, & Derks, 2012). Career-related proactive behaviors lead to the growth of career competencies (Akkermans, Brenninkmeijer, Huibers & Blonk, 2013). A career is characterized as a specific series of working experiences of individuals over time while career competencies include a build-up of work-related abilities, knowledge and skills that are related to career advancement. Besides being essential for the management of your work, proactivity is also necessary for maintaining one's career competencies. Proactive behavior is linked to subjective and objective career competencies (Fuller & Marler, 2009). By taking responsibility for the success of one's professional career, proactive behavior plays a crucial role. Another way to ensure that employees fulfill their job expectations and ambitions is by improving career competencies (Plomp et al., 2016). Taken collectively, we suggest that individuals with proactive behavior are likely to do things necessary to achieve career ambitions and, as such, acquire relevant career competencies. Therefore, we have developed the hypothesis that H5. There is a positive impact of servant leadership on career competence with the serial mediation of a) psychological safety and proactive behavior and b) self-efficacy and proactive behavior.
Whereas clear evidence of the connection between proactive behavior and a successful career has been mentioned, but the underlying processes are little understood. However, numerous calls are being made for identifying the variable which mediates the relation between the personality of leaders and the career of employees (Barrick & Mount, 2005). We here argue that proactive behavior can sometimes be a characteristic that initiates the process of adaptation in employees. Career adaptability was defined by Savickas (1997) as "the willingness to face the predictable activities of career and the unpredictable changes brought on by modification in the working environment. The study refers to a more defined onedimensional concept of career adaptability as a phenomenon that affects how a person sees his\her ability to plan and adapt to change plans for the future and career tasks, particularly in the view of unexpected circumstances (Rottinghaus, Day, & Borgen, 2005). To successfully manage their career paths in the era of a more erratic and boundless career, this concept of career adaptability is extremely relevant to individuals by definition. In addition to the impact of career adaptability on a successful career, we believe that adaptability in the career itself is influenced by proactive behaviors. Moreover, the evidence could be made for the given classification through the piece of evidence that career adaptability is similar to the active effort of the individual to support his/her professional career instead of a reactive reaction to the given situation of career (Crocitto, 1998;Spurk, Volmer, Hagmaier, & Kauffeld, 2013). Since proactive behavior portrays someone who influences his\her working environment actively, proactive behavior is supposed to predict the individual's extent of career adaptability. Research that defines positive relationships between proactive behavior with entrepreneurial ambitions (Prabhu, McGuire, Drost, & Kwong, 2012), job crafting (Bakker et al., 2012) and career adaptability has also given empirical support for this theory (King, 2004). Hence, we made the following hypothesis: H6. There is a positive impact of servant leadership on career adaptability with the serial mediation of a) psychological safety and proactive behavior and b) self-efficacy and proactive behavior.
These hypotheses and theoretical background bring us to the theoretical framework depicted in Figure 1.

Research design and method
We used the technique of structural equation modeling and perform multiple regression along with an empirical analysis according to the hypothesis that follows positivist philosophy. Since the data are objective, they strive to check the impact of the mentioned variables (see the model for reference). The survey form method has been used for the AGJSR collection of data. We used Smart-PLS software. The data were then diagnosed according to the reliability, validity and collinearity tests. For hypothesis testing, we used bootstrapping (Mackinnon, 2009) of 5000 subsamples on the software to get robust results.

Sample and sampling technique
The data were collected from the doctors, Hos, dentists and nurses as the study targeted the health industry and particularly hospitals and their staff members. The survey was conducted and around 350 questionnaires were distributed, and only 310 were used to analyze the data for results. The data were collected in two phases from the same participants to mitigate the common bias.

Diagnosis
The two measures Cronbach alpha and composite reliability measure the internal consistency of the items. The standard value of Cronbach's alpha is 0.7 or above, and results show, as   Table 1, that Cronbach's alpha of CA, CC, PB and SL are highly related to each other. While the standard value for composite reliability is 0.6 or above and results show all desirable values, so it means that the items of all constructs are highly related to each other. The standard value for average variance extracted (AVE) is 0.5 or above.
The discriminant validity of the constructs was tested with heterotrait-monotrait (HTMT) test, as Table 2 shows the discriminant validity between constructs. The standard value of HTMT is 0.9 or below and as we can see that all the constructs' value is 0.9 or below so it shows that the constructs of the proposed model are discriminant with each other.
The discriminant validity of individual items of the constructs was measured with the cross-loading test. The result shows, as depicted in Table 3, that the value of the item of each construct is less than the items of other constructs, so it shows that the items are highly consistent with their constructs only as it is shown in the above table.
Hypothesis testing Original sample. When the impact of servant leadership on career adaptability was checked, it was found that in the total effects as shown in Table 4, with the increase in 1 unit of SL, there would be a 38.5% increase in CA, while in the direct effects without mediation as shown in Table 5, the increase shall be 3.1%, which is a marginal effect. When the impact of servant leadership on career competencies was checked it was found that with the increase in 1 unit of SL, in case of total effects, there would be a 41.5% increase in CC, while in the direct effect without mediation, it shall be 11.4% increase in CC, which is a marginal effect.
The serial mediation was tested with partial least square and structural equation modeling, and the results in Table 6   The role of servant leadership safety, which results in proactive behavior of the employees, and this ultimately results in career competencies of the employees. It was also found that servant leadership also creates self-efficacy, and this also results in proactive behavior which leads to career competencies.  Table 6. Specific indirect effects AGJSR In the same way, the path of servant leadership to psychological safety to proactive behavior also results in career adaptability of the employees as well and the path of servant leadership to self-efficacy to proactive behavior results in career adaptability. The results show that all serial mediating paths have been tested significantly. Table 7 depicts the strength of the model and hypothesis testing showing that all the paths show strong variance through the results.

Discussion
The study focused on the impact of servant leadership on "career competence" and "career adaptability" in the health sector with the serial mediation of "psychological safety" and "proactive behavior" as well as "self-efficacy" and "proactive behavior" in the same way. The results of this study suggested that servant leaders do not directly enhance the ability of followers to be career competent to a considerable level. These findings differ from the previous research of an identical context (Thao & Kang, 2018), which found that career competency is positively influenced by servant leadership in a regional engineering firm of Vietnam. This shows that the contradiction in results may be because of the difference in an organizational context. However, the research (Chiniara & Bentein, 2016) stated that individual performance is positively influenced by servant leadership through the positive mediating role of career competence. Secondly, we found that the servant leader also does not have a direct impact on the career adaptability of followers. In existing literature, there is hardly any research that has tested proper relationship between servant leadership and career adaptability, but the research conducted by Williams et al. (2017) stated that servant leadership magnifies follower creativity and also amplifies career-related efficiencies in followers.
Moreover, we have checked the serial mediation of psychological safety and proactive behavior between servant leadership and career competence as well as servant leadership and career adaptability. Through results, we have found a positive response between these serial mediators, which indicates that when the characteristics of leaders will be as servant leaders, it creates an environment of satisfaction in the workplace which ultimately lets employees feel secure, and then they will start taking risk which eventually enhances the future proactive behaviors in employees. Employees then start taking active participation in their careers; hence, their career-related skills, knowledge and abilities also develop, which leads to the development of career competencies. In prior research, no serial mediation has been tested between servant leadership and career competency, but the impact of servant leadership on psychological safety and then psychological safety with proactive behaviors and proactive behaviors with career competence has been checked respectively (Chughtai, 2016;Gong, Cheung, Wang, & Huang, 2012;Plomp et al., 2016). However, our findings consistent with the findings of Chughtai (2016) showed that partially psychological safety mediates the impact of servant leadership on feedback-getting behavior. Scholars also suggested that followers who feel secure working with their leaders and are ready to share  Table 7.

R-square
The role of servant leadership their ideas and feelings regarding their career with their leaders are more active in developing their careers rather than just accepting the existing career-related situation (Crant, 2000;Gong et al., 2012) and hence enhancing the proactivity of employees (Gong et al., 2012). Another positive finding on the impact of psychological safety on proactive behavior was conducted which supports a part of our serial mediation to some extent (Ohly & Fritz, 2007).
We have also checked the role of self-efficacy as the mediator between servant leadership and proactive behavior. The result stated that when leader helps their followers and make them a priority then followers become self-confident, and they start believing that they could do the particular task efficiently; hence, it proves that servant leadership is positively related to self-efficacy, which eventually increases proactive behaviors in followers. Nevertheless, because of some limitations in the existing literature, no research evaluated the serial mediation of self-efficacy and proactive behavior between servant leadership and career competency. One of the past research studies examines the mediating role of self-efficacy between servant leadership and creativity, which one way supports our results (Yang et al., 2017). Additionally, the impact of self-efficacy on proactive behaviors has also been tested in past research and that also proves that there is a positive impact of self-efficacy on proactive behavior.
Finally, we tested the mediating impact of proactive behavior on career competency and adaptability. This was, however, one of our main findings. And we conclude that there is a positive impact of proactive behavior on career competency as well as on career adaptability, which shows that there is no direct impact of servant leadership on career competency and career adaptability but surprisingly with the flow from servant leadership to proactive behavior with the mediation of psychological safety and self-efficacy in two different ways ends up getting the enrichment in career competency as well as in career adaptability. Our findings support the concept that employees with proactive behaviors are interested in taking the initiative to align their knowledge, abilities and skills (career competency) (Plomp et al., 2016).
Thus, we concluded that proactive behavior enhances career competency and career adaptability and that servant leadership promotes proactive behaviors in employees. This is among the significant contribution of this study in theory.

Theoretical and practical implications
This study aimed to explore the impact of servant leadership on the career success of individuals (career competence and career adaptability) with a serial mediating impact of psychological safety and proactive behavior as well as self-efficacy and proactive behavior. This research has an enormous contribution to the theory as it fulfills the gap in the existing literature. First, past research has been limited to only some styles of leadership and ignores the effective and innovative approaches to leadership (Chughtai, 2016). This research examines the relationship between servant leaders and career success (career adaptability and career competence) in the health sector with mainly proactive behavior as a common mediator and hence contributes to psychological context too. This study also provides an innovative dimension of leadership in literature for the health sector. Second, in a country like Pakistan, unlike non-Western countries, which are substantially different, we examined the framework provided in this study. This further deepens the understanding of proactive behaviors and all the variables suggested in this study. Third, this study tested the framework at a broader sample of 310, and data were taken from both private and public hospitals in Pakistan. Fourth, previous studies take this assumption servant leadership plays a vital role in employees' psychological health; hence, it is also proven in our study. Hence, this study contributes to a large scale in theory.

AGJSR
The study also provides some important practical implications and provides a deeper understanding of leaders in the health sector of Pakistan. First, the behaviors of SL are consistent with the environment which supports employees in hospitals in Pakistan. In addition to that, leaders must work on building trustworthy relations which helps in enhancing proactive behaviors and leads to career success.
Pakistan has rampant incivility behaviors and issues in organizations, especially in the health sector, where diversity is not encouraged, and incivility causes more turnover issues (Samad, Memon, & Kumar, 2020). This clearly hampers the career growth, career satisfaction and adaptability in the organizations (Faheem & Mahmud, 2015). This study suggests fostering servant leadership with mentioned process to bring more curbs on incivility and encourage diversity of races, ethnicity and other divides, since servant leadership has more capacity to manage the matters in diverse workforce.
Moreover, incivility is generally surrounded by contextual factors that surface mainly as selective incivility, where selective groups are generally stereotyped or targeted with incivility (Cortina, 2008). This happens with marginalized groups and contextual factors, such as status and power, gender composition, group process and other contextual factors play their role in this selective incivility (Kabat-Farr, Settles, & Cortina, 2020). One more qualitative study explores in the context of United Kingdom that selective incivility exists at multi-level with multi-dimensions in the context of subtle racism (Ozturk & Berber, 2022). Servant leadership, if adopted with all its clear paths of impact, can mitigate this and other types of incivility as it has capacity to address the contextual factors of selective incivility, and the inclusive culture can be easily motivated (Ozturk, Tatli, & Ozbilgin, 2015).
In hospitals where leaders encourage building trust and teamwork among the individuals working in the organization, such practices will surely result in career success (career competence and career adaptability) in the health sector. Also, leaders should promote selfefficacy in practices to get more fruitful results.

Limitations and future recommendations
It is difficult for any scholar to carry out a study that does not have any certain limitations. There are also several limitations to our analysis because of the same reason: First, this research was conducted in Pakistan, especially in the hospitals of Karachi, which is a developing city. Thus, in the future, studies could be conducted in other cities of Pakistan as well as in other countries to check if comparable findings are extricated. Second, our research is limited to the health sector of Pakistan. Future research could dive into any other sector with almost the same model to see if findings in other sectors are distinct from what we see here. Third, only a single independent variable has been tested in this study, i.e. servant leadership, and in future studies in the same sector, i.e. health sector, we can use a new leadership approach, i.e. knowledge-oriented leadership.