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This study aims to examine the impact of leaders’ abusive supervision on employees’ work engagement in the health sector. The study further examined the interactive effect of leaders’ abusive supervision and employees’ proactive personality on work engagement via employees’ silence.

Data were collected from 343 health workers in five hospitals in Ghana. The Hayes Process Macro and AMOS were used to analyse mediation, moderation and moderated-mediation relationships

The study findings indicate that leaders’ abusive supervision has a detrimental impact on employees’ work engagement. The study further found that employees’ silence did not mediate the relationship between abusive supervision and work engagement. Employees’ proactive personalities positively moderated the relationship between abusive supervision and employees’ silence.

This study advances understanding of how perceived leaders’ abusive supervision affects health workers’ work engagement. This study contributes to the literature by confirming employees’ silence as a pathway linking abusive supervision to work engagement. The study further identifies employees’ proactive personality as a moderating variable in the relationship between abusive supervision and employees’ silence.