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Integration of health services involves multiple interdependent leaders acting at several levels of their organisation and across organisations. This paper aims to explore the complexities of leadership in an integrated care project and aims to understand what leadership arrangements are needed to enable service transformation.

This case study analysed system and organisational leadership in a project aiming to integrate primary and specialist care. To explore the former, the national policy documents and guidelines were reviewed. To explore the latter, the official documents from the transformation team meetings and interview data from 17 health-care professionals and commissioners were analysed using thematic analysis with the coding framework derived from the comprehensive and multilevel framework for change (Ferlie and Shortell, 2001).

Although integration was supported in the narratives of the system and organisational leaders, there were multiple challenges: insufficient support by the system level leadership for the local leadership, insufficient organisational support for (clinical) leadership within the transformation team and insufficient leadership within the transformation team because of disruptions caused by personnel changes, roles ambiguity, conflicting priorities and insufficient resources.

This study provides insights into the interdependencies of leadership across multiple levels and proposes steps to maximise the success of complex transformational projects.

This study’s practical findings are useful for those involved in the bottom-up integrated projects, especially the transformation teams’ members. The case study highlights the need for a toolkit enabling local leaders to operate effectively within the system and organisational leadership contexts.

The 2008 financial crisis that hit conventional banks provides a market opportunity for special types of banks. Furthermore, given the current financial reform for financial inclusion and economic concern of the Nigerian Government, there is a need for research on the adoption of Islamic banks. Accordingly, the purpose of this study is to determine the predictors of Islamic bank adoption in Nigeria.

Data is collected from 385 Islamic bank customers in northern Nigeria and is analyzed using the partial least square structural equation modeling technique.

The result reveals that trust, social influence, knowledge and government support have a significant positive relationship with the adoption of Islamic banks, while relative advantage and compatibility do not. The model (trust, social influence, knowledge, government support, relative advantage and compatibility) explained 50% of the variance in the adoption of Islamic bank.

These findings are very important to scholars, the policymakers and Islamic bank operators in designing their marketing strategies. It shows that trust, social influence, government support and knowledge are predictors of Islamic bank adoption.

This study extended the diffusion of innovation (DOI) theory by combining relative advantage, compatibility with trust, social influence, knowledge and government support to the model. The developed model is validated for the study of Islamic bank adoption in an emerging market, Nigeria. Arguably, it is the only study that test effect sizes (f²) and predictive relevance (Q²) of extended DOI on Islamic banks.