Abstract In the dynamic global public healthcare sector, “wicked problems” are fraught with ambiguity and recursive outcomes, complicating interventions and often rendering traditional resolution strategies ineffective. Despite the urgency, the relationship between leadership actions and these unyielding challenges remains under-explored. This study addresses the gap in the literature by evaluating current leadership approaches and research trends through a dual-methodological lens. Utilizing a systematic literature review (SLR) and bibliometric analysis of 1,168 articles from the Web of Science database (2014–2024), we map the intellectual landscape of the field. The findings reveal a multi-disciplinary range of challenges, categorizing wicked problems into clusters of complex system entanglement, epidemiological risk, biodiversity loss, and population health infrastructure. Critically, the analysis identifies that current leadership responses are frequently constrained by limited information collaborations, inflexible policy design, and hierarchical decision-making. This paper contributes to the development of complex systems and leadership literature in five distinct ways: (1) identifying global leadership approaches to wicked problems; (2) mapping critical collaborative research trends; (3) tracing the evolution of thematic research clusters; (4) isolating gaps between research and practice; and (5) proposing a novel Adaptive Systems Framework. This framework offers a strategic alternative to static management models, advocating for adaptive, collaborative, and reflexive leadership actions essential for navigating the persistence of wicked problems in public healthcare.
Klerk et al. (2026) studied this question.