DelimitationsDelineation is a feature that will not add any relevant facts to the proposed study and areas not covered by the research. Boundaries are set so that goals do not become too large to achieve. For example, delimitations include the objectives, research questions, variables, theoretical objectives, and populations chosen as the study's targets. The study is limited to collecting information through descriptive and qualitative data collection method by working with HR managers, directors, general managers, financial controllers and vice presidents. One limitation of this study is the small sample of experts who will be involved in a broad topic. One of the objectives of the study is to investigate and discover the ideas encountered by SAHC leaders that influence their decision-making process. This study is expected to contribute remarkable insights to the limited body of knowledge relating to SAHC leaders. Summary of Chapter 1 The first chapter provides a brief history of the problem study between the 1990s and today. It shows that during the period from 1990 to the present, health care and other public organizations have simultaneously experienced structural changes and challenges from various perspectives. The first chapter also defines the research problem and challenges facing MDC SACH leaders, and also explores the burdens these challenges create for leadership. The objective of the study is stated in the first chapter along with the potential impacts of the challenges on leadership in SAHC organizations. The study aims to broaden awareness by focusing on how SAHC leaders have different views on the skills that constitute superior leadership. The first chapter also presents......in the middle of the document......strategies for handling challenges. Specific challenges that will be explored include:; cost containment, cultural issues, HIPPA, Privacy Act and employee retention. Applying strategies from the MDC literature experienced by SAHC leaders can not only improve management of many of these challenges, but can also improve understanding and expand knowledge of possible ideas for advancing understanding of leaders on how to overcome and manage challenges. The literature review includes a collection of sources used for the proposed study and literature revealed to be relevant to the study. This chapter also examined the characteristics of certain leadership styles, particularly as they relate to healthcare and MDCs faced by SAHC leaders. This literature review further identified knowledge gaps and offered significant insights into the ongoing impacts of these gaps for MDCs..