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This book arises from the interest in understanding how leadership and management influence the functioning of public institutions, taking as a case the Regional Health Directorate of Ucayali during the year 2020. Based on observation and analysis, we explore the internal dynamics, the forms of leadership exercised and the management strategies that marked the performance of the entity in a complex and challenging context. Our purpose is to provide a reflective view on the reality of public management in the health sector, highlighting the importance of the human factor, communication and decision making in institutional results. This work seeks to contribute with proposals and recommendations that strengthen leadership capabilities, promote a more participatory organizational culture and guide efforts towards a more efficient, ethical and committed management for the welfare of citizens.