The influence of inclusive HR practices and leadership on employee outcomes in healthcare sector using hybrid SEM and ANN approach

Purpose This study examines the impact of inclusive human resource practices (IHRP) and inclusive leadership (IL) on employee performance (EP) and employee learning (EL) in public hospitals in Basra, Iraq. It also explores the mediating effect of work engagement (WE) and the moderating influences of proactive personality (PP) and positive affective tone (PAT). Design/methodology/approach Drawing on conservation of resources (COR) theory and social exchange theory (SET), the study evaluated a moderated mediation model using survey data collected from 320 employees across three public hospitals in Basra, Iraq. The relationships among variables were analysed using a two-stage approach that combines Partial Least Squares Structural Equation Modelling (PLS-SEM) with artificial neural networks (ANN). Findings The results indicate that WE mediates the effects of IHRP on both EP and EL, and the effects of IL on EL, whereas the indirect path from IL to EP was not supported. PP was found to enhance the effects of both IHRP and IL on WE. Additionally, PAT positively influenced the relationships between WE and outcomes but negatively impacted the IL–WE connection at elevated levels. ANN analysis revealed that IHRP and PP exhibit greater predictive salience than WE. Practical implications The findings highlight the importance of incorporating PAT alongside PP in the design of IHRP and IL development initiatives, particularly in high-pressure public healthcare environments. Originality/value The study contributes to the existing literature by integrating COR and SET in a moderated mediation framework. It employs PLS-SEM and ANN to effectively combine theoretical evaluation with predictive validation in resource-scarce healthcare contexts.