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Culture's Place in Quality of Care in a Resource-Constrained Health System

Comparison Between Three Malawi Districts

Bibliographic Data

ID4633751
AuthorsPatrick B Patterson (0000-0002-5538-1723, University of Alberta, Edmonton, Alberta, Canada), Zubia Mumtaz (0000-0003-4590-9739, University of Alberta, Edmonton, Alberta, Canada, corresponding author), Ellen Chirwa (University of Malawi, Zomba, Malawi), Janet Mambulasa (0000-0003-4061-7198, Amref Health Africa, Nairobi, Kenya), Fannie Kachale (0000-0003-4489-2613, Government of Malawi, Lilongwe, Malawi), Josephat Nyagero (0000-0003-1499-8185, Amref Health Africa, Nairobi, Kenya)
Year2021
Volume31
Issue13
Pages2528-2541
Publication date2021-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueQualitative Health Research (JOURNAL)
Journal identifiersISSN: 1049-7323 • E-ISSN: 1552-7557
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/10497323211037636
PMID34581657
OpenAlexW3203450505
LanguageEN
Citations received1
References cited38

Public health scholars describe "culture of quality" in terms of desired values, attitudes, and practices, but this literature rarely includes explicitly stated theories of culture formation. In this article, we apply Fredrik Barth's transactional model to demonstrate how taking a theory-centered approach can help to identify what would be necessary to foster "cultures of quality" outlined in the public health literature. We draw on data from a study of the Republic of Malawi's Performance and Quality Improvement for Reproductive Health initiative. These data were generated in 2017-2018 through a 6-month organizational ethnography in three facilities selected to represent a range of districts with differing social and economic contexts. Our analysis revealed facility-level organizational cultures in which staff valued providing care, but responded to structural constraints by normalizing divergence from quality-of-care protocols. These findings indicate that sustaining a quality-oriented organizational culture requires addressing underlying conditions that generate routine experiences and practices

Economic growth · Economics · Epistemology · Ethnography · Health care · Knowledge management · Organizational culture · Political science · Public relations · Sociology · Transactional leadership · Computer Science · Global Maternal and Child Health · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Psychology

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Unique citing works1
Citations per year0,5
Citation span2024 - 2024 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 1
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