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Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts
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 ap...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207986/ https://www.ncbi.nlm.nih.gov/pubmed/34581657 http://dx.doi.org/10.1177/10497323211037636 |
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author | Patterson, Patrick B. Mumtaz, Zubia Chirwa, Ellen Mambulasa, Janet Kachale, Fannie Nyagero, Josephat |
author_facet | Patterson, Patrick B. Mumtaz, Zubia Chirwa, Ellen Mambulasa, Janet Kachale, Fannie Nyagero, Josephat |
author_sort | Patterson, Patrick B. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9207986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-92079862022-06-21 Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts Patterson, Patrick B. Mumtaz, Zubia Chirwa, Ellen Mambulasa, Janet Kachale, Fannie Nyagero, Josephat Qual Health Res Research Articles 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. SAGE Publications 2021-09-28 2021-11 /pmc/articles/PMC9207986/ /pubmed/34581657 http://dx.doi.org/10.1177/10497323211037636 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Research Articles Patterson, Patrick B. Mumtaz, Zubia Chirwa, Ellen Mambulasa, Janet Kachale, Fannie Nyagero, Josephat Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title | Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title_full | Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title_fullStr | Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title_full_unstemmed | Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title_short | Culture’s Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts |
title_sort | culture’s place in quality of care in a resource-constrained health system: comparison between three malawi districts |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207986/ https://www.ncbi.nlm.nih.gov/pubmed/34581657 http://dx.doi.org/10.1177/10497323211037636 |
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