Influence of organisational culture on the implementation of health sector reforms in low- and middle-income countries: a qualitative interpretive review

Figures & data

Figure 1. Key search terms.

Table 1. House et al. dimensions of organisational culture.

Dimension	Definition
Power distance	Extent of distribution and concentration of power across the organisation or the society
Institutional collectivism	Extent to which the organisation or society encourages and rewards communal action and sharing of resources
In-group collectivism	Level of pride, satisfaction and loyalty shown by members towards their organisation or society
Uncertainty avoidance	Degree to which the members of an organisation or society avoid unknown circumstances or uncertainty by depending on accepted practices, rules or procedures
Gender egalitarianism	Extent to which the organisation or society minimises differences in roles and opportunities based on gender.
Aggressiveness	Extent to which members of an organisation or society are competitive and confrontational with each other
Humane orientation	Extent to which an organisation or society encourages and rewards altruistic behaviour
Future orientation	Extent to which organisations or societies develop plans and strategies for future
Performance orientation	Extent to which the organisation or society encourages excellence and awards improvement

Figure 2. Search flow diagram.

Table 2. Characteristics of the literature.

Type of health sector reform	Country and organisations of focus	Methodology
Decentralisation (n = 6)	Brazil (n = 2); Public sector district health system	Ethnographic studies (n = 2)
	Ghana (n = 3); Public sector district health system	Qualitative studies (n = 3)
	Uganda (n = 1); National Ministry of Health	Case study (n = 1)
Comprehensive health sector reform to strengthen primary health care (n = 1)	Nigeria; 4 hospitals: Three public sector hospitals and one not-for- profit mission hospital	Quantitative study
Public-private partnerships between the State and Civil Society Organisations (n = 1)	India; Partnership between two civil society organisations and the public state	Multi-site ethnographic studies

Figure 3. Framework of the relationship between dimensions of organisational culture, organisational practices and implementation of health sector reforms. Adapted from Jaakko et al. [46]. The boundary of the organisation is represented by a dotted line to show the influence of the wider political and social context.

Jaakko Y-K, Kagoné M, Souares A, et al. The influence of organizational culture on information use in decision making within government health services in rural Burkina Faso. Nordic J Afr Stud. 2010;19:250–273.

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