Measuring Organizational Culture in Ethiopia’s Primary Care System: Validation of a Practical Survey Tool for Managers
Publish Year: 1401
نوع سند: مقاله ژورنالی
زبان: English
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JR_HPM-11-12_029
تاریخ نمایه سازی: 17 مرداد 1403
Abstract:
Background Organizational culture has been widely recognized as predictive of health system performance and improved outcomes across various healthcare settings. Research on organizational culture in healthcare has been largely conducted in high-income settings, and validated scales to measure this concept in primary healthcare systems in lowand middle-income country (LMIC) settings are lacking. Our study aimed to validate a tool to measure organizational culture in the context of the Ethiopian Primary Healthcare Transformation Initiative (PTI), a collaborative of the Federal Ministry of Health (FMoH) and the Yale Global Health Leadership Initiative to strengthen primary healthcare system performance in Ethiopia.Methods Following established survey development and adaptation guidelines, we adapted a ۳۱-item US-based organizational culture scale using (۱) cognitive interviewing, (۲) testing with ۱۱۷۶ district and zonal health officials from four regions in Ethiopia, and (۳) exploratory factor analysis (EFA).Results Based on the results of cognitive interviewing, an adapted ۳۰-item survey was piloted. The factor analyses of ۱۰۳۴ complete surveys (۸۸% complete responses) identified five constructs of the scale which demonstrated strong validity and internal consistency: learning and problem solving, psychological safety, resistance to change, time for improvement, and commitment to the organization. Of the ۳۰ a priori items, ۲۶ items loaded well on the five constructs (loading values ۰.۴۰-۰.۸۶), and ۴ items failed to load. Cronbach alpha coefficients were ۰.۸۶ for the scale as a whole and ranged from ۰.۶۵ to ۰.۹۰ for the subscales. The five-factor solution accounted for ۶۲% of total variance in culture scores across respondents.Conclusion Through validation and factor analyses, we generated a ۲۶-item scale for measuring organizational culture in public primary healthcare systems in LMIC settings. This validated tool can be useful for managers, implementers, policy-makers, and researchers to assess and improve organizational culture in support of improved primary healthcare system performance.
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Authors
Lingrui Liu
Global Health Leadership Initiative, Yale University, New Haven, CT, USA
Leslie A. Curry
Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
Kidest Nadew
Global Health Leadership Initiative, Yale University, New Haven, CT, USA
Mayur Desai
Global Health Leadership Initiative, Yale University, New Haven, CT, USA
Erika Linnander
Global Health Leadership Initiative, Yale University, New Haven, CT, USA