Stakeholder expectations of performance in public healthcare services: Evidence from a less developed country

Abstract

Purpose

The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The study emerges from extant literature indicating potential variations in stakeholder conceptions and expectations of performance within public services.

Design/methodology/approach

The paper draws on institutional and structuration theories to investigate cross-sectional stakeholder expectations of performance together with power relations embedded within public healthcare performance expectations. Empirical data are drawn from semi-structured interviews with 33 stakeholders including legislators, policymakers, regulators of health services, healthcare professionals and health facility managers.

Findings

The findings not only reiterate the constructed and multi-dimensional nature of performance but also highlight the hierarchical configuration of stakeholder expectations linking macro-level health outcomes with micro facility-level service delivery processes.

Practical implications

The study points towards the need of harmonising the national performance measurement (PM) framework to ensure that macro-level goals are suitably cascaded and translated into micro-level service delivery processes through bottom-up structuration linkages.

Originality/value

In addition to filling the gap of explicating public healthcare PM practices in a less-developed economic context, the paper integrates insights from institutional and structuration theories to depict stakeholder expectations of performance through a multi-level and hierarchical framework.

Citation

Phiri, J. (2017), "Stakeholder expectations of performance in public healthcare services: Evidence from a less developed country", Meditari Accountancy Research, Vol. 25 No. 1, pp. 136-157. https://doi.org/10.1108/MEDAR-08-2016-0070