Search results

This paper aims to investigate funding and performance monitoring practices in Zambia’s health sector from an institutional and stratified ontology perspective. Such an approach was deemed appropriate in view of pluralistic institutional environments characterising most African economies that are also considered to be highly stratified.

Blended with insights from stratified ontology, the paper draws on institutional pluralism as a theoretical lens to understand the institutional structures, mechanisms, events and experiences encountered by actors operating at different levels of Zambia’s health sector. The study adopted an interpretive approach that helped to investigate the multifaceted and subjective nature of social phenomena and practices being studied. Data were collected from both archival sources and interviews with key stakeholders operating within Zambia’s health sector.

The study’s findings indicate the high levels of stratification within Zambia’s health sector as evidenced by the three sector levels that possessed different characteristics in terms of actor responses to donor influence. This study equally demonstrates the capacity of agents operating under highly fragmented institutional environments to engage in enabling and constraining responses depending on the understanding of their empirical world.

Through blending insights from stratified ontology with institutional pluralism, the study contributes to the literature by demonstrating the enabling and constraining reflexive capacity of agents to exercise choices under highly fragmented institutional environments while responding to multiple demands and expectations to sustain the co-existence of diverse stakeholders. Accordingly, the study advances thinking on the application of institutional theory to critical accounting research in line with recent ontological and epistemological shifts in institutional theory.

The purpose of this paper is to investigate institutions of accountability in Zambia in order to understand how social networks may influence such institutions not to discharge their mandates as expected from time to time. The study equally seeks to explore how social networks may perpetuate corrupt activities and compromise the functioning of institutions of accountability.

The conceptual framework adopted in this study draws on insights from social network theory (SNT) and Bourdieu’s ideas of capital to devise a critical lens for investigating network activity and its influence on the functioning of institutions of accountability. Qualitative data were collected through semi-structured interviews with respondents drawn from different institutions of accountability. Social network analysis was conducted through content analysis.

Research findings highlight the presence of networks of a corrupt nature operating within government structures and some institutions of accountability. Manifested in the form of systemic and familial archetypes, these networks appear to be championed and propelled by senior government officials like controlling officers and other actors of a political nature including ministers and presidents. Most of these corrupt activities are organised through brokerage mechanisms that interface internal and external networks.

Due to the clandestine nature of corruption activities, however, the study was unable to determine measures of centrality and density since these details were not forthcoming during interviews. Such information could only become available if willing individuals involved in corruption could be identified so that they explain who they conduct their corruption with together with the number of connections involved and the most influential individuals in those networks.

This study helps us to understand that activities of a corrupt nature are often undertaken through well-connected groups and networks that make it difficult for institutions of accountability to detect and untangle such activity. The study also suggests that accountants and other accountability actors may have forgotten that accounting is not just a technical discourse for enhancing one’s economic status but is an ethical profession as well. There is a great need to put institutions in place which should hold everyone, including the president and ministers, accountable to the Zambian people in the light of wrongdoing. Dismantling the corrupt network activities inferred from the data entails a complete top-down change in systems of politics, governance, wealth distribution and social values.

This study contributes towards filling the gap of undertaking accounting research of a critical nature focussed on African contexts (Rahaman, 2010). The paper is equally an attempt at providing empirical flesh to Laughlin’s (1991) framework on organisational transformations through complementing that framework with SNT. The study is also among the first to draw on the experiences and insights of actors working within institutions of accountability to highlight accountability challenges within an African context.

This paper examines the relationship between key actors in an organisation and informal professional networks. It uses pragmatic constructivism (PC) as a research paradigm together with concepts borrowed from the theory of social networks to investigate how these actors responded to a particular set of non-financial performance targets.

The implementation process of waiting time targets in the Accident and Emergency Department was observed as part of an in-depth study at a large English National Health Service hospital. The main sources of data were face-to-face interviews with key actors, documentary archival evidence and observation diaries.

The results indicated that with the effect of information sharing through these networks, implementation methodology switched from systems approach to actors approach. Professional connections between key actors had allowed them to generate their own understanding in responding to new performance measures. As a consequence, the perceptions of other actors in relevant networks, as well as the implementation practices were influenced.

This is a single-site, in-depth case study; hence, the findings are not generalizable.

This study demonstrated just how influential some key actors can be in shaping the implementation of performance measures.

The paper contributes to PC by providing evidence on the influence of informal professional networks and structural holes in shaping organisational topos.

The purpose of this paper is to investigate accounting and performance reporting practices embraced in the midst of a pluralistic institutional environment of an emerging economy (EE), Zambia. The research is necessitated due to the increased presence and influence of donor institutions whose information needs may not conform to the needs of local citizens in many EEs.

The study draws on institutional pluralism and Ekeh’s post-colonial theory of “two publics” to depict pluralistic environments that are typical of EEs. Primary data were collected through semi-structured interviews with 33 respondents drawn from the main stakeholder groups involved in health service delivery including legislators, policy makers, regulators, healthcare professionals and health service managers. Data analysis took the form of thematic analysis which involved identifying, analysing and constructing patterns and themes implicit within the data that were deemed to address the study’s research questions.

Findings indicate that Zambia’s institutional environment within the health sector is highly fragmented and pluralistic as reflected by the multiplicity of both internal and external stakeholders. These stakeholder groups equally require different reporting mechanisms to fulfil their information expectations.

The multiple reporting practices evident within the health sector entail that the effectiveness of health programmes may be compromised due to the fragmentation in goals between government and international donor institutions. Rather than pooling resources and skills for maximum impact, these practices have the effect of dispersing performance efforts with the consequence of compromising their impact. Fragmented reporting equally complicates the work of policy makers in terms of monitoring the progress and impact of such programmes.

Beyond Goddard et al. (2016), the study depicts the usefulness of Ekeh’s theory in understanding how organisations and institutions operating in pluralistic institutional environments may be better managed. In view of contradictory expectations of accounting and performance reporting requirements between the civic and primordial publics, the study indicates that different practices, mechanisms and structures have to be embraced in order to maintain institutional harmony and relevance to different communities within the health sector.

To investigate implementation of benchmarking (BM) in three hospital trusts by adapting receptive context of change model according to BM principles of EFQM business model.

Perceptions of managers, clinicians and finance personnel towards implementation of BM are compared. Both qualitative and quantitative data are collected in three hospitals and results are cross compared to analyse both organisational and professional perceptions.

The paper concludes that there are limits to the rapid or broad implementation of BM principles in health services. It argues that the patients and their expectations are not referred in BM. It also suggests that local implementation programmes should be used for BM health services.

Future research could use data from other hospitals and apply same/similar framework in order to create knowledge representing the general attitude in hospitals and between professionals towards BM in health services.

Both academics and professionals working in the field of health services management might find the paper useful especially in managing different professional groups' attitude in managing change in large organisations.

The originality of the paper is the fact that it attempts to report on both professional and organisational approaches in implementation of BM. It also attempts to report on not only organisational factors but also individual and external factors of change for BM.