Health System Reform and Organisational Culture: An Exploratory Study in Abu Dhabi Public Healthcare Sector

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Abstract

The Health system in Abu Dhabi has undergone a series of far reaching reforms during the past six years, yet in spite of the structural transformations, public confidence in the performance of this vital sector is still skeptical at best and employee engagement is still low. The thesis was underpinned by the aim to reveal the challenges in public health system reform outside the context of western administration. This thesis is an attempt to analyse the intricate, multidimensional concept of organisational culture within the complex structure of public healthcare sector in a fast growing economy like Abu Dhabi.Managing organisational culture is increasingly viewed as an essential part of health system reform. Organisational culture in health care organisations has gained increased consideration as an important factor that affects health systems reform and influences the quality of health care. The research project aims to explore the context of health system reform in Abu Dhabi and to understand the organisational culture of the different constituents of its public healthcare sector. Using a multi-method investigation combining both qualitative and quantitative approaches using the Competing Values Framework as conceptual framework, this research aims to provide a critical assessment of organisational culture in healthcare sector in Abu Dhabi. Semi-structured interviews were conducted in the regulator, operator, and three public hospitals prior to the use of a survey instrument based on the Organisational Culture Assessment Instrument (OCAI). The data analysis revealed that the prevailing cultural model of the Abu Dhabi public sector organisations was concurrently governed by hierarchy and market cultures while the presence of clan and adhocracy models was relatively limited. Interesting variations in assessment of clan culture were found between UAE nationals and other nationality clusters. The findings also revealed a desired cultural shift manifested by a higher emphasis on clan and adhocracy cultures and a lower emphasis on hierarchy and market culture. Those results confirm the presence of two opposing or competing cultural dimensions clan/adhocracy vs. hierarchy/market.This research makes a considerable contribution to the sparse empirical studies in health system reforms and organisational culture in the Arab Gulf states, and proposes important explanations and possible solutions to the salient challenges facing the health system in Abu Dhabi.

Keyword(s)

Competing Values Framework; Health System Reform ; Organisational Culture; Public Healthcare; UAE

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