Evidence map›Paper›PMID 34581657›Full record

ArticleQualitative health research2021

Culture's Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts.

Patrick B Patterson, Zubia Mumtaz, Ellen Chirwa, Janet Mambulasa, Fannie Kachale, Josephat Nyagero

Abstract read
In one paragraph

Article in Qualitative health research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Patrick B PattersonUniversity of Alberta, Edmonton, Alberta, Canada.
Zubia MumtazUniversity of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-4590-9739
Ellen ChirwaUniversity of Malawi, Zomba, Malawi.
Janet MambulasaAmref Health Africa, Nairobi, Kenya.
Fannie KachaleGovernment of Malawi, Lilongwe, Malawi.
Josephat NyageroAmref Health Africa, Nairobi, Kenya.

Funding

CIHR
6 · The paper itself

Abstract

Public health scholars describe "culture of quality" in terms of desired values, attitudes, and practices, but this literature rarely includes explicitly stated theories of culture formation. In this article, we apply Fredrik Barth's transactional model to demonstrate how taking a theory-centered approach can help to identify what would be necessary to foster "cultures of quality" outlined in the public health literature. We draw on data from a study of the Republic of Malawi's Performance and Quality Improvement for Reproductive Health initiative. These data were generated in 2017-2018 through a 6-month organizational ethnography in three facilities selected to represent a range of districts with differing social and economic contexts. Our analysis revealed facility-level organizational cultures in which staff valued providing care, but responded to structural constraints by normalizing divergence from quality-of-care protocols. These findings indicate that sustaining a quality-oriented organizational culture requires addressing underlying conditions that generate routine experiences and practices.

Indexed as

Organizational CultureQuality ImprovementHumansMalawiMedical AssistanceQuality of Health Carecare provisionMalawiorganizational cultureOrganizational ethnographyquality improvement

Identifiers

PMID34581657
PMCPMC9207986

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.