Suchergebnisse

Background: Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations' mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments' formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy.

Abstract-Global consensus and national policies have emphasized deinstitutionalization, or a shift in providing mental health care from institutional to community settings. Yet, psychiatric hospitals and asylums receive the majority of mental health funding in many countries, at odds with research evidence that suggests that services should be delivered in the community. Our aim is to investigate the norms, actors, and strategies that influence the uptake of deinstitutionalization internationally. Our study is informed by prior literature on management and implementation science. The success and failure of mental health care operations depend on identifying and overcoming challenges related to implementing innovations within national contexts. We surveyed 78 experts spanning 42 countries on their knowledge and experiences in expanding community-based mental health care and/or downsizing institution-based care. We also asked them about the contexts in which said methods were implemented in a country. We found that mental health care, whether it is provided in institutions or in the community, does not seem to be standardized across countries. Our analysis also showed that moving deinstitutionalization forward requires meaningful engagement of three types of actors: government officials, health care professionals, and local experts. Progress toward deinstitutionalization depends on the partnerships formed among these actors and with diverse stakeholders, which have the potential to garner resources and to scale-up pilot projects. In conclusion, different countries have adapted deinstitutionalization in ways to meet idiosyncratic situations and population needs. More attention should be given to the management and implementation strategies that are used to augment treatment and preventive services.

Organizations instantiate multiple institutional logics, which operate in a nested fashion across levels of analysis. A demand on organizations in the Global South from aid donors is to adopt new management systems. Management systems like kaizen, a Japanese business philosophy of continuous improvement, have an inherent logic. Kaizen's adoption in Ethiopia, a postsocialist state, can be rendered ceremonial if its logic is not fully instantiated along with prevailing logics within recipient organizations. Our examination of the Ethiopian Sugar Corporation is an application of Besharov and Smith's 2014 framework. We assume there is a high degree of centrality in this state-owned enterprise, because any managerial logic absorbed would have to adhere to the state logic. We conducted interviews, supplemented by archival data review, to illustrate what actors do to improve compatibility with state logic. Our findings suggest three institutional logics were instantiated, in order: the macro logic of developmental authoritarianism; micro logics of production order and social control; and the meso logic of knowledge brokerage. We propose the concept of layered logic, or ordering of institutional logics, each serving a distinct purpose yet fitted with the others.

Muslim community-based health organisations (MCBHOs) represent a new wave of non-profit organisations outside of mosques and Islamic community centres. In this article we examine MBCHOs' core management competencies because they are instantiations of institutional logics, which result in different forms of organisational hybridity within the third sector. Theoretically, we focus on the instantiations that are associated with a societal institutional logic (religion) and two organisational field logics (voluntarism and healthcare). Empirically, we draw from a survey, maps, tax filings and strategic plans. We observed convergences in financial and human resource management and divergences in community engagement and patient assessment among 110 MCBHOs located in the United States. Volunteering and patient care hold the meaning of faith. Our findings suggest that most MCBHOs resemble an assimilated hybrid, characterised by managerial practices that adhere to the core logics of healthcare and voluntarism, with traces of the Islamic religious logic. We thus introduce the concept of 'faithwashing'.