Stratified ontology, institutional pluralism and performance monitoring in Zambia’s health sector

Phiri, Joseph and Guven-Uslu, Pinar ORCID: (2022) Stratified ontology, institutional pluralism and performance monitoring in Zambia’s health sector. Journal of Accounting and Organizational Change, 18 (2). pp. 217-237.

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Purpose: 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. Design/methodology/approach: 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. Findings: 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. Originality/value: 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.

Item Type: Article
Uncontrolled Keywords: donor funding,institutional pluralism,performance monitoring,stratified ontology,zambia
Faculty \ School: Faculty of Social Sciences > Norwich Business School
UEA Research Groups: Faculty of Social Sciences > Research Groups > Accounting & Quantitative Methods
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Depositing User: LivePure Connector
Date Deposited: 23 Apr 2021 23:49
Last Modified: 23 Oct 2022 02:23
DOI: 10.1108/JAOC-06-2020-0081


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