The effects of local culture on hospital administration in West Sumatra, Indonesia

Abstract

PurposeProblems in health-care leadership are serious in West Sumatra, Indonesia, especially in hospitals, which are controlled locally. The purpose of this paper is to present the experience of three hospitals in balancing the conflicting demands of the national health-care system and the traditional model of leadership in the local community.Design/methodology/approachThree case studies of the hospital leadership dynamic in West Sumatra were developed from in-depth interviews with directors, senior administrators and a representative selection of employees in various professional categories.FindingsAn analysis of findings shows that traditional views about leadership remain strong in the community and color the expectations of hospital staff. Hospital directors, however, are bound by the modern management practices of the national system. This conflict has intensified since regional autonomy which emphasizes the local culture much more than in the past.Research limitations/implicationsThe research was carried out in one Indonesian province and was limited to three hospitals of different types.Practical implicationsThe findings elucidate a potential underlying cause of problems in hospital management in Indonesia and may inform culturally appropriate ways of addressing them.Originality/valueThe social and cultural contexts of management have not been rigorously studied in Indonesia. The relationship between local and national culture reported here likely has a similar effect in other parts of the country.