Testing the Contextual Interaction Theory in a UHC pilot district in South Africa

Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps. Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators.Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.

Daily Life of the American Embassy in Czechoslovakia in 1945—1948

The article is devoted to the study of various aspects of daily life of the US Embassy in Czechoslovakia in 1945—1948. The author considers the main areas of its work, major problems and difficulties that American diplomats had to overcome being in difficult conditions of the post-war economic recovery and international tension growth. Special attention is paid to the role of Ambassador L. A. Steinhardt, his methods of leadership, interactions with subordinates, with the Czechoslovak authorities and the State Department. This allows to reveal some new aspects of American diplomacy functioning, as well as to identify poorly explored factors that influenced American politics in Central Europe during the years when the Cold War was brewing and tensions between Moscow and Washington were rising. The article is based on unpublished primary sources from the American archives.

Testing the Contextual Interaction Theory in a UHC Pilot District in South Africa

Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.

Testing the Contextual Interaction Theory in a UHC Pilot District in South Africa

Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.

Testing the Contextual Interaction Theory in a UHC pilot district in South Africa

Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.

Do vertical and shared leadership need each other in change management?

Purpose – Despite the increasing importance of shared leadership, researches examining its relations with vertical leadership, a complementary source of power, has been scarce. Therefore, the purpose of this paper is to extend the authors’ knowledge on this little-known topic by analysing vertical and shared leadership interactions in a change management project. Design/methodology/approach – A qualitative content analysis based on nine semi-structured interviews with top and middle managers, and a dataset of documents including corporate reports, a Road Map book and presentations was carried out, analysing the reciprocal leadership relationships by using an extended framework, which includes directive, transformational, transactional and empowering behaviours. Findings – Both in radical and incremental step, vertical as well as shared leadership interacted, showing their reciprocal need to deal with change. Leadership approaches and behaviours, conceptually and empirically distinct, even if highly related, are complementary sources that shape a constant compromise, according to the contextual demands of the project, to face change. Research limitations/implications – Further studies could strengthen the generalizability of the findings that suffer for the qualitative method. Moreover further studies could extend leadership interactions beyond leader-change management team relationships to the top-bottom levels of the organization. Contribution to theory is mainly twofold. First, findings highlight that for every specific change phase, both radical and incremental ones, different gradients of vertical and shared leadership are required. Second the authors found that leadership behaviours could be contrasting, requiring the ability to perform the multiple roles and behaviours in a well-balanced way in order to deal with the contextual demands of the change project. Practical implications – The paper includes implication for developing and training leaders, as well as followers, to have effective and multiple leadership skills and be able to apply them in different contexts, both by switching from vertical to shared, and vice versa, and by having the capability to respond with appropriately behaviours to a wide range of situations, that could also be mixed and opposing more than linear. Originality/value – The paper fills a gap in research about the interactions between vertical and shared leadership dynamics, through a qualitative study, during a change management project.

An Exploration of Substitutes for Leadership: Problems and Prospects

Despite the conceptual premise of Kerr and Jermier's (1978) substitutes for leadership model, there has been little evidence of empirical support when substitutes for leadership are modeled as interactions with leader behaviors. In this study we attempted to show that one reason that significant interaction effects have not been found in prior research is the restricted range of the sample. We therefore investigated the interaction between substitutes for leadership and leader behaviors using a broad-based sampling design based on Mintzberg's (1993) model. We found support for interactions between the substitutes for leadership and leader behaviors. The conclusion we reached is not that the original model of Kerr and Jermier is wrong, but rather that the methods used to test leadership interactions have not been appropriate. In addition, we found evidence in this research that supports aspects of Mintzberg's (1993) Structure in Fives model.