Organizational Strategy and Culture co-alignment, external environment and performance of large private Health Facilities in Kenya

Abstract

While strategy implementation represents one of the ways by which organizations achieve their goals and objectives, strategy alone may not significantly influence performance. It may need to be complemented with culture even as a given organization pays attention to external environment. Unfortunately, the assessment of these complementary effects has received limited attention in the empirical literature. The main objective of this study was to examine the influence of external environment on the relationship between organizational strategy-culture co-alignment and performance of large private health facilities in Kenya. The basic health care is central to poverty reduction in every country. The private sector health facilities complement the efforts of the Kenyan government in enhancing the health of the citizens, hence their performance is critical. The specific objectives that mirror the study hypotheses were to: establish the influence of organizational strategy on performance; examine the influence of organizational culture on performance; ascertain the influence of organizational strategy-culture co-alignment on performance; determine the influence of external environment on the relationship between organizational strategy-culture co-alignment and performance; and probe whether the joint-effect of strategy, culture and external environment on performance is significantly greater than the sum-total of the independent effects of the same individual variables or not. Through a cross-sectional descriptive survey, data from 58 large private health facilities were gathered using a structured questionnaire and analyzed using descriptive statistics, simple and multiple linear regression, canonical correlation and sensitivity analyses. The results revealed that organizational strategy, culture and strategy-culture co-alignment have not statistically significant effects on the performance of the facilities. External environment was found to have no moderating effect on the relationship between strategy-culture co-alignment and performance of the facilities. The results further indicated that the joint effect of strategy, culture and external environment on performance was significantly greater than the sum-total of the independent effects of the same variables. Despite the statistically not significance results exhibited in the case of efficiency, effectiveness and relevance, the high explanatory power of the joint effect of strategy, culture and external environment implies that they are critical components in shaping organizational performance. Conclusively, the facilities do not align their strategies and cultures for the achievement of better performance. The findings contribute to the general body of knowledge and provide a backdrop for further advancement of theory and research on certain strategic orientations. The findings also imply that organizational managers have to scan and monitor environmental developments in order to inform their decision-making appropriately. The study informs the policy makers on the need to set mechanisms that support strategy and culture fit. The study limitations included a wide geographical spread of the facilities and limited generalizability. Based on the limitations of the study, areas for further research have been suggested to address other contexts or using different methodologies and conceptualizations.