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The moderating role of support for innovation in sub-Saharan African healthcare teams: a multilevel perspective

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Abstract

In Mali, where the healthcare system is severely underfunded, service delivery is often in such a state of crisis that adaptivity is essential for the continued performance and resilience of staff. The aim of this study is to enhance understanding of the correlates of team-level support for innovation. Specifically, this study investigates the central role played by team-level support for innovation in the relationship between individual-level trust and adaptivity. It also investigates whether innovation support affects the relationship linking team-level participative safety and team-level adaptivity. A single-source, mono-method, multilevel, and cross-sectional study was undertaken in Mali using validated questionnaires with healthcare providers in community healthcare centers. As expected, results indicate that team-level support for innovation positively moderates the relationship between individual-level trust and adaptivity. However, contrary to expectations, results also show that team-level support for innovation negatively moderates the positive relationship between participative safety and team-level adaptivity. This study contributes to extant literature by showing that team-level support for innovation affects adaptivity differently depending on whether it is at the individual- or team-level. While strong team-level support for innovation fosters a positive relationship between trust and individual-level adaptivity, efforts directed at supporting innovation at the team level may have a less positive impact on team adaptivity in a resource-scarce environment. Our results also suggest that managers and leaders in Malian community health centers should instill a climate of participative safety in their teams as well as foster trust behaviors in individuals if individual-level adaptivity is to be encouraged.

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Acknowledgements

We wish to thank all the research participants as well as the research team. We also wish to thank David Zombré, A.J. Corner, Jane O’Reilly, and Neil MacMillan for their valuable input.

Funding

This work was funded by three Canadian agencies: World Agency Canada (WAC), the Canadian Institutes of Health Research (CIHR), and the International Development Research Centre (IDRC). Our study is part of a larger research program on “Results-based financing for equitable access to maternal and child healthcare in Mali and Burkina Faso.” This seven-year program is part of the “Innovation for Maternal and Child Health in Africa” initiative. This research was also supported by the Montfort Research Chair in Organization of Health Services.

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Authors and Affiliations

  1. Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, Ontario, K1N 6N5, Canada

    François Durand

  2. Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) and Université de Paris, Inserm ERL 1244, 45 rue des Saints-Pères 75006, Paris, France

    Valéry Ridde

  3. Association Malienne de Recherche et Formation en Anthropologie des Dynamiques Locales, cité el-Farako, BP E5448, Bamako, Mali

    Laurence Touré & Abdourahmane Coulibaly

  4. Faculté de Médecine et d’Odonto-stomatologie, Bamako, Mali

    Abdourahmane Coulibaly

  5. IRL 3189 “Environnement, Santé, Sociétés” (UCAD-Dakar, USTTB-Bamako, CNRST-Ouagadougou, CNRS-France), Paris, France

    Abdourahmane Coulibaly

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Each author has made a substantial contribution to designing the study. VR and LT worked on data acquisition. FD and VR drafted the manuscript. FD worked on data analysis and interpretation. FD and AC worked on the revision of the manuscript. All authors approved the submitted version. Each author agreed to be both personally accountable for their own contributions and ensure that questions related to the accuracy or integrity of any part of the work, even parts in which they were not personally involved, have been appropriately investigated and resolved, and that the solution in question has been documented in the literature.

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Correspondence to François Durand.

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Durand, F., Ridde, V., Touré, L. et al. The moderating role of support for innovation in sub-Saharan African healthcare teams: a multilevel perspective. Curr Psychol 43, 1446–1456 (2024). https://doi.org/10.1007/s12144-023-04341-6

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