# The role of context in strategic human resource management within private hospitals in Ethiopia, compared to public hospitals

## TL;DR

This study explores how government policies affect human resource management in private and public hospitals in Ethiopia.

## Contribution

The study provides new insights into how contextual factors influence strategic human resource management in private versus public hospitals in Ethiopia.

## Key findings

- PNFP hospitals benefit from supportive government engagement and less coercive pressure.
- PFP hospitals face rigid regulations and use skilled workforces to justify higher service prices.
- Public hospitals lack flexibility in strategic human resource management due to strict policies.

## Abstract

Private hospitals in Ethiopia complement the resource constrained public hospitals. Health policy reforms have promoted further expansion of the private sector, despite a rigid policy that provide little room for strategic human resource management(SHRM). Consequently, private hospitals encounter challenges to live up to their potential. This study investigates the contextual mechanisms influencing SHRM in private for-profit (PFP) and not-for-profit (PNFP) hospitals, in comparison to public hospitals.

A qualitative approach was employed, utilizing structured interviews with CEOs, administrators, and HR managers from ten private hospitals. To make the comparison between private and public hospitals possible, the same protocols of the companion studies in public hospitals was followed. Thematic analysis through deductive coding based on the Contextual SHRM framework was conducted, using ATLAS.ti 8 software.

Our findings reveal that PNFP hospitals benefit from constructive government engagement and experiencing less coercive pressure, which appears to enable them to address underserved populations and mitigate public hospital capacity issues. In contrast, PFP hospitals perceive regulations as rigid and constraining. Though PFP hospitals compete for patients, they employ highly skilled workforce as a means towards delivering higher quality and valuable services to justify the higher price charged to patients.

Our study shows that stringent governmental policies/regulations exert pressure on SHRM of PFP hospitals. In contrast, PNFP hospitals perceive regulations as supportive. This condition is different from public hospitals which lack rooms to maneuver for crafting SHRM. Future research agenda are called for engaging employees for valuable insights into SHRM practices and performance.