An assessment of "Organization Culture" in District Program Management Units established under National Health Mission in a western state of India.

ABSTRACT

Background: State programme management unit and District Programme Management Units (DPMU) are established under National Health Mission with an expectation to strengthen the management structures at the state and district levels, respectively. This is a major initiative to bring change in organisation structure and an effort to embrace change in working culture. The study was undertaken in a western Indian state to assess and compare the organisation culture in DPMUs. Methods: Districts of the state were divided into three strata based on the geographical and demographic features. One district from each stratum was randomly selected for the study. In-depth interview of nine key officials in each sampled DPMU was conducted with the use of standardised questionnaire-openness, confrontation, trust, authenticity, proactiveness, autonomy, collaboration and experimentation (OCTAPACE), developed by Pareek. Results: Values of OCTAPACE were diversely distributed with significant difference in distribution of scores between these domains (p < 0.05). Pro-action and Trust scores were relatively higher and consistent in the study units. Values of experimentation were lower and inconsistent. There was no significant difference in the distribution of scores between three sampled DPMUs for openness, confrontation, trust, authenticity, pro-action, autonomy and experimentation (p > 0.05). However, the distribution of collaboration score was significantly less in DPMU of desert district in comparison to DPMU of plain and tribal district (p < 0.05). Conclusion: The lacuna in values of organisation culture should be addressed to strengthen the existing management structures at the state and district levels.