Based on the eight factors of elements discussed earlier in section 3.3 who have an impact on deciding about choosing JV as the option to proceed with This section discuss various forms of commitment, resource contribution and linkage to the JV relationship and also examines the effect of management control and conflict resolution conflict/control. This research aims to develop a framework for assessing JV model that lead to process improvements in LMIC healthcare system, the empirical part of this research comes from a study of the healthcare system in the province of Taiz, Yemen and the 280 million US$ Hamad Medical City (HMC) that will be explored as a potential model for LMICs. HMC is an NGO based on a contribution from the State of Qatar to the Republic of Yemen aimed at both improving the healthcare system in Yemen and identifying success aspects for possible replication in other LMICs. Yin (1994) described a case study as an empirical inquiry that investigates contemporary phenomenon within their real life context, especially when the boundaries between phenomena and context are not clearly evident. As Yin (1994) further elaborated, that it gives the option of studying an organisation and its environment in its own setting and gaining insights into the intricate processes that surround it. Nevertheless, to avoid the collection of data that are not of tangible source, a special attention has been given to all stages of data collection, i.e. how the participant responded during the survey questionnaires that allows more refining to ensure real emphasis of gained knowledge and integration of various research ideas.
87 The research focus will be to display the need of health systems in LMIC’s to incorporate JV approaches as outsourcing option that will allow them to deliver comprehensive solutions to address the rising mortality and morbidity rates. In contrast to traditional outsourcing in the developed world as more strategic functions were outsourced, that implies streamline of management process to allow effective implementation of outsourcing plans. As a result, firms started building closer relationships with their vendors. Organizations stretched their boundaries to gain competitive advantage through outsourcing (Hätönen & Eriksson, 2009). However, in case of Yemen, the lack of political stability and security is an issue that may prevent the creation of a good business environment that encourages vendor client relationships. This will put a burden on the efforts of NGOs like HMC to create joint ventures by bringing local and foreign partners to manage technology driven services; e.g. diagnostic imaging and laboratory services from which HMC and other public hospitals may benefit.
This research provides a methodical, analytical and focused review of those empirical studies examining how the development of outsourcing relationship approach based on a JV model can contribute in the improvement of LMICs healthcare system. Although there are several advantages to outsourcing, there are also many barriers to outsourcing in healthcare. If the fundamental infrastructure of outsourcing; including education, determining the appropriate goal, using entrepreneur managers, etc., are not reformed, the main goal of outsourcing in the health sector (cost reduction, increasing quality, efficiency and effectiveness) is not achieved (Agharahimi et al., 2012).
88 Literature Review HMC Case Study Research Questions False Proposition First Stage Investigation WHY Result Analysis True Proposition Focused Literature Review
Aims and objectives Conclusion and Recommendation Second Stage Investigation HOW Third Stage Investigation WHAT Proposition: Outsourcing can have a positive Impact on improvement of Yemen health services Proposition: Yemen needs JV model to develop capacity for improvment health sector services Proposition: Barriers and challenges facing outsourcing Yemen health services
Figure 4.1 Research plan and proposition testing
Figure 4.1 shows the research plan and proposition used within this study. The proposition will be described later in chapter 5 to demonstrate the research plan and proposition testing process. Further, chapter 7 covers in more detail the testing and validity these proposition. The underlying thought being that the way a researcher perceives the world and to a great extent, determines his or her philosophical assumptions about that world and then constructs and phenomena within it is the focus (Myers, 1997). The research has a clear purpose for discovering things in a systematic way (Saunders et al., 2009) and for developing useful knowledge to support organization problem solving in the field (Huff et al., 2006). Furthermore, it is based on logical relationships and not just on beliefs (Ghauri & Gronhaug, 2005).
The study employs a mixed method approach in conducting the empirical part of the study because it was found to be helpful when trying to develop knowledge such as cause
89 and effect thinking, reduction to specific variables, propositions and questions and use of measurement and testing (Creswell, 2003). Case studies are considered to be a very common form of qualitative evidence because qualitative data can be very powerful and should not be overlooked when assessing impact. Consequently, the use of an explanatory case study type would be used if you were seeking to answer a question that sought to explain the presumed causal links in real-life interventions that are too complex for the survey or experimental strategies. Furthermore, the explanations would link program implementation with program effects, this type of case study is used to explore those situations in which the intervention being evaluated has no clear, single set of outcomes (Yin, 2003).
In a comparison to the inductive approach, the deductive content analysis is guided by a more organized and structured process. The deductive approach is based on previously formulated, theoretically derived categories and the initial coding starts with a theory or relevant research findings. By using existing theory or prior research, researchers begin by identifying key concepts or variables as initially coding categories of analysis while bringing them in connection with the text (Hsieh & Shannon, 2005). The present research uses the five sequential stages proposed by Robson (2002) to conduct scientific research, that is namely the deductive research proposition;
Expressing the proposition in operational terms
Testing these operational proposition
Analysing the results
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