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How performance targets can ingrain a culture of ‘performing out’: An ethnography of two Indian primary healthcare facilities

Priya Das, Tom Newton-Lewis, Karima Khalil, Madhavi Rajadhyaksha and Phalasha Nagpal

Social Science & Medicine, 2022, vol. 300, issue C

Abstract: Low- and middle-income country health systems often apply decontextualised and unrealistic performance targets to facilities. This can lead to empty compliance and ‘performing out’, whereby managers and providers manipulate or inflate data to create the false impression of a functional system. While this is a well-recognised pitfall of audit-style performance accountability processes, the social processes by which these practices emerge has not been well described in the literature.

Keywords: Performance management; Complex adaptive systems; Health systems; Bourdieu; Organisational culture; Intangible software; India (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1016/j.socscimed.2021.114489

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