ORAL PRESENTATION Open Access Cultural adaptation among doctors: findings from sister hospital programme in East Nusa Tenggara Province, Indonesia Atik Triratnawati From 7th Postgraduate Forum on Health Systems and Policies Phitsanulok, Thailand. 24-25 June 2013 Background East Nusa Tenggara (ENT) Province has adapted sister hospital (clinical contracting out) programme to decrease maternal and neonatal rate since 2010. The district hospitals from 11 regencies established partner- ship with larger hospitals from different places in Indo- nesia. Specialists from partner institutions (obstetrics and gynaecology, paediatrics, anaesthesia) who conducted health services transferred their knowledge, man- agement skills and culture of work. Cultural adaptation is important process of the internalisation of the new values. The aims of this study were to identify and understand the process of cultural adaptation between two different types of hospitals in order to anticipate potential conflicts. Materials and methods The study was conducted in 2010 - 2012. Observations and in-depth interviews were performed on 40 local physicians and specialists of 11 district hospitals. Results The process of adaptation among doctors from two different types of hospitals in some cases may have increased the risk of conflict between them, due to the differences in culture of work. The local culture of work was the lack of discipline, full of hierarchy systems, and was relatively slower than the partner institutions. Cul- ture shock that occurred among the local doctors was work culture, competency, self-esteem, and also differences in incentives. The clinical contracting out may influence inequality in relationship and subordinate. The local doctors felt that they were junior and unskilled. The potential conflict may occur if there is no mechan- ism of communication between them. Conclusions Cultural adaptation is a long process that must be performed continuously, otherwise potential conflict may occur. Open forum and equal communication between local doctors and partners are essential. Published: 29 January 2014 doi:10.1186/1471-2458-14-S1-O5 Cite this article as: Triratnawati: Cultural adaptation among doctors: findings from sister hospital programme in East Nusa Tenggara Province, Indonesia. BMC Public Health 2014 14(Suppl 1):O5. Submit your next manuscript to BioMed Central and take full advantage of: • Convenient online submission • Thorough peer review • No space constraints or color ﬁgure charges • Immediate publication on acceptance • Inclusion in PubMed, CAS, Scopus and Google Scholar • Research which is freely available for redistribution Submit your manuscript at www.biomedcentral.com/submit Correspondence: [email protected] Faculty of Cultural Science, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia Triratnawati BMC Public Health 2014, 14(Suppl 1):O5 http://www.biomedcentral.com/1471-2458/14/S1/O5 © 2014 Triratnawati; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Cultural adaptation among doctors: findings from sister hospital programme in East Nusa Tenggara Province, Indonesia

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Page 1: Cultural adaptation among doctors: findings from sister hospital programme in East Nusa Tenggara Province, Indonesia

ORAL PRESENTATION Open Access

Cultural adaptation among doctors: findingsfrom sister hospital programme in East NusaTenggara Province, IndonesiaAtik Triratnawati

From 7th Postgraduate Forum on Health Systems and PoliciesPhitsanulok, Thailand. 24-25 June 2013

BackgroundEast Nusa Tenggara (ENT) Province has adapted sisterhospital (clinical contracting out) programme todecrease maternal and neonatal rate since 2010. Thedistrict hospitals from 11 regencies established partner-ship with larger hospitals from different places in Indo-nesia. Specialists from partner institutions (obstetricsand gynaecology, paediatrics, anaesthesia) who con-ducted health services transferred their knowledge, man-agement skills and culture of work. Cultural adaptationis important process of the internalisation of the newvalues. The aims of this study were to identify andunderstand the process of cultural adaptation betweentwo different types of hospitals in order to anticipatepotential conflicts.

Materials and methodsThe study was conducted in 2010 - 2012. Observationsand in-depth interviews were performed on 40 localphysicians and specialists of 11 district hospitals.

ResultsThe process of adaptation among doctors from two dif-ferent types of hospitals in some cases may haveincreased the risk of conflict between them, due to thedifferences in culture of work. The local culture of workwas the lack of discipline, full of hierarchy systems, andwas relatively slower than the partner institutions. Cul-ture shock that occurred among the local doctors waswork culture, competency, self-esteem, and also differ-ences in incentives. The clinical contracting out mayinfluence inequality in relationship and subordinate. The

local doctors felt that they were junior and unskilled.The potential conflict may occur if there is no mechan-ism of communication between them.

ConclusionsCultural adaptation is a long process that must be per-formed continuously, otherwise potential conflict mayoccur. Open forum and equal communication betweenlocal doctors and partners are essential.

Published: 29 January 2014

doi:10.1186/1471-2458-14-S1-O5Cite this article as: Triratnawati: Cultural adaptation among doctors:findings from sister hospital programme in East Nusa TenggaraProvince, Indonesia. BMC Public Health 2014 14(Suppl 1):O5.

Submit your next manuscript to BioMed Centraland take full advantage of:

• Convenient online submission

• Thorough peer review

• No space constraints or color figure charges

• Immediate publication on acceptance

• Inclusion in PubMed, CAS, Scopus and Google Scholar

• Research which is freely available for redistribution

Submit your manuscript at www.biomedcentral.com/submit

Correspondence: [email protected] of Cultural Science, Universitas Gadjah Mada, Yogyakarta 55281,Indonesia

Triratnawati BMC Public Health 2014, 14(Suppl 1):O5http://www.biomedcentral.com/1471-2458/14/S1/O5

© 2014 Triratnawati; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

mailto:[email protected]

http://creativecommons.org/licenses/by/2.0

http://creativecommons.org/publicdomain/zero/1.0/