National response to the HIV pandemic, in particular for OVC

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Theoretical framework

The theoretical framework of institutional theory was selected related to and as a way to make the findings in this study explicit. Institutional theory will be presented with particular focus on the concept of organizational field and institutional isomorphism.

 Institutional theory

Institutional theory includes a framework of explanations over how organizations are in a close interchanged relation to their surroundings, consisting of other organizations. In addition, the theoretical perspective contains an understanding of the organizations to follow rules (formal and informal) rather than choosing economically rational way of action. This includes actions of following rules/conventions and norms, that with time is regarded as taken-for-granted. Resources and customers are not the only focus of competition between organizations, but also institutional legitimacy and political power as well as economic and social fitness. Furthermore, the theory emphasis the process in which organizations change to evolve into stable units (Eriksson- Zetterquist, 2009).
The premise of the theory is that institutions emerge when people construct their social reality, which is in line with a social constructivist perspective. The view of the ability of humans to consciously develop and influence institutions are varying across different subjects. Sociologists generally assume that people are not free to choose which institutions, procedures and legal standards to follow (Eriksson- Zetterquist, 2009). There is further a disagreement among disciplines about the definition of institution, from emphasizing on micro or macro, cognitive or normative aspects (DiMaggio & Powell, 1991). The definition of institution that will be utilized in this study is the one of Jepperson (1991, p. 145 referred in Eriksson-Zetterquist, 2009, p.15):
Institution represents a social order or pattern that has attained a certain state or property; institutionalization denotes the process of such attainment. By order or pattern, I refer, as is conventional, to standardized interaction sequences. An institution is then a social pattern that reveals a particular reproduction process. When departures from the pattern are counteracted in a regulated fashion, by repetitively activated, social constructed, controls – that is, by some set of rewards and sanctions – we refer to a pattern as institutionalized. Put another way: institutions are those social patterns that, when chronically reproduced, owe their survival to relatively self-activating social processes.
According to the above definition, formal organizations are thus understood to be systems of coordinated and controlled activities which has emerged in highly institutionalized contexts. Meyer and Rowan (1977) argue that many formal organizational structures arise as reflection of rationalized institutional rules. These rules function as myths which the organization gain legitimacy, resources, stability and enhanced survival prospects. Professions, policies and programs are established alongside the services and products that are understood to produce rationality. This results in a force that drive many new organizations to incorporate practices and procedures already defined as rationalized concepts of organizational work and are institutionalized in society. And so, many organizations adopt them ceremonially. The formal organizational structures contribute to legitimacy and enhanced survival prospects through reflection of myths in the organization’s institutional environment. The myths are stressed not necessarily to be effective, but are used in order to make the organization be seen as rational, modern and adequate. As the organizations trying to implement the same myth, organizations evolve a similar shape (isomorphic). Those organizations that chose to refrain from myths, seems deviant and nonchalant, or non-legitimate. Isomorphic results then in survival through adaption and is legitimized of its members and the surroundings. Institutionalized rules are seen as embedded in society through reciprocated interpretations. The rules can be taken for granted, supported by the public opinion or enter the legal system (Meyer & Rowan, 1977).
Organizations that reflect institutional rules tend to stretch their formal structures to maintain ceremonial conformity in a context of uncertainties, by becoming loosely coupled. The organizations then build the gap between their formal structures and actual work activities (Meyer & Rowan, 1977).


 The organizational field

Organizational field may include « industries » in the same trade, or « industries” that are chained to each other (e.g. supplier – producer – retailor), and can be distinguished from a national o international perspective (DiMaggio & Powell, 1983). In this study the “industry” is the NGOs that are working with orphans and other vulnerable children. The concept provides an explanation on how organizations with their surroundings give rise to different processes and meaning activities. In other words, an explanation of organizations interaction with each other, through cultural and normative processes. Thus, the organization is affected through fields and forces in the field. The organizational field include those organizations that constitute a recognized area of institutional life; resource and product consumers, key suppliers, regulatory agencies, and other organizations that produce similar products or services (DiMaggio & Powell, 1983). Organizational field in this study consists of international organizations, the government and public of Botswana as well as other organizations in the country working with this target group. When organizations interact on the field, they will turn more similar in shape – isomorphism (DiMaggio & Powell, 1983).

Institutional isomorphism

DiMaggio and Powell (1983) described a move of the engine of rationalization and bureaucratization from the competitive marketplace to the state and the professions. Bureaucracy remains the common organizational form, but the organizations are argued by DiMaggio and Powell (1983) of becoming more homogeneous. The structural change in organization seems less driven by the need for efficiency or competition. Bureaucratization and other homogenizations emerge out of the “structuration” (Giddens, 1979) of organizational fields. Which rather is effected by the state and the professions. A paradox arises when a set of organizations emerge as a field; “rational actors make their organizations increasingly similar as they try to change them” (DiMaggio & Powell, 1983, p. 147). This outcome occurs from three isomorphic processes – coercive, mimetic and normative. It is important to notice that this typology is not always empirically distinct (DiMaggio & Powell, 1983). Isomorphism is defined as; “a constraining process that forces one unit in a population to resemble other units that face the same set of environmental conditions” (Hawley, 1968 referred in DiMaggio & Powell, 1983, p. 149).
Coercive isomorphism, emerge from political influences and the issue of legitimacy. Coercive isomorphism results from formal and informal pressure on the organization from other external organizations upon them are dependent, as well as cultural expectations in the further surrounding of society. The more dominant organizations require adjustment of the field’s less dominant or dependent organizations in adopting the structures that are considered legitimate. This pressure can be viewed as a force, a persuasion or as an invitation to join in collusion. Coercive isomorphism can in this regard also be linked to a development of organizational hierarchies, in relation to organization that aim of gaining support from more hierarchically organized donor organizations (DiMaggio & Powell, 1983).
Organizational change can also be a direct response to government mandate. An example is when organizations must adopt new pollution control technologies to conform to environmental regulations. The organization’s behavior and structure is also affected by the existence of a common legal environment. By for example – the vicissitudes of the budget cycle and financial reports that ensure eligibility of federal funds (DiMaggio & Powell, 1983). As rationalized stated and other large rational organizations expand their dominance over more arenas of life, the organizational structures have been argued to increasingly reflect rules that are legitimated and institutionalized by and within the state. Organizations are for that reason increasingly organized around rituals of conformity to wider institutions (Meyer & Rowan, 1977).
Mimetic isomorphism, is a response to uncertainty by imitation and modelling of successful concept from other organizations in their field. The organization can escape expenses and the need to develop « new » solutions to a problem by the imitation of other organizations. The imitation can be adopted unintentional or explicit. Examples are if the environment creates symbolic uncertainty or if technologies are poorly understood, then mimetic can serve as a way to overcome the struggle and gain legitimacy. The imitation can further take a ritual aspect to enhance the organizations legitimacy, for example a company can adopt regulations to demonstrate that they are trying to improve working conditions (DiMaggio & Powell, 1983).
Meyer (1981, referred in DiMaggio & Powell, 1983, p. 152) argue that one can predict newly emerging organization without knowledge about the nation itself, because “peripheral nations are far more isomorphic –in administrative form and economic pattern- than any theory of the world system of economic division of labor would lead one to expect.”
Normative isomorphism, is associated with professionalization and primarily steams from members of a professional group’s collective struggle to define the conditions and methods of their work. The influence of professions and educations affect what is considered to be the « right way » of doing things, which may include moral duties (DiMaggio & Powell, 1983).
Professionalism is about a particular profession’s common endeavor to identify the methods and conditions that will apply, and to create a common understanding and legitimation of the profession. There is a consistent compromise between professionals with non-professionals, and director etc. In addition, normative isomorphism is related to the force of socialization. The professionals are for example socialized to behave in the same way (DiMaggio & Powell, 1983). In this context the professionalism has two sources. Firstly, it becomes important to hire staff with a university degree since formal education has gained a greater influence in society. This include legitimation in a cognitive base produced by university specialists. Secondly, the development and growth of professional networks has contributed to spreading models for organizing across organizational boundaries. For example, universities are important in the development of organizational norms among professionals (DiMaggio & Powell, 1983).
Finally, organizations are often rewarded for being similar to other organizations in their areas, by facilitating transactions between organizations, to be recognized as legitimate and reputable, and to fit into administrative categories to be entitled to public and private funds. However, in some organizational fields, the pressure of competitive efficiency is alleviated because the number of organizations are limited and there are strong fiscal and legal obstacles to enter and exit the field (DiMaggio & Powell, 1983). This was found at the NGOs in this study due to a limited number of NGOs in the field. The understanding of isomorphism is relevant at the NGOs as the findings point to similarities among the organizations working with orphans and other vulnerable children. For example, there were similar; ways of organizing the institutions; interventions strategies that were used; professions working there and challenges faced by the professionals. Several forces from external organizations were found to affect the work of staff members at the NGOs, therefore institutional theory is used in this study to understand these forces.


1. Introduction
1.1 Aim and research questions
2. Background
2.1 An overview of the context of Botswana
2.1.1 National response to the HIV pandemic, in particular for OVC
2.2 Review of previous research
2.2.1 Orphans and vulnerable children in Botswana
2.2.2 Service provision to orphans and other vulnerable children
3. Theoretical framework
3.1 Institutional theory
3.1.1 The organizational field
3.1.2 Institutional isomorphism
4. Methodology
4.1 Choice of method
4.2 Field experiences
3.3 Analytical process
3.3.2 Focused coding
3.4 Quality criteria
3.5 Ethical considerations
5. Results
5.1 International influences
5.1.1 Regulation that lack contextual sensitivity
5.1.2 A reduction of funding
5.2 The “impact” of culture
5.3 Perceptions of changes associated to social support
5.5 Organizational features
5.6 Summary
6. Discussion
6.1 Method discussion

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