The competing of institutional logics and practice variation on community based rehabilitation project in Thailand

Abstract

The purposes of this research included 1) to study the set of institutional logics existing in Community-Based Rehabilitation (CBR) project including the dimension of state, professional, community, religion, market, and family, 2) to study the interrelation of institutional logics in terms of consistency, conflict, and competing logics, and 3) to study the structural dimensions that influence institutional logics in CBR project. The research design used the qualitative research method. Secondary data was collected from related documents and research while the primary data was collected through in-depth interviews with 20 key informants from the seven (7) groups of CBR stakeholders: state officials, community’s member, PWD’s families, professionals, private companies, people with disabilities (PWDs) and non-profit organizations.

The results showed that the set of logics in CBR was consisted of six (6) main logics, which were state logic, professional logic, community logic, religion logic, market logic and family logic. State logic included seven (7) sub-logics that were as follows: the proactive health promotion, decentralized logic, separation of authority, control and audit, the power to determine the truth, universal policy, and dependency on state budget. The professional logic had four (4) sub-logics namely the truth must have empirical evidence, the truth must be endorsed by knowledge, professionals are knowledge-holders, diagnose the truth and pass knowledge to the ignorant, and knowledgeable people are professionals who do things properly. Community logic, meanwhile, consisted of four (4) sub-logics: abomination of disability, mutual assistance, mutual trust, and the power of outside community networking. Religion logic took root from the norms of pilgrimage. Market logic consists of two (2) sub-logics that were specifically economic self-reliance and creating the image of the company with corporate social responsibility (CSR). Lastly, family logic was made of five (5) sub-logics namely mutual assistance of family members, mutual understanding among family members, disability is a family secret, economic responsibility as a family member, and concern for family members.

Interrelation of the institutional logics manifested the consistency of institutional logics creating harmonization of ideas, values and norms that determined the direction of common practice. The conflict of institutional logics showed the attempt to replace another logic thus, establishing an inconsistent action. Finally, the competing of institutional logics displayed practice variation to build acceptance of the practice and re-define CBR’s meaning. CBR project was influenced by structural dimensions including the state, on the belief that PWDs are a burden of the state. Professionals viewed PWDs as patients. People in community viewed that PWDs should be able to receive assistance. PWDs also believed that disabilities were caused by social actions and causality. Family viewed PWDs as an economic burden and keep PWDs as a family secret. The private business used CBR project as a tool to create a good image for the company in the form of CSR. Lastly, non-profit organization saw PWDs as people with potential.

An analysis of these findings suggested that the diversity of institutional logic and the three (3) forms of interrelation did not make the CBR project as a hybrid organization in response to a resilient environment but rather, it reinforced the state’s strict control hindering and restricting collaboration logic of CBR project objectives. The influence from the structural dimensions was hidden by beliefs of disability and the diverse viewpoints of aiding PWDs from different purposes of each dimension. This resulted to the project’s direction lacking on clarity and unity and it always facing the challenge of survival. The results on a set of institutional logics and the influences of structural dimension enabled CBR’s stakeholders to better understand each other in a more diverse range of dimensions thus, being able to offer solutions for unified and sustainable operations based on true participation in improving the quality of life of the PWDs in the community.