La crisis finisecular y la mujer en la regeneración nacional

There is no standard approach to analysis of mixed data. Using the transcripts or notes of qualitative interviews or observations by thoroughly reading and re-reading them, is one approach to analysing this type of data (Saunders et al., 2012).

Taylor and Bogdan (1984) explained that all researchers develop their own ways of analysing qualitative data. Flick (2007) stated, "we can distinguish two basic strategies in handling texts: on the one hand the coding of the material with the aim of categorising and/or theory development; and on the other hand the more or less strictly sequential analysis of the text aiming at reconstructing the structure of the text of the case". Merriam (1998) described the process of data analysis as being a complex action of moving back and forth between data and concepts, between description and interpretation, using both inductive and deductive reasoning. The qualitative data might be integrated at several stages in the research process: at the data collection, the data analysis, the interpretation phase or a combination of phases (Creswell, 2003). Patton (1987) indicated that three things occur during analysis: organized data, reduced data through summarization and categorization and identified and linked data patterns and themes.

Drawing on existing literature, scale items were adapted and adopted to capture the manager’s perceptions and behaviours to operationalize the variables. Respondents were asked to rate their perceptions on five-point Likert scale (1 “strongly disagree” and 5“strongly agree”) for most of the independent variables (IVs). However, the amount and nature of data sought for this research resulted in a lengthy and complex research instrument which required interviewer assistance to secure the necessary response rate, quality of data and organization of a large segment of participants. Bernard (2000)

125 suggested several approaches to data analysis: including hermeneutics or interpretive analysis, narrative and performance analysis, discourse analysis, grounded theory analysis, content analysis and cross-cultural analysis. Pope et al. (2000) also provided strategies for analysing data using the framework approach which includes: becoming familiar with the raw data by immersing oneself in it; developing a thematic framework in which one has identified all the key issues, concepts and themes; indexing all of the data in textual form by coding transcripts or short text descriptors; charting the data using summaries of experiences; mapping and interpretation of data using charts to define concepts; mapping the range and nature of the phenomena; creating typologies; finding association between themes to find explanations; and developing findings.

The relevance of nonresponse errors to the study was the possible differences in perceptions of those who responded to the survey and those who did not respond. For this reason, there were a number of techniques employed to increase response rates (Dillman, 2007). According to Dillman, responses can be improved on web-based surveys with respondent-friendly design and up to five contacts with the questionnaire recipient (pre- notice letter, questionnaire, thank-you postcard, replacement questionnaire to any non- respondent, final contact). Other factors that impact response rates are deadlines, reinforcement toward the participants of the importance of their input into the goals of the survey (Porter & Whitcomb, 2003). These include telephone call reminders and incentives (Dillman, 2007).

Without any doubt, these findings are not without their limitations because one of the potential problems with a survey methodology is the existence of non-response bias (Zikmund et al., 2010). There are several steps to overcome non-method bias in responses: first, applicable to a five-point semantic differential scale is the mixing of both

126 positively and negatively worded items psychologically, proximally separate the variables and overcome common method bias in responses (Podsakoff et al., 2003); second, to satisfy the statistical concern of common method bias variance during collecting data, reverse questionnaire items were recoded to make the constructs symmetrical (Podsakoff & Organ, 1986); third, exploratory factor analysis was conducted for collected data sets and there was no single factor that accounted for most of the variance in the predictor and criterion variables; and finally, conducted a principle component analysis that revealed that all the indicators of the measures loaded to the respective constructs without showing any cross loading or without suggesting/emerging any new construct. After all of that, common method bias variance was not noticed to be a problem in this research study.

5.10 Summary of the Chapter

This chapter is of the upmost importance as it gives deep insight about research methodology, research variables; and furthermore, the related methodological approach is presented in this section. To achieve the aim and objectives of this study, the research philosophies, approaches strategies and data collection methods were selected and justified. The chapter discussed the fact that deductive and inductive methods were selected and the decision behind this choice has been justified. A case study was adopted as a research strategy for the collection of data. The validity, reliability and the ability to generalise was provided.

The decision to use a mixed methodology approach and the use of semi-structured interview technique and questionnaires as the main sources of evidence has been fully rationalised by reference with mention being made to the intention to triangulate the data

127 secured by document review. Also, piloting the interview protocol and its importance was also specified. Finally, the chapter highlighted how the data was collected and analysed. The next chapter will cover the discussion of the findings that emerged from the collected data from the three stages of structured and semi-structured questionnaire; the basic instruments for mixed data collection approach as shown in fig. 6.1. The questionnaire was additionally determined to allow the respondents to tell stories regarding constructs linked to the commitment building process, to seek examples and often unearth issues that were explored counter-intuitively (Com et al., 2006). Furthermore, the findings will be presented in chapter 6 to support views on expanding the use of joint ventures as an approach in improvement the LMIC healthcare system. Moreover, the results will serve as a base in evaluating JV performance success. The JV performance success will be tested as part of inter-partner relationships and in particular it is impact on the JV performance.

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CHAPTER SIX

RESULT REVIEW AND ANALYSIS

6.1 Introduction

The last chapter covered the research philosophy and other related methodological approaches. To recognize which research design fit, research philosophy is demonstrated in section 5.4. The survey approach and methodology summarized is in section 5.5. Meanwhile, section 5.6 provided an overview of the research strategy and its structure to satisfy the research aim and objectives. While the method of data analysis was presented in section 5.7 to address the main goal of the research questions was to identify the process leading to them to provide a window of exploration for future research in the field. Section 5.8 presented the pilot study exercise. Finally, section 5.9 explained a range of data collection methods and examines a number of different variables achieved the validity and reliability of the selected mixed method research approach.

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Figure 6.1 Structured and semi-structure survey process flow

Survey analysis

To provide a clear understanding about the healthcare setting and challenges

Survey to investigate the Barriers/ Challenges for outsourcing (How)

85 respondent of 27 Taiz- Republic of Yemen public and private hospitals management Survey to investigate the reasons for outsourcing in Yemen (Why)

One-to-one interviewof 6 policy makers, 11 healthcare providers and 4 consultants to allow the design of research questioners

 Understanding of issues relating to outsourcing

 How outsourcing help the organization achieve its

strategic goals

 How join venture can ensure provide qualified resourced

 What kind of development plans that can offer incentives

and rewards to in-house staff for achieving great quality measures.

 Importance of healthcare reform

 Healthcare financing options

 How JV can help in LMIC healthcare improvement

Selection of 50 members that compromise healthcare providers, policy makers, vendors and consultants participated in group discussions

 Investigate issues related to benefits, drivers, challenges,

barriers

 Ppotential areas of value-creating for outsourcing

 benefits that outsourcing for hospital services

 Reasons for Outsourcing hospital services

 Potential Areas to be considered for Outsourcing

 Barriers/Challenges for Outsourcing

To investigate the relationships of the factors that affect the implementation of joint ventures in LMIC healthcare system (What)

188 responded from both Low and

Mid-income countries healthcare

providers, vendors and consultants

Explore 8 main factors which hypothesized the effect of satisfaction with the overall performance of joint ventures in LMIC healthcare system

 Key drivers behind joint venture success Satisfaction

with joint venture performance Partners level of influence on joint venture

 Commitment to the business venture Joint Venture

Performance

 Problems encountered during the stages of the joint

venture

 Frequency and intensity of inter-parent conflicts

Hypothesis Testing First stage (Part I) Third stage Second stage First stage (Part II)

130 This chapter covers three stages of the structured and semi-structured questionnaire basic instruments for mixed data collection shown in fig. 6.1. The questionnaire was

additionally determined to allow the respondents to tell stories regarding constructs linked to the commitment building process, to seek examples and often unearth issues that were explored counter-intuitively (Com et al., 2006). This technique was also followed for clarification of terms/variables, elaboration on topic and collection of respondent’s own words of usage which was not supported or covered by quantitative questionnaires (Luna-Reyes & Andersen, 2003). The variables, for example: cultural similarity, commitment, control, contribution and trust were taped in the questionnaire to capture a broad view of these variables with respect to the performance of the JV in the LMIC.

The first stage survey was intended to investigate the LMIC for possible reasons for outsourcing (Why).The initial phase involved one-to-one semi-structured interview with a selection of 6 policy makers, 11 healthcare providers and 4 consultants as shown in table 5.1 over a span of two months and with the literature review that allowed the design of research questionnaires for the next stages. These semi-structured interviews increased the understanding of issues relating to outsourcing, such as: How does it help the organization achieve its strategic goals? How can joint ventures ensure the provision of qualified resources? And what kind of development plans can offer incentives and rewards to in-house staff for achieving great quality measures? Also it helps to provide a clear framework about the healthcare setting and challenges initially the questions were more around the barriers that hospitals have in developing countries in achieving these objectives.

In the second phase the conversational interview was helpful to design further group discussion needed to construct intended research study on how joint ventures as a means

131 of outsourcing can contribute in the improvement of the LMIC healthcare system. Based on a selection of 50 members, the second phase comprised healthcare providers, policy makers, vendors and consultants in group discussions. During this general semi-

structured interview and group discussions with a relatively small sample size that did not permit elaborated statistical analysis. Supporting to that, in his study of 57 participants, Wilson (2006) argues that many studies as a small sample, but , in JV research this is a reasonable number of participants.

The discussions were focused on foreign partner contributions in LMIC healthcare reform and how essential the health systems in LMICs need to be reformed in order to deliver comprehensive approaches that will halt and reverse the rising mortality and morbidity rates. However, this approach studied how it will be applied in a particular to developing countries.

In addition, the question was raised regarding the possibility of the JV adapting to the medical system model that provides comprehensive services to the community which includes primary, secondary and tertiary care services. This includes the combination of upgrading the level of care in the current centres and establishing new state-of-the-art primary healthcare centre (PHC) with affiliations with leading technology partners. It was further pointed out that the operation should be financed through a mix out-of-the pocket payments by patients, insurance system payments and payments by charity organizations through capitation arrangements.

The second stage survey was to investigate the barriers/ challenges for outsourcing in Yemen (How). The questions were more around the barriers in hospitals in developing countries. Some emphasis has been given to explore the main benefits that outsourcing could bring to the LMIC health Sector. In addition to understanding the reasons driving

132 the decision to outsource activities in an organization, the potential areas to be considered for outsourcing were evaluated in detail.

Finally, the third stage was a survey to investigate the LMIC healthcare system overall JV performance basis and requirements (What). At first, various drivers were compared which vary between least, average and most important JV success for the improvement of the LMIC healthcare system. This is critical assessment of the level of satisfaction with the JV agreement and other governance procedures within the JV partnership with regards to protection of intellectual property, dispute resolution and verification of work task performance among JV partners. To assess the JV strategy formulation, foreign or local parent firms’ level of influence and commitment were reviewed.

In the assessment of the JV journey, all critical issues that drive the success of the JV compared with the initial expectations at the time the business venture was viewed. The problems and challenges encountered during the negotiation and operational stages of the JV differ in relationship with thepartner’s contribution and establishment of clear

agreement of the JV objectives. At the end, the questionnaire to measure both the frequency and intensity of inter-parent conflicts was evaluated by measuring both the frequency and intensity of the inter-parent conflicts by addressing how often and to what extent had conflicts arisen between the parent firms and their foreign partner over the issues related to operations commitment, control, contribution and overall performance. The main goal of the research questions was not to capture the value itself of the JV in healthcare in the LMIC but rather the process leading to them to provide a window of exploration for future research in the field. An important aspect of this research is that it employs a range of data collection methods and examines a number of different variables as determining factors affecting the implementation of the JV concept for the

133 improvement of healthcare in the LMIC. However, the elaboration made in chapter II and III of literature review uses both an explanatory and a descriptive approach to explain why a JV model can be used for studying outsourcing option for the improvement of the healthcare system. Nonetheless, case studies involving face-to-ace semi-structured interviews and group discussions explained in 6.2 section assisted in answering the why questions of the exploratory approach followed by a literature review for this study. Section 6.3 further expands with details on the second stage of the survey questions to answer; the how questions to be able to close the cycle and establish clear understanding of the problem to develop a framework map for prompt research outcomes. The third stage survey questions involves the instrument development process and as

demonstrated in section 6.4, the structured questionnaire was designed using subjective rating scales that incorporated the previous operational indicators of each variable. Drawing on the existing literature, scale items were adapted and adopted to capture a manager’s perceptions and behaviours to operationalize the variables. Respondents were asked to rate their perceptions on five-point Likert scales (1 “strongly disagree” and 5“strongly agree”) for most of the independent variables of the JVs. Qualitative research design can be complicated depending upon the level of experience a researcher may have with a particular type of methodology. Pope et al., (2000) provided strategies for

analysing qualitative data which typically involves immersing oneself in the data to become familiar with it, then looking for patterns and themes, searching for various relationships between data that help the researcher to understand the material, then visually displaying the information and writing. As such, this the research was moved more toward mixed method approach.

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