Organizational features associated with compassion in two primary healthcare centres in Kenya and Uganda

Abstract

To alleviate and prevent suffering, healthcare systems require collective action through organizational design and management. Therefore, healthcare organizations are appropriate contexts for studying the epidemiology of compassion – an emerging science that seeks to understand individual and systemic factors that foster compassion. Most research on compassion in healthcare settings has been conducted in high-income countries, focused on individual attributes that facilitate the giving of compassion. Less attention has focused on compassion in low- and middle-income country settings, or on organization- and system-level conditions that often determine whether compassion flourishes or falters. Epidemiology is a quantitative science, yet qualitative research can identify characteristics that warrant further testing and quantitative assessment. We conducted qualitative case studies of two primary healthcare organizations in Uganda and Kenya to examine how compassion is cultivated and sustained at the organizational level. Using the five components of the social architecture framework (network structures, organizational culture, roles, routines, and leaders) we discuss characteristics of these organizations that may enable compassionate responses to suffering among staff. Qualitative research in healthcare settings, framed by principles of organizational science, offers a pathway to sustaining healthcare workers and improving patient care. Increased attention to organizational and system-level compassion is needed, particularly in low- and middle-income countries where suffering is profound and complex.