Dynamic Interactions between the Macro-Environment, Development Thinking and Group Behaviour

This paper explores the hypothesis that groups' behaviour is greatly influenced by the societal environment in which they operate. It does so by looking at societal norms over three eras in developing countries, and the ways in which these affected behaviour at a micro-level as evidenced by the health sector. In the Colonial (and neo-colonial) era macro-norms were hierarchical and based on power relationships; in the post-world war two era, the dominant norms combined power and control with a more cooperative rhetoric; while in the post-1980 era, macro-norms have leaned heavily towards markets and monetary incentives as a way of organising behaviour. It is shown that micro-behaviour in the health sector largely reflects these macro-norms, with the organisation and incentives of health institutions following the sort of incentive system favoured at a macro-level, although in each era, exceptions can be observed, and many organisations combine different elements of behaviour. It is noted that in the most recent era, excessive reliance on monetary incentives is tending to undermine trust and cooperation, and that this may endanger the efficiency as well as the equity of outcomes since trust and cooperation are generally important ingredients of both efficiency and equity