Cross-Cultural Management in Healthcare: A Case Study of Malamulo Hospital, a Seventh-Day Adventist Mission Hospital in Malawi, Africa

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This paper examines the complexity of cross-cultural management in a Seventhday Adventist mission hospital in Malawi and the effect of national and organizational culture on employee accountability, with the goal of expanding cross-cultural management capacity among the leaders of Malamulo Hospital and Adventist Health International. The literature provides cultural dimensions to understand the national culture of Malawi as compared to the United States. However, literature on cross-cultural leadership fails to address the nuances of healthcare management in a mission context.

In this study I identify how people in the Malawian culture hold each other accountable and how the organizational culture of the hospital can be influenced to promote appropriate accountability and performance. In order to achieve this I used a case study method using focus groups, semi-structured interviews, document review, and observation at Malamulo Hospital in Malawi.

The data fell into five themes that demonstrated an organizational culture where accountability was inconsistent and the core value of the Malawian culture is interpersonal relationships, which should inform the management policies and processes. I used two of Bolman and Deal’s frames—Human Resource and Symbolic—and Trebesch’s ECO model as theoretical frameworks to address the findings through a twoday workshop implemented for representatives from all healthcare facilities and the health science college in Malawi. I suggest that this type of training could be extended to other mission hospitals within Adventist Health International to expand their crosscultural management capacity.

Mentor: Susan Maros, PhD

Degree Name

Doctor of Intercultural Studies (DIS)

First Advisor

Maros, Susan

Document Type





Malamulo Hospital (Blantyre, Malawi) Case studies, Adventist Health International (Loma Linda, Calif.), Hospitals Malawi Administration, Missions, Medical Cross-cultural studies, Hospitals Employees Training of.


Missions and World Christianity


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