Collectivist Antecedents of Organizational Commitment Among Foreign Funded HIV/AIDS Programs IN South Africa

Background: As a health-related foreign assistance program, the U.S. President's Emergency Plan For AIDS Relief (PEPFAR) faces the challenge of ensuring the sustainability of the organizations it funds. The issue of human capacity sustainability is especially relevant to PEPFAR, as many of its partner organizations operating in African nations struggle to recruit and retain qualified staff. One method of enhancing sustainability involves increasing organizational commitment, as staff members with high organizational commitment have been found to have low organizational turnover, withdrawal, and absenteeism. Research conducted within the United States has found this variable to be influenced by personal characteristics, and work experiences. However, research in collectivist settings has begun to indicate that work relationships are especially important influences of organizational commitment. But until now, research investigating collectivist antecedents has included only intra-organization relational variables, and few studies have investigated relationships involving the external recipient community. This study hypothesized that intra-organizational relationships as well as relationships with the recipient community would be more important than personal work experiences as predictors of organizational commitment among PEPFAR staff in South Africa. Diffusion of innovation attributes provided the framework for recipient community variables, and helps us to better understand the interaction between community and work force sustainability in international programs.

Methods: Purposive sampling was used to recruit PEPFAR funded HIV/AIDS organizations in South Africa. Forty-five organizations agreed to participate in the research, and represented programs operating in all of South Africa's provinces, among all of South Africa's eleven official language groups. Participants (n=502) included staff members working in PEPFAR funded HIV/AIDS programs, providing direct service to clients. Participants completed a one-time survey, which asked questions about organizational commitment, work experiences, and relationships both within the organization and with clients. Hierarchal regression was used to determine the influence that groups of variables had on staff member's organizational commitment.

Results: Analysis indicated that personal demographics and work experiences had low levels of influence on organizational commitment. The non-significance of staff satisfaction with pay was a particularly relevant finding, as a number of studies conducted in the United States have found this to be an important predictor of organizational commitment. Staff participation in decision-making was important as an intra-organization relationship predictor, influencing a large portion of the variance in organizational commitment. Many of the diffusion attributes included as recipient community variables were not found significant predictors. Results indicated that select variables relating to the diffusion attribute compatibility, such as the community's participation in decision-making, as well as the staff's ability to speak local languages were significant predictors. Job satisfaction was an important predictor, although analysis showed that this variable may best be identified as a recipient community focused variable.

Conclusions: Results offer culturally appropriate means of establishing organizational commitment among PEPFAR funded programs in South Africa. Results also establish a need for the PEPFAR policy to establish culturally appropriate organizational and management approaches in addition to culturally appropriate HIV/AIDS program strategies. The contribution of social work to foreign assistance initiatives such as PEPFAR is discussed.