The moderating role of support for innovation in sub-Saharan African healthcare teams: a multilevel perspective

In Mali, where the healthcare system is severely underfunded, service delivery is often in such a state of crisis that adaptivity is essential for the continued performance and resilience of staff. The aim of this study is to enhance understanding of the correlates of team-level support for innovation. Specifically, this study investigates the central role played by team-level support for innovation in the relationship between individual-level trust and adaptivity. It also investigates whether innovation support affects the relationship linking team-level participative safety and team-level adaptivity. A single-source, mono-method, multilevel, and cross-sectional study was undertaken in Mali using validated questionnaires with healthcare providers in community healthcare centers. As expected, results indicate that team-level support for innovation positively moderates the relationship between individual-level trust and adaptivity. However, contrary to expectations, results also show that team-level support for innovation negatively moderates the positive relationship between participative safety and team-level adaptivity. This study contributes to extant literature by showing that team-level support for innovation affects adaptivity differently depending on whether it is at the individual- or team-level. While strong team-level support for innovation fosters a positive relationship between trust and individual-level adaptivity, efforts directed at supporting innovation at the team level may have a less positive impact on team adaptivity in a resource-scarce environment. Our results also suggest that managers and leaders in Malian community health centers should instill a climate of participative safety in their teams as well as foster trust behaviors in individuals if individual-level adaptivity is to be encouraged.