An Analysis of a Paper on Public Services Reforms in Saudi Arabia

A critical analysis of the paper 'Public Services Reforms in Neo- Patrimonial Systems: The Commercialization of Healthcare and Education in Saudi Arabia' by Asquer and Alzahrani reveals that there are both contributions made by the work to the field and a technical error in the paper. This paper will explain the nature and aims of the research done, analyze the literature review, evaluate the sampling technique, discuss the method of data collection, and critically reflect on the relevancy of the work to academic debate.

Asquer and Alzahrani use a grounded theory approach in the paper, seeking to build an explanatory framework beginning with empirical fieldwork, from the exploration of which an explanation of the situation as it is will emerge (Denscombe, 2010, p. 107). Thus, an explanation is sought by exploring potential causal conditions of the policy change as shown in "Table 2. Components of the explanatory argument" of the paper. Descriptions of the situation are used to set the context and help in the generation of hypothesized causal conditions. This is the nature of the work in question, and a case study is highly applicable with this approach as, "The value of a case study approach is that it has the potential to deal with the subtleties and intricacies of complex social situations" (Denscombe, 2010, p. 60).

The aims of the paper are best stated once in the abstract and once in the conclusion. A specific aim is stated on page 2, "This study aims to explain the commercialization of the healthcare and education services that took place in Saudi Arabia since the 2000s." A more general aim is stated on page 28, "In addition, this study also indicates some ways to carry forward a research program that aims to enrich theoretical accounts of public sector reforms outside the context of representative democracies." (Asquer and Alzahrani, 2020) The study of this case as a decentralizing process can be seen as complementary and opposite to the study of Bolivia's recentralization of nutrition planning (Hoey, 2017).

On page 5 of the paper it is stated that literature will be reviewed on two things: "public services reforms and on the definition of neo-patrimonial systems." In the paper's reference section there are a total of 117 sources. In the literature review section for public services reforms there are 45 citations used, which is 38 percent of the total references. In the literature review section for neo- patrimonial systems there are 19 citations used, which is 16 percent of the total references, bringing the total citations in the literature review section to 64. Thus, more than half of the citations, approximately 55 percent, of all references are in the literature review, and there are over twice as many citations for public services reforms as there are for neo-patrimonial systems. There are 1,612 total words in the literature review section, with 928 for public services reforms and 684 for neo-patrimonial systems. This means that in the public services reforms section there is one reference per 20 words, in the neo-patrimonial section there is one reference per 36 words, and in the literature review section as a whole there is one reference for every 25 words. The literature review is a variable in research that changes depending on the approach taken (Saunders et al., 2009, p. 61). There is also the history of the subject to consider. It seems that for this paper this is a high amount of reference material, and that there is a good focus on the aims stated in the paper by drawing from diverse sources. The sources used are in the vast majority from the past three decades.

In some versions of a grounded approach to research the literature review section can be limited (Denscombe, 2010, p. 111). Asquer and Alzahrani however included an extensive supply. When it is included, "The literature review should demonstrate how research being reported relates to previous research and, if possible, how it gives rise to particular issues, problems and ideas that the current research addresses." (Denscombe, 2010, p. 314) The paper includes applicable research as it relates to public services reforms, education and healthcare as focused on in the paper, neo-patrimonial systems, and Saudi Arabia. In seeking to discover unknown factors in public policy reform the case can be made that such extensive referencing can limit the creative generativity of new hypotheses. It is best to keep an open mind (Denscombe, 2010, p. 108). From the fact that the writers do generate some new hypotheses and indicate directions for further research we can surmise that the extensive referencing has not limited the generation of new possible solutions being brought forward. This then shows that the purposes of the literature review have been achieved in this paper.

One of the authors of the paper conducted interviews with twelve people, all considered key informants and experts who played a pivotal role in the public policy reform in Saudi Arabia in the education and healthcare industries, focused on one institution from each sector. This small size is proper in the case of exploratory samples focused on qualitative research and seeking to discover new insights or to generate new explanations (Denscombe, 2010, p. 24). Sampling is done because of the limitations of the resources of the researchers in that there are practical difficulties of time, money, and access (Saunders et al., 2009, p. 212). The researchers use non- probability sampling with a sample interview size of 12. They state that this number was reached by stopping the growth of the sample size when data saturation was reached, which is a generally recommended practice, and it is thought that 12 is an adequate number for in-depth interviews of a homogenous group (Saunders et al., 2009, p. 235). The authors clearly chose a purposive sampling because of the relevance and knowledge of the selected interviewees, which coincides with seeking the best information for an exploratory sample (Denscombe, 2010, p. 35). It is also implied by the authors that the interviews may have been conducted with the idea of theoretical sampling. This type of sampling is consistent with their grounded theoretical approach (Denscombe, 2010, p. 36).

There are two adjustments that could be made to the sampling used in this paper that have the potential of improving the research. One is a small adjustment to those already utilized, in that snowballing could be helpful, i.e. asking for recommendations for other interviewees from present participants. Snowball sampling works well in exploratory work, it works in conjunction with purposive and theoretical sampling as the authors have already utilized, and it also merges well with the grounded theory being used by the authors (Denscombe, 2010, p. 37). The added advantage that it gives lies in the unknown potentiality of an unexpected recommendation that may emerge leading away from data saturation.

The second option for an adjustment to sampling has more possibilities and more opportunity. The 12 interviewees in this research sample were all part of the upper echelon of organizations that are involved in setting and implementing policy and policy change. And that is a reasonable data set for a paper focused on the causes behind policy changes. But, it misses the views and beliefs around the issue of people lower in the social-economic strata of the society. Now, it is posited that this will matter less in a neo-patrimonial system such as that in Saudi Arabia. Yet, it is worthy of note whether or not the same needs for change were seen by the lower strata. This could be conducted with probability based sampling to coincide and support the in-depth interviews as conducted, or it could be that in-depth interviews would be conducted with users of the systems that ideally had used the organizational services before the implementation of the reforms. This is also an excellent option for continuing research into whether or not some of the generated hypothetical causal conditions of the authors, such as the anticipation of future changes in the oil industry and the struggle for the retention of skilled professionals, were also prevalent among those without influence on the policies themselves. If so, which group the ideas were first generated in, how they moved from one group to another, or whether the concerns arose simultaneously because of the shared perceived context of the country within the world, are of interest.

Many people would probably make a recommendation that the authors incorporate a larger sample size or probabilistic sampling into the research. While both could be of use, especially doing interviews at more institutions including those that failed and those that succeeded, the scope of the project must be taken into consideration. Also, the purpose and underlying philosophy with which the questions and aims were pursued. In-depth interviews are useful when working to generate new explanations through exploration. This grounded theory lends itself less to quantitative methods and more toward qualitative methods in such a case. The sampling techniques must be in accord with this underlying philosophy for the extraction of useful information. Therefore, I favor the two adjustments that I have proposed above.

There are advantages and disadvantages to the collection method the authors used in this project. They point out one of the most obvious in the conclusion of the paper, there isn't quantitative measuring and so statistical analysis cannot be used. They, however, are also not explicit on the type of interviewing that they conducted, as to how structured the questioning was. From the wide ranging information we may suspect that it was in-depth interviewing, which is supported by one of the authors of the paper being a member of one of the studied organizations and therefore possessing intimate knowledge of the culture and context. This high level of knowledge helps to increase the quality of the data collected during interviewing (Saunders et al., 2009, p. 328). Using a case study allows the authors to focus on drawing out the complexities of a single example, allows for the concentration of effort and resources, is good for theory-building, and allows for triangulation of information, for which the authors also used some additional sources to corroborate (Denscombe, 2009, p. 62). But, a case study can also be difficult to draw generalizations from, and when done these generalizations can be questioned for their credibility and the data can be seen as soft (Denscombe, 2009, pp. 61-63). This is noted by the authors in the conclusion of their paper.

They also point out that to posit the hypothetical causal connections that they generate they utilize their own interpretative work. This idea that the self-identity of the researchers is a factor in and has an influence on the analysis of the data is true with qualitative research such as that done for this project, and perfectly coincides with the inductive approach of moving from a specific case study and moving toward hypothetical generalizations (Denscombe, 2009, p. 273). This methodology of data collection does lend itself well to mixed methods of sampling, which may be of use to the authors in future related research (Teddlie and Yu, 2007).

Two of the most important advantages of the collection and measurement of the primary data in this study by the authors are ethnography and phenomenology. By conducting the interviews in Arabic the authors gain an advantage in detailed data collection by not having loss in miscommunication. Their ethnographic approach also allows them direct access, contact with relevant actors, and a holistic view. The authors seem to have overcome the associated potential disadvantages of the approach by being able to gain access, not falling into story-telling, not having obvious blind spots, or getting stuck in stand-alone descriptions. (Denscombe, 2009, p. 91)

Without the phenomenological approach that was taken in this project the new causal hypotheses that were generated would not be possible because they necessarily incorporate perceptions, meanings, attitudes, beliefs, feelings, and emotions to be able to conjecture about motivations leading to policy reorientation (Denscombe, 2009, p. 94). Such an approach is suited to a small scale study, but also reinforces the tendency for some of the potential criticisms of the paper that we've already seen, e. g. soft data and generalizations with questionable credibility (Denscombe, 2009, pp. 102-103). The authors note that obtaining documentation is difficult because of the very cultural phenomenon that they are seeking to study, in that neo-patrimonial systems can work through the preferences of individuals that don't get recorded in official formats. Nevertheless, their use of secondary sources in an effort to triangulate their findings from the transcribed interviews helps address this concern to some extent.

On page 25 of the paper it reads, "In addition, evidence from the Saudi Arabia case suggests that the commercialization policy was transferred domestically from one sector (healthcare) to another (education) for reasons that include the combined effects of mechanisms of actor certification and availability heuristics (hypothesized causal condition No. 7 in Table 2). " In this case healthcare and education are improperly reversed, as demonstrated both in Table 2 and elsewhere in the paper. In a paper dealing with causal chain hypotheses this is significant. Other errors in the paper are at the level of copyediting and do not rise to the level of needing notice in this analysis.

Asquer and Alzahrani have ventured into the unknown well informed on their subject matter, seeking new information and new formulations to posit new causal chains in the field of policy reform, and come away from the endeavor successful, in that they have been able to put forth the hypothesis that awareness of opportunities and threats in the current retention of skilled professionals and the anticipation of future financial changes precipitated the initiation of public services policy reforms. This is a relevant contribution to research in the field of study which will help to generate critical thinking and debate where it is known, and hopefully spur on further research into the unknowns waiting to be discovered.

Reference List

Asquer A and Alzahrani A (2020) ‘Public Services Reforms in Neo-Patrimonial Systems: Commercialisation of Healthcare and Education in Saudi Arabia’

Denscombe M (2010) The Good Research Guide: For Small-Scale Social Research Projects. 4th Edition. London: Open University Press.

Hoey L (2017) ‘Reclaiming the authority to plan: How the legacy of structural adjustment affected Bolivia’s effort to recentralize nutrition planning’. World Development, 91, 100-112.

Saunders M, Lewis P, Thornhill A (2009) Research Methods for Business Students. 5th edition. Harlow UK: Financial Times Prentice Hall.

Teddlie C and Yu F (2007) ‘Mixed method sampling: A typology with examples’. Journal of Mixed Methods Research, 1 (1), pp. 77-100.

________________________________________________

Find more at JeffThinks.com or JeffreyAlexanderMartin.com