Authors

Discussion

Informality in post-socialist contexts, including Russian healthcare has been studied in multiple forms and on different societal levels. Scholars address this issue on a macro-level as a regulatory logic, shaping institutional landscape of health provision, and as micro-level practices, which compensate for the organizational gaps, and communicative failures. This paper focuses on the organizational level of Russian healthcare and elaborates on informality as a set of coordination practices, which allow health professionals navigating themselves and their patients in the context of multiple inconsistencies.

Drawing on qualitative data collected as institutional ethnography (2018-2020) of the Maternity Hospital, this study reveals a particular mode of dealing with organizational gaps and institutional challenges, conceptualized as "manual management". The analysis of empirical data show that the formal rules and orders, regulating the field of maternity care, are in some cases inconsistent. In addition, health providers are trapped between these rigid State requirements and consumeristic patients' demands. If formal rules are violated or care receivers’ expectations are not met, sanctions and complaints can follow. Thus, medical professionals and Hospital administration elaborate informal coping strategies in order to overcome these challenges, and provide better maternity care.