Modeling the Antecedents and Outcomes of Knowledge Stagnation in the Ministry of Health, Treatment, and Medical Education
Keywords:
Knowledge stagnation, interpretive structural modeling, fuzzy Delphi, absorptive capacity, knowledge management, Ministry of HealthAbstract
This study aimed to develop a multi-level interpretive structural model identifying the antecedents and outcomes of knowledge stagnation in the Ministry of Health, Treatment, and Medical Education. This research employed a mixed-method exploratory–confirmatory design, integrating qualitative analysis, fuzzy Delphi validation, and Interpretive Structural Modeling (ISM). In the qualitative phase, 20 experts—including faculty members and senior specialists in organizational behavior, human resource management, and administrative roles within the Ministry—were selected through purposive sampling until theoretical saturation. Semi-structured interviews were conducted to extract initial antecedents and outcomes of knowledge stagnation. The extracted factors were then evaluated by 44 additional experts using a fuzzy Delphi questionnaire to determine relevance, clarity, and appropriateness. Linguistic judgments were converted into triangular fuzzy numbers and defuzzified using Minkowski-based formulas to establish consensus. In the final phase, ISM was applied to model hierarchical relationships among confirmed antecedents and outcomes across structural, behavioral, and contextual dimensions, generating driving and dependence powers for each factor and determining multi-level structures. The ISM results revealed that structural weaknesses—including inadequate infrastructures, inappropriate hierarchical structures, and insufficient work processes—serve as the strongest antecedents driving knowledge stagnation. Behavioral determinants such as weak knowledge leadership, poor communication networks, lack of knowledge absorption, and resistance to change emerged as core behavioral drivers. Contextual factors, particularly weak national regulations and lack of cross-ministerial knowledge modeling, showed significant systemic influence. The outcomes hierarchy indicated that threatened organizational survival, diminished agility, reduced learning, loss of innovation, and declining societal knowledge quality are key consequences. The multi-level model demonstrated that foundational structural and contextual weaknesses cascade into behavioral stagnation and ultimately shape strategic and societal outcomes. Knowledge stagnation in the Ministry of Health arises from interconnected structural, behavioral, and contextual deficiencies that reinforce one another, and addressing it requires systemic interventions that strengthen infrastructures, leadership, learning culture, and inter-organizational knowledge governance.
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[1] R. Fierro and G. Benalil, "Benefits, Process and Challenges of Knowledge Management," Journal of Enterprise and Business Intelligence, pp. 083-094, 2024, doi: 10.53759/5181/jebi202404009.
[2] J. Fernando, S. Popadiuk, and S. Neusa Maria Bastos Fernandes dos, "Knowledge Management at Unilever South America – Enabling Conditions and Their Interaction With the SECI Model," Revista De Negócios, vol. 24, no. 2, p. 7, 2019, doi: 10.7867/1980-4431.2019v24n2p7-26.
[3] F.-E. Zamfir, "The Impact of Knowledge Transfer on the Organizational Performance," Proceedings of the International Conference on Business Excellence, vol. 14, no. 1, pp. 577-588, 2020, doi: 10.2478/picbe-2020-0054.
[4] X. Yin, J. Chen, and C. Zhao, "Double Screen Innovation: Building Sustainable Core Competence Through Knowledge Management," Sustainability, vol. 11, no. 16, p. 4266, 2019, doi: 10.3390/su11164266.
[5] E. Lafuente, Á. R. Solano, J. C. Leiva, and R. Mora-Esquivel, "Determinants of Innovation Performance," Academia Revista Latinoamericana De Administración, vol. 32, no. 1, pp. 40-62, 2019, doi: 10.1108/arla-10-2017-0309.
[6] S. A. d. S. Souza, S. Débora Eleonora Pereira da, and A. F. d. Abreu, "Absorptive Capacity of Signals Captured From Environment for Innovation," Ram Revista De Administração Mackenzie, vol. 20, no. 6, 2019, doi: 10.1590/1678-6971/eramd190029.
[7] S. Bawa, I. W. Benin, and A. S. Almudaihesh, "Innovation Networks and Knowledge Diffusion Across Industries: An Empirical Study From an Emerging Economy," Sustainability, vol. 16, no. 24, p. 11308, 2024, doi: 10.3390/su162411308.
[8] A. M. Silva et al., "Knowledge Management and Its Impact on Social Performance in Solidarity Organizations: The Role of Absorptive Capacity and Organizational Learning," Ciriec-España Revista De Economía Pública Social Y Cooperativa, no. 110, pp. 291-319, 2024, doi: 10.7203/ciriec-e.110.26025.
[9] K. Wongmahesak, N. Wongsuwan, B. Akkaya, and M. Palazzo, "Impact of Knowledge Management Process on Organizational Performance: The Mediating Role of Technological Innovation," Knowledge and Process Management, vol. 32, no. 1, pp. 54-64, 2024, doi: 10.1002/kpm.1795.
[10] M. Appoh, N. Oboyi, A. Sobowale, B. Ogunwale, S. Gobile, and O. A. Alabi, "Organizational Culture and Its Impact on Knowledge Transfer: A Literature Review in the Context of Developmental Disabilities Administration Organizations," Ijamrs, vol. 4, no. 6, pp. 2278-2287, 2024, doi: 10.62225/2583049x.2024.4.6.4303.
[11] E. Hosseini, M. Tajpour, and M. Mohiuddin, "Perspective Chapter: The Role of Knowledge Employees’ Voices in Creating Knowledge in Digital Startups," 2022, doi: 10.5772/intechopen.105646.
[12] S. Nayak, J. Bhatnagar, P. Budhwar, and J. Mukherjee, "Commitment Based Human Resources Practices and Knowledge Creation in Ambidextrous Organizations: A Moderated Mediation Study on Expatriates Working in India," Thunderbird International Business Review, vol. 64, no. 5, pp. 511-529, 2022, doi: 10.1002/tie.22307.
[13] S. Snehvrat and S. K. Dutta, "Building Organizational Knowledge in Corporate Entrepreneurship: Role of Time and Commonality," International Journal of Organizational Analysis, vol. 33, no. 8, pp. 2626-2648, 2025, doi: 10.1108/ijoa-04-2024-4419.
[14] L. Zapata-Cantú, "Knowledge Generation to Foster Innovation in Mexico: How Human Capital Matters," 2019, doi: 10.5772/intechopen.86216.
[15] L. L. Barakat, "Knowledge Management Mechanisms at MNCs and the Enhancing Effect of Absorptive Capacity," Aib Insights, vol. 22, no. 4, 2022, doi: 10.46697/001c.38310.
[16] M. Yadav, A. Pandey, A. Chandel, and X. H. Nghiem, "Knowledge Sharing and Absorptive Capacity," pp. 241-256, 2024, doi: 10.4018/979-8-3693-3820-9.ch011.
[17] G. Tahat, "Knowledge Sharing, Organizational Capabilities, and Innovation Management to Sustain Competitive Advantage: A Qualitative Multi-Case Study," Journal of Management Research, vol. 13, no. 1, p. 43, 2021, doi: 10.5296/jmr.v13i1.18147.
[18] G. Tahat, "Innovation Management to Sustain Competitive Advantage: A Qualitative Multi-Case Study," Research in Business and Management, vol. 8, no. 1, p. 1, 2021, doi: 10.5296/rbm.v8i1.18799.
[19] P. Hughes, M. Hughes, P. Stokes, H. Lee, P. Rodgers, and W. Y. Degbey, "Micro-Foundations of Organizational Ambidexterity in the Context of Cross-Border Mergers and Acquisitions," Technological Forecasting and Social Change, vol. 153, p. 119932, 2020, doi: 10.1016/j.techfore.2020.119932.
[20] X. An, L. Qi, J. Zhang, and X. Jiang, "Research on Dual Innovation Incentive Mechanism in Terms of Organizations’ Differential Knowledge Absorptive Capacity," Plos One, vol. 16, no. 8, p. e0256751, 2021, doi: 10.1371/journal.pone.0256751.
[21] A. J. Kashan, K. Mohannak, and R. T. d. Oliveira, "Exploring Microfoundations and Multilevel Mechanisms of Absorptive Capacity in an Emerging Economy: Empirical Evidence From a Leading Car Manufacturer," Journal of Management & Organization, vol. 31, no. 3, pp. 1389-1418, 2023, doi: 10.1017/jmo.2023.20.
[22] L. Makhloufi, A. Laghouag, A. A. Sahli, and F. Bélaïd, "Impact of Entrepreneurial Orientation on Innovation Capability: The Mediating Role of Absorptive Capability and Organizational Learning Capabilities," Sustainability, vol. 13, no. 10, p. 5399, 2021, doi: 10.3390/su13105399.
[23] F. María del Rosario Demuner, "Technological Level in the Relationship Between Absorptive Capacity and Response Capacity in Manufacturing Companies," Ram Revista De Administração Mackenzie, vol. 24, no. 3, 2023, doi: 10.1590/1678-6971/eramr230174.en.
[24] S. Mirza, A. Mahmood, and H. Waqar, "The Interplay of Open Innovation and Strategic Innovation: Unpacking the Role of Organizational Learning Ability and Absorptive Capacity," International Journal of Engineering Business Management, vol. 14, 2022, doi: 10.1177/18479790211069745.
[25] T. Dolmark, O. Sohaib, G. Beydoun, and F. Taghikhah, "Agent-Based Modelling of Individual Absorptive Capacity for Effective Knowledge Transfer," Journal of Ambient Intelligence and Humanized Computing, vol. 15, no. 9, pp. 3479-3492, 2024, doi: 10.1007/s12652-024-04826-7.
[26] Z. Cinthya Mônica da Silva, "New Perspectives for Knowledge Management in Inter-Organizational Networks and Relations in Agribusiness," European Conference on Knowledge Management, vol. 23, no. 2, pp. 1260-1268, 2022, doi: 10.34190/eckm.23.2.709.
[27] R. G. Rodrigues, C. Sampaio, P. Duarte, and J. M. H. Mogollón, "Cross-Border Innovation: Assessing Concepts, Contexts, and Content," Sustainability, vol. 14, no. 23, p. 15581, 2022, doi: 10.3390/su142315581.
[28] C. Sun, Q. Xia, and X. Mei, "Evaluation of Product Innovation Practice of Chinese Internet Companies Based on DANP Model," Wireless Communications and Mobile Computing, vol. 2022, no. 1, 2022, doi: 10.1155/2022/5744875.
[29] O. C. Okonkwo, "Types of Knowledge Transferred Within International Interfirm Alliances in the Nigerian Oil Industry and the Potential to Develop Partners’ Innovation Capacity," Administrative Sciences, vol. 15, no. 11, p. 423, 2025, doi: 10.3390/admsci15110423.
[30] S. Kordova, O. Or, and A. Benis, "Intergenerational Knowledge Management in a Cutting-Edge Israeli Industry: Visions and Challenges," Plos One, vol. 17, no. 7, p. e0269945, 2022, doi: 10.1371/journal.pone.0269945.
[31] J. K. Oludare, O. S. Oladeji, P. K. Adeyemi, and B. Otokiti, "Thematic Analysis of Knowledge Management Practices and Performance of Multinational Manufacturing Firms in Nigeria," International Journal of Multidisciplinary Research and Analysis, vol. 06, no. 01, 2023, doi: 10.47191/ijmra/v6-i1-32.
[32] M. P. Sari, D. Games, and D. K. Sari, "The Effects of Organizational Inertia and Dynamic Capability on Firm Performance: Business Model Innovation as a Mediating Variable at Small Industry of Rendang in West Sumatera," Dinasti International Journal of Education Management and Social Science, vol. 5, no. 4, pp. 578-588, 2024, doi: 10.31933/dijemss.v5i4.2591.
[33] O. A. Shvetsova, P. Tanubamrungsuk, and S. Lee, "Organization Leadership in the Automobile Industry: Knowledge Management and Intellectual Capital," The Open Transportation Journal, vol. 15, no. 1, pp. 16-30, 2021, doi: 10.2174/1874447802115010016.
[34] X. Ye, N. Wang, and Y. Han, "Knowledge Governance and Innovative Employee Performance," Management Decision, 2025, doi: 10.1108/md-05-2024-1015.
[35] C. L. Cristofaro, W. Vesperi, R. Reina, A. M. Melina, and M. Ventura, "Telling a Story to Share Knowledge: A Case Study of Agrifood Corporate Museum," European Conference on Knowledge Management, vol. 25, no. 1, pp. 878-883, 2024, doi: 10.34190/eckm.25.1.2763.
[36] B. Thiel et al., "Adoption of a Postoperative Pain Self-Report Tool: Qualitative Study," Jmir Human Factors, vol. 9, no. 2, p. e33706, 2022, doi: 10.2196/33706.
[37] M. H. Khasmafkan-Nezam, "Harnessing Information System Capabilities to Enhance Organizational Agility: The Interplay of Green Absorptive Capacity, Collaborative Knowledge Creation, And strategic Flexibility," Journal of Enterprise Information Management, pp. 1-35, 2025, doi: 10.1108/jeim-02-2025-0080.
[38] I. Raisal, A. K. Tarofder, and A. Haleem, "Interplay of Knowledge Creation Capability and Organizational Forgetting on Absorptive Capacity and Innovation Performance Among SMEs: a Symmetrical Approaches," Asian Journal of Economics Business and Accounting, pp. 1-12, 2019, doi: 10.9734/ajeba/2019/v11i430135.
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