Only two of the institutional factors, the flow of information between government and health facilities, as well as that between health facility and health workers, were found to be statistically significant meaning that there was a relationship between effectiveness and the two institutional factors.
Such factors seem to have discouraged collaboration between the three institutional spheres of the Triple Helix dynamics (Park and Leydesdorff 2010).
In this study, given CSR is a multifaceted concept, we also suggest that there is an interconnection between the three institutional factors of modernity, governance, and tradition as reflected in the portrayal of context in our conceptual model.
This paper is built on an assumption that, when enhancing the interaction between the three institutional spheres, there is a need to understand how a set of competences can be shaped for a more productive collaboration.
The four institutional review boards approved this study.
There is not much difference between the two groups in other institutional sectors, with the exception of funds supplied to domestically licensed banks from the first group, which edged up to 10.0% in 2004.
Within this framework, we investigate the interactions among those two institutional decisions and the obtained institutional structure.
It is one of the cores in the dynamic interaction between 'the three institutional spheres', universities, industries and government, fostering entrepreneurship, innovation and economic growth (Etzkowitz and Leydesdorff 1997; Etzkowitz 2008).
Nor can we be 100% confident in assigning differential US and euro zone economic outcomes to the impact of divergent monetary and fiscal policies, given the links between the two regions and the different institutional structures.
Equally important, increased American assistance has been accompanied by closer institutional links between the two countries' defense and intelligence communities, as well as more intimate personal ties between both communities' top echelons.
