The Role of International Actors in Post-Communist Countries: Coercion or Persuasion? The Transfer of Hospital Design Standards by International Organizations and Private Firms

Abstract

This paper explores the role of international actors in post-communist transformation. By taking the case of hospital design standards, it explains how the national actors choose to leave aside the national regulations and to adopt foreign technical standards. The paper takes the case of technical standards employed for the modernization of healthcare facilities in Ukraine and Moldova. An in-depth comparative case study of two projects revealed that national architects of these post-soviet countries use foreign standards. While the change of standards is a similar outcome in both cases, the international actors involved are different. My findings suggest that while both international organizations and private actors diffuse foreign technical standards in post-soviet countries, the processes through which they realize it differs. Whereas international organizations dispose of coercive means to impose foreign solutions, private actors need to negotiate and to convince for their adoption. Drawing on recent debates on policy diffusion and transfer (Dolowitz and Marsh 2012; 2000, Simmons and al. 2008, Stone 2010, 2012), the results shed light on “carriers” of institutional arrangements among different political systems.

Keywords: transfer, standards, international actors, post-soviet states