“…underfunding in the face of growing healthcare needs and expectations; explanations based on economic behaviour) conditions [11,[24][25][26]. On the other hand, however, and reflecting the advances in institutional theory when studying other informal practices [22,23], it can be argued that institutions are "the rules of the game" which prescribe what is socially acceptable, and thus both constrain and encourage different types of activity [15]. In all societies, there are not only formal institutions (i.e., codified laws and regulations) that lay out the legal rules of the game, but also informal institutions which are the "socially shared rules, usually unwritten, that are created, communicated and enforced outside of officially sanctioned channels" [27, p.727].…”