The role of strategic human resource Management in institutional performance in the Yemeni health sector: a context of crisis and conflict

This study examines how strategic human resource management (SHRM) practices, comprising strategic, organizational and technological dimensions, function as bundled intangible resources associated with institutional performance in the Yemeni healthcare sector, a protracted conflict-affected setting. Performance was operationalized through three non-financial, perception-based dimensions adapted from the balanced scorecard: internal process efficiency, employee satisfaction (a proxy for beneficiary satisfaction) and learning and growth. Using a cross-sectional descriptive-analytical design, data were collected via a questionnaire administered to a proportionate stratified sample of 393 healthcare professionals from public hospitals, private hospitals and the Ministry of Public Health and Population, representing a population of 5,884 employees. Descriptive findings showed a high level of SHRM practices (M = 3.75) and a moderate level of institutional performance (M = 3.64). Structural equation modeling indicated a statistically significant positive association between SHRM practices and performance (p < .001), with the strategic dimension showing the strongest association (β = 0.418); the multidimensional model accounted for 70.8% of the variance. Multi-group analysis revealed a significant moderating role of ownership: the technological dimension was not significantly associated with performance in public hospitals, plausibly reflecting infrastructure limitations and salary disruptions linked to the conflict, but was strongly associated in private hospitals. Theoretically, the study extends the resource-based view by identifying a boundary condition: the value of technological HRM resources is contingent on complementary financial and infrastructural assets. Because the data are cross-sectional and self-reported, findings are interpreted as associations rather than causal effects, and performance reflects employees’ perceptions rather than objective indicators.