From Practice to Legacy: Empowering Midwives through Succession Planning in Philippine Birthing Homes (A Gioia Methodological Study)
Ed Raphael Espinoza | Glenda Ganzon
Discipline: midwifery
Abstract:
Succession in small healthcare enterprises, particularly midwife-led birthing clinics in the Philippines, presents unique
challenges influenced by family aspirations, regulatory requirements, and mission-driven values. The purpose of this
novel type of study is to discover the succession plans of two birthing home owners in the province of La Union using
purposive sampling. The study employed a qualitative design guided by the Gioia methodology to capture participants’
lived experiences and surface data-driven concepts. Data were gathered through unstructured interviews. Following
Gioia’s three-step analytic process, transcripts were open-coded into first-order concepts, aggregated into secondorder themes, and distilled into aggregate dimensions that represent the emergent theory. Analysis produced 17 firstorder concepts clustered into 17 second-order themes in the first participant, while the second participant had 23 firstorder concepts clustered into 23 second-order themes. These themes converged into 12 aggregate dimensions:
Succession Aspirations, Successor Selection Challenges, Preparation for Continuity, Values & Principles for
Succession, Fears and Risks in Succession, Transitioning Ownership Role, Foundational Beliefs for Survival,
Succession Context, Successor Readiness, Core Qualities for Succession, Sustaining the Legacy and Ownership and
Structural Considerations which depict the structural importance of a strong succession plan. The findings reveal that
while founders initially aspire for family succession to preserve legacy and socioemotional wealth, the lack of qualified
heirs or the departure of family members often necessitates identifying non-family staff as potential successors.
Succession success is contingent on a combination of technical competence, regulatory compliance, and values
stewardship, including compassion, patient-centered care, and trustworthiness. Founders employ strategies such as
staged role transitions, mentoring, comprehensive knowledge transfer, and operational guidance to ensure continuity
of operations. Despite fears of business closure, sabotage, and client resistance to new leadership, founders
demonstrate resilience by fostering loyalty, emphasizing ethical practices, and creating pseudo-familial relationships
with trusted staff. The study proposes a mission-driven succession model, highlighting a shift from family-centered
continuity to professionalized, ethically grounded leadership in small healthcare enterprises. Practical implications
include guidance for founders on early succession planning, training, and mentoring of successors, as well as
recommendations for policymakers to support certification, capacity-building, and regulatory frameworks that
facilitate continuity of care. This research contributes to succession literature by integrating socioemotional,
institutional, and stewardship perspectives in a context-specific model for healthcare micro-enterprises.
References:
- Abubakar, R. A., Chauhan, A., & Kura, K. M. (2015). Workplace deviance: A review of antecedents, moderating, and mediating variables. International Journal of Business and Management, 10(5), 254–267. https://doi.org/10.5539/ijbm.v10n5p254
- AlYami, M. S., Watson, R., & Arabiat, D. (2023). Succession planning in nursing leadership: A narrative review. Healthcare, 11(4), 454. https://doi.org/10.3390/healthcare11040454
- Audretsch, D. B., Boente, W., & Tamvada, J. P. (2007). Religion and entrepreneurship. Jena Economic Research Papers, 75(2007), 1–34. https://doi.org/10.2139/ssrn.1025968
- Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.
- Baum, J. R., & Locke, E. A. (2004). The relationship of entrepreneurial traits, skill, and motivation to subsequent venture growth. Journal of Applied Psychology, 89(4), 587–598. https://doi.org/10.1037/0021-9010.89.4.58
- Becker, G. S. (1993). Human capital: A theoretical and empirical analysis, with special reference to education (3rd ed.). University of Chicago Press.
- Block, J. H. (2012). R&D investments in family and founder firms: An agency perspective. Journal of Business Venturing, 27(2), 248–265. https://doi.org/10.1016/j.jbusvent.2010.09.003
- Cabrera-Suárez, K., De Saá-Pérez, P., & García-Almeida, D. (2001). The succession process from a resource‐ and knowledge‐based view of the family firm. Family Business Review, 14(1), 37–48. https://doi.org/10.1111/j.1741-6248.2001.00037.x
- Catapang, R. C. (2022). Management competencies of selected family-owned SMEs in NCR: Basis for development of Filipino succession planning framework. Family Business Management Studies (FBMS) Journal. https://www.fbmsjournal.com/wp-content/uploads/2022/12/08_Management-Competencies-of-FO-SMEs-in-NCR.pdf https://doi.org/10.14456/fbms.2022.18
- Chan, F., Jalandoni, D., Sayarot, C. A., Uy, M., Daradar, D., & Aure, P. A. H. (2020). A family affair: A quantitative analysis of third-generation successors’ intentions to continue the family business. Organizations and Markets in Emerging Economies, 11(2), 462–481. https://doi.org/10.15388/omee.2020.11.4
- Chrisman, J. J., Chua, J. H., & Sharma, P. (2005). Trends and directions in the development of a strategic management theory of the family firm. Entrepreneurship Theory and Practice, 29(5), 555–576. https://doi.org/10.1111/j.1540-6520.2005.00098.x
- Chrisman, J. J., Chua, J. H., & Sharma, P. (2009). Defining the family business by behavior. Entrepreneurship Theory and Practice, 33(3), 451–465. https://doi.org/10.1111/j.1540-6520.2009.00313.x
- Civil Code of the Philippines, Republic Act No. 386. (1949). Official Gazette. https://www.officialgazette.gov.ph/1949/06/18/republic-act-no-386/
- Coffie, R. B., Osei, M., Aboagye, A. Q. Q., & Musah, A. (2024). Leadership style and succession planning in family-owned SMEs: The moderating role of transformational and participatory leadership. Journal of Family Business Management. https://doi.org/10.1108/JFBM-05-2023-0072
- Corley, K. G., & Gioia, D. A. (2011). Building theory about theory building: What constitutes a theoretical contribution? Academy of Management Review, 36(1), 12–32. https://doi.org/10.5465/amr.2009.0486
- Cruz, C., Justo, R., & De Castro, J. O. (2012). Does family employment enhance MSEs performance? Integrating socioemotional wealth and family embeddedness perspectives. Journal of Business Venturing, 27(1), 62–76. https://doi.org/10.1016/j.jbusvent.2010.07.002
- Dana, L. P. (2009). Religion as an explanatory variable for entrepreneurship. International Journal of Entrepreneurship and Innovation, 10(2), 87–99. https://doi.org/10.5367/000000009788161280
- Davis, J. H., Schoorman, F. D., & Donaldson, L. (1997). Toward a stewardship theory of management. Academy of Management Review, 22(1), 20–47. https://doi.org/10.5465/amr.1997.9707180258
- De Massis, A., Chua, J. H., & Chrisman, J. J. (2008). Factors preventing intra‐family succession. Family Business Review, 21(2), 183–199. https://doi.org/10.1111/j.1741-6248.2008.00118.x
- De Massis, A., Sharma, P., Chua, J. H., & Chrisman, J. J. (2012). Family business studies: An annotated bibliography. Edward Elgar Publishing. https://doi.org/10.4337/9781781002988
- Department of Health. (2017). Licensing requirements for birthing homes in the Philippines. Manila: DOH.
- Dyer, W. G. (2003). The family: The missing variable in organizational research. Entrepreneurship Theory and Practice, 27(4), 401–416. https://doi.org/10.1111/1540-8520.00018
- Family Code of the Philippines, Executive Order No. 209. (1987). Official Gazette. https://www.officialgazette.gov.ph/1987/07/06/executive-order-no-209-s-1987/
- Garman, A. N., & Glawe, J. (2004). Succession planning. Consulting Psychology Journal: Practice and Research, 56(2), 119–128. https://doi.org/10.1037/1061-4087.56.2.119
- Garman, A. N., & Tyler, J. L. (2004). Succession planning in healthcare organizations. Journal of Healthcare Management, 49(1), 43–49. https://doi.org/10.1097/00115514-200401000-00009
- Gioia, D. A., & Pitre, E. (1990). Multiparadigm perspectives on theory building. Academy of Management Review, 15(4), 584–602. https://doi.org/10.5465/amr.1990.4310758
- Gómez-Mejía, L. R., Haynes, K. T., Núñez-Nickel, M., Jacobson, K. J. L., & Moyano-Fuentes, J. (2007). Socioemotional wealth and business risks in family-controlled firms: Evidence from Spanish olive oil mills. Administrative Science Quarterly, 52(1), 106–137. https://doi.org/10.2189/asqu.52.1.106
- Grant, R. M. (1996). Toward a knowledge‐based theory of the firm. Strategic Management Journal, 17(S2), 109–122. https://doi.org/10.1002/smj.4250171110
- Handler, W. C. (1990). Succession in family firms: A mutual role adjustment between entrepreneur and next-generation family members. Entrepreneurship Theory and Practice, 15(1), 37–51. https://doi.org/10.1177/104225879001500105
- Handler, W. C. (1994). Succession in family business: A review of the research. Family Business Review, 7(2), 133–157. https://doi.org/10.1111/j.1741-6248.1994.00133.x
- Heartbeat International. (n.d.). Succession planning for maternity housing. Retrieved from https://www.heartbeatinternational.org/succession-planning-for-maternity-housing
- Hernandez, M. (2012). Toward an understanding of the psychology of stewardship. Academy of Management Review, 37(2), 172–193. https://doi.org/10.5465/amr.2010.0363
- International Journal of Innovative Science and Research Technology (IJISRT). (2024). The succession planning of family-own merchandising business in Davao de Oro, Philippines (Vol. 9, Issue 6). https://doi.org/10.38124/ijisrt/IJISRT24JUN1291
- Ip, B., & Jacobs, G. (2006). Business succession planning: A review of the evidence. Journal of Small Business and Enterprise Development, 13(3), 326–350. https://doi.org/10.1108/14626000610680235
- Irava, W. J., & Moores, K. (2010). Clarifying the strategic advantage of familiness: Unbundling its dimensions and highlighting its paradoxes. Journal of Family Business Strategy, 1(3), 131–144. https://doi.org/10.1016/j.jfbs.2010.08.002
- Jensen, M. C., & Meckling, W. H. (1976). Theory of the firm: Managerial behavior, agency costs and ownership structure. Journal of Financial Economics, 3(4), 305–360. https://doi.org/10.1016/0304-405X(76)90026-X
- Kim, S. (2012). Does person–organization fit matter in the public sector? Testing the mediating effect of person–organization fit in the relationship between public service motivation and work attitudes. Public Administration Review, 72(6), 830–840. https://doi.org/10.1111/j.1540-6210.2012.02572.x
- Klugah, G. E., Korang, V., Esifie, F. R., & Iddrisu, M. A. Z. (2025). Enhancing SME performance through succession planning, family influence, and successor attributes: Evidence from Ghana’s hospitality sector. SN Business & Economics, 5, 125. https://doi.org/10.1007/s43546-025-00881-0
- Le Breton-Miller, I., Miller, D., & Steier, L. P. (2004). Toward an integrative model of effective FOB succession. Entrepreneurship Theory and Practice, 28(4), 305–328. https://doi.org/10.1111/j.1540-6520.2004.00047.x
- Longenecker, J. G., & Schoen, J. E. (1978). Management succession in the family business. Journal of Small Business Management, 16(3), 1–6.
- Malik, N. A., & Yusof, S. (2024). Succession planning and the role of family–business relationships in Malaysian SMEs. Asia-Pacific Journal of Business Administration. https://doi.org/10.1108/APJBA-2023-0117
- McCormack, B., & McCance, T. (2010). Person-centered nursing: Theory and practice. Wiley-Blackwell. https://doi/org/10.1002/9781444390506
- McKee, M., Healy, J., & Raine, R. (2013). The role of leadership in health care services: Lessons from the European Observatory on Health Systems and Policies. The Lancet, 382(9889), 9–11. https://doi.org/10.1016/S0140-6736(13)62317-6
- Miller, D., Steier, L., & Le Breton-Miller, I. (2008). Lost in time: Intergenerational succession, change, and failure in family business. Journal of Business Venturing, 18(4), 513–531. https://doi.org/10.1016/S0883-9026(03)00058-2
- Nonaka, I., & Takeuchi, H. (1995). The knowledge-creating company: How Japanese companies create the dynamics of innovation. Oxford University Press.
- Nwokoye, E., Okpala, C., & Anene, C. (2023). Succession autonomy, leadership continuity, and SME sustainability in Nigeria. African Business and Finance Review Journal, 12(2), 45–60.
- Pahnke, A., Schlepphorst, S., & Schlömer-Laufen, N. (2024). Family business successions between desire and reality. Journal of Business Venturing Insights, 21, e00457. https://doi.org/10.1016/j.jbvi.2024.e00457
- PhilHealth. (2020). Accreditation requirements for maternity care package providers. Pasig City: Philippine Health Insurance Corporation.
- Politis, D. (2005). The process of entrepreneurial learning: A conceptual framework. Entrepreneurship Theory and Practice, 29(4), 399–424. https://doi.org/10.1111/j.1540-6520.2005.00091.x
- Reif, T., Bauer, D., Junge, S., & Hossnofsky, V. (2025). An update on family firm succession: A systematic literature review and future research directions. Journal of Family Business Strategy, 16(3), 100671. https://doi.org/10.1016/j.jfbs.2025.100671
- Reitsma, A., Hutton, E. K., Kaufman, K., & Sword, W. (2019). Implementing birth centers into maternal-newborn services in Ontario, Canada: Interprofessional teamwork and integration. Journal of Midwifery & Women’s Health, 64(1), 98–105. https://doi.org/10.1111/jmwh.12883
- Renfrew, M. J., McFadden, A., Bastos, M. H., Campbell, J., Channon, A. A., Cheung, N. F., & Declercq, E. (2014). Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care. The Lancet, 384(9948), 1129–1145. https://doi.org/10.1016/S0140-6736(14)60789-3
- Ringo, D. S., & Kibambila, V. K. (2025). Transcending the past into the future: The effects of succession planning and incumbents’ willingness to step aside on the sustainability of family businesses. Journal of Trade Science, 2, 110–127. https://doi.org/10.1108/jts-03-2024-0013
- Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2016). Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews, 4, CD004667. https://doi.org/10.1002/14651858.CD004667.pub5
- Santiago, A. L. (2000). Succession experiences in Philippine family businesses. Family Business Review, 13(1), 15–35. https://doi.org/10.1111/j.1741-6248.2000.00015.x
- Scott, W. R. (2008). Institutions and organizations: Ideas and interests (3rd ed.). Sage Publications.
- Scott, W. R. (2014). Institutions and organizations: Ideas, interests, and identities (4th ed.). SAGE Publications.
- Sharma, P., Chrisman, J. J., & Chua, J. H. (2003). Succession planning as planned behavior: Some empirical results. Family Business Review, 16(1), 1–15. https://doi.org/10.1111/j.1741-6248.2003.00001.x
- Silva, F. L., & Pimentel, R. C. (2024). A decision-support model for succession planning in small family firms: An interpretive structural approach. Journal of Small Business Strategy, 34(1), 89–108. https://doi.org/10.1080/10438599.2024.1893021
- Sobrevega, E. B., & Lopena, G. L. (2024). Entrepreneurial competencies and succession planning of family business owners in a second-class municipality in Iloilo Province: An explanatory sequential mixed methods study. Philippine Social Science Journal, 7(3), 85–100. https://doi.org/10.52006/main.v7i3.1040
- Vigoda-Gadot, E., & Drory, A. (Eds.). (2006). Handbook of organizational politics. Edward Elgar Publishing.
- Yusuf, N. B., & Rahman, M. S. (2024). Knowledge sharing, innovation capability, and socioemotional wealth in Malaysian family businesses. Journal of Family Business Strategy, 15(2), 100642. https://doi.org/10.1016/j.jfbs.2024.100642
- Zacher, H. (2016). Within-person relationships between daily individual and team satisfaction and job performance. Journal of Occupational and Organizational Psychology, 89(4), 857–874. https://doi.org/10.1111/joop.12155
- Zhou, F. (2023). Succession planning and firm innovation. Finance Research Letters, 58, 104314. https://doi.org/10.1016/j.frl.2023.104314