Managers and professionals have begun to recognize the importance and links between problem-solving

and decision-making abilities as a result of recent political and economic events, as well as changes in
the practice and delivery of health and social care. Assessing the impact of political, economic, socio-
cultural, environmental, and other external influences on health-care policy, proposals, and
organizational programs is becoming a recognized stage of strategic development and planning
mechanisms for health-care organizations. As a result, the goal of this type of strategic analysis is to
identify the organization's most pressing concerns. This type of analysis can be carried out by reviewing
the external (organizational) environment using the PEST-analysis (also known as STEP-analysis), which
has been extended to the PESTELI checklist detailed below. PESTELI Analysis is a great method for
grasping the “big picture” of your operating environment, as well as the opportunities and risks that
exist within it. Understanding your surroundings allows you to maximize possibilities while minimizing
hazards. Economic and political insights were combined to provide a new and convincing explanation.
The variations in policy choices that economists identified as causes of divergence were explained as
reflecting differences in political power structures, as pioneered by Bates (1981). Nationally destructive
policies were not errors, but rather well-thought-out initiatives to serve the elite's interests. This fruitful
union of economics and political science is shown by the following examples. Despite the importance of
a political economics theory based on interests and power abuses, culture is being cautiously
reintroduced as a viable explanation. The economic literature on culture has recently been surveyed.
Feelings like esteem, justice, and hatred are examples of other-related values. Peer esteem is earned
when one performs behaviors that are well-liked by others because they follow their rules. Self-esteem
is gained through acting in accordance with internalized norms, which have therefore become part of a
moral obligation rather than a personal desire. Internalization is an inherently social process. The
external conceptions that are being internalized are other people’s values. Similarly, narratives that
profess to explain how the world works are contingent on the interactions that occur. Parents teach
their children, and everyone learns from their peers. People learn information in numerous ways, some
of which are untrue. People may nevertheless act rationally, seeking to maximize benefit within a given
set of restrictions. Other values, on the other hand, are part of the utility that they are maximizing, and
the apparent limitations that the maximization problem is subject to may have been posited by false
narratives. The behavior generated by a culture’s distinctive values and narratives is manifested, and
that behavior may be maladaptive. It also spreads to new members and hence has the potential to be
quite tenacious. In Section 2.2, I present formal models that show how culture can influence outcomes
in ways that elite interest models do not anticipate. The packages of norms, values, and narratives
produced by identities and networks may be primary for political outcomes, just as values, rather than
institutions, may be primary for democracy and tax rates. Section 3 examines their importance in state
legitimacy, successful state organization functioning, expectation coordination, and social learning.