INTRODUCTION:
Private hospitals in Ethiopia complement the resource constrained public hospitals. Health policy reforms have promoted further expansion of the private sector and enabled them to play a more significant role in healthcare provision. These reforms are introduced within the context of a health system that is perceived as rigid and to provide little room for strategic human resource management (SHRM). This study investigates the contextual mechanisms influencing SHRM in private for-profit (PFP) and private not-for-profit (PNFP) hospitals, in comparison to public hospitals.

METHODS:
A qualitative approach was employed, utilizing structured interviews with CEOs, administrators, and HR managers. Thematic analysis through deductive coding based on the Contextual SHRM framework was conducted, using ATLAS.ti 8 software.

RESULTS:
Our findings reveal that PNFP hospitals benefit from constructive government engagement and experiencing less coercive pressure, which appears to enable them to effectively plan and mitigate public hospital capacity issues. In contrast, PFP hospitals perceive regulations as rigid and constraining. Many PFP hospitals either partially comply or completely disregard governmental regulatory mandates in case of inconsistencies.Though PFP hospitals primarily compete for patients, they employ highly skilled workforce as a means towards delivering higher quality, timely and more valuable hospital services to justify the higher price charged to patients.

CONCLUSIONS:
Our study shows that stringent governmental policies/regulations exert pressure on SHRM of PFP hospitals. At the same time, these hospitals exploit leeway when regulatory enforcement capacity is lacking. In contrast, PNFP hospitals perceive regulations as supportive. This condition is different from public hospitals which lack rooms to maneuver for crafting SHRM. Future research agenda are called for engaging employees for valuable insights into SHRM practices and performance as well as patient outcomes.