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Purpose This study examines how six knowledge management (KM) dimensions, namely creation, absorption, organization, storage, dissemination and application, relate to organizational creativity and innovation among managers in public primary healthcare. Design/methodology/approach A multi-wave cross-sectional survey was conducted among 95 managers across 20 public primary healthcare facilities between 2019 and 2022. Data were collected using structured measures of KM, creativity and innovation. Multiple regression, bootstrap confidence intervals, multicollinearity diagnostics and supplementary mediation analyses were used to examine associations. Recruitment-year differences and potential common-method bias were also assessed. Findings Knowledge absorption, dissemination and application showed positive associations with creativity and innovation. Knowledge creation was positively associated with innovation in bivariate analysis but showed a negative adjusted coefficient when the KM dimensions were entered simultaneously, suggesting sensitivity to shared variance among correlated predictors. After accounting for knowledge application, the direct association between knowledge creation and innovation was no longer statistically significant. Creativity and innovation were highly correlated (r = 0.907), indicating substantial construct overlap that may also reflect the organizational context. Research limitations/implications The study is limited by its modest sample size, multi-year data collection, individual-level self-reported measures and potential common method and selection biases. Recruitment spanned pre-COVID-19, COVID-19 and post-COVID-19 periods, and facility-level clustering was not modeled. The high correlation between creativity and innovation also raises concerns about discriminant validity. The findings should therefore be interpreted as associations rather than causal effects. Despite these limitations, the results indicate that knowledge application and absorption may be important areas for managerial attention in resource-constrained public primary healthcare settings and provide directions for future multilevel and longitudinal research. Practical implications The findings suggest that healthcare managers should place greater emphasis on mechanisms that enable relevant knowledge to be absorbed, shared and translated into routine practice. Structured knowledge-sharing routines, peer learning, interdisciplinary collaboration, documentation of effective practices, continuing professional development and integration of lessons into managerial procedures may support these processes. In resource-constrained settings, strengthening the use of existing organizational knowledge may be more feasible than relying primarily on additional financial or technological resources. Healthcare leaders and policymakers may consider incorporating these mechanisms into managerial development and organizational-learning initiatives, while recognizing that the present findings reflect associations rather than demonstrated causal effects. Social implications Effective knowledge management may contribute to stronger organizational capacity for creativity and innovation in public primary healthcare, with potential implications for the quality and responsiveness of healthcare services. Strengthening mechanisms for knowledge sharing, learning and application may help healthcare organizations make better use of existing knowledge and experience, particularly where financial and technological resources are limited. Such improvements may support managers and healthcare teams in responding to changing service needs and developing locally appropriate solutions. However, because this study identifies associations rather than causal effects, these potential social benefits should be considered as areas for further investigation rather than established outcomes. Originality/value The study contributes evidence from a resource-constrained public primary healthcare setting by jointly examining 6 KM dimensions against both creativity and innovation. The findings suggest that knowledge application and related processes may be particularly important for translating knowledge into organizational outcomes, while highlighting the need for larger multilevel and longitudinal studies.
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Nourian et al. (2026) studied this question.
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