Several factors contribute to institutional inertia:
1. Bureaucratic Structures: Large organizations often have complex hierarchical structures that slow down decision-making processes. 2. Conservative Culture: Institutions may have a culture that values tradition over innovation, making them resistant to new approaches or technologies. 3. Resource Constraints: Limited resources can make it difficult to implement new programs or strategies. 4. Regulatory Hurdles: Strict regulatory frameworks can delay the adoption of new methods or interventions. 5. Risk Aversion: Fear of potential negative outcomes can lead to a preference for maintaining the status quo.