Abstract
Through the singular case of a not-for-profit hospital that started a restructuring project in 2008, this thesis focuses on the role of the management control system in the the dissemination of a financial vision and management of change in a pluralistic organisation.If the Moroccan health system is undergoing multiple changes and reforms like other countries, the common point of these reforms is the integration of new public management, which is inspired by the management of private companies, attesting to the expansion of financialisation in the health sector.The results of research of the participant and post-participant observation type (supplemented by more than 20 interviews of the free and semi-directive type) show how the management control system becomes a mediator of change. However, this role of mediator cannot be fulfilled without the presence of certain necessary conditions.The mobilization of the network actor theory makes it possible to highlight interactions, power games, alignments of interest through the analysis of controversies and their resolution. It also allows for a fine analysis to be carried out through the identification of the different moments of the translation.By making the results of the change visible (self-financing of the extension), the management control system acquires the status of a spokesperson, with the replication of the model to other private non-profit hospitals. In this way, the development and evolution of the hospital leads to the creation of an ecosystem capable of satisfying several groups of actors, allowing the network to expand.