Niekerk Lindi van, Manderson Lenore, Fosiko Nedson, Likaka Andrew, Blauvelt Carla Pamela, Msiska Barwani, Rifkin Susan
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Chembe Collaborative, Los Angeles, CA, USA.
Int J Health Policy Manag. 2024 Nov 18;13. doi: 10.34172/ijhpm.8141.
Governments worldwide are increasingly interested in scaling up effective public health innovations, but it is not always easy to institutionalize innovations, arising outside the public health system, as a part of national delivery. Evidence on how country governments can practically achieve this is limited. This article describes the institutionalization of the Chipatala Cha Pa Foni (CCPF, Health Center by Phone) social innovation into the Malawian public health, and identifies positive institutional practices that local actors drew on to achieve this.
A positive-oriented interdisciplinary multi-method qualitative case study design was adopted. Data were collected from key informant interviews, observations, and documents over 18 months. A composite social innovation framework, informed by institutional theory and positive organizational scholarship, guided the thematic content analysis.
Four clusters of positive institutional practices aided the institutionalization of the innovation: building high-quality relationships; creating opportunities for experiential interaction; cultivating hope; and logic attunement and awareness. We describe how these four practices operated together as a process of 'everyday creativity' to achieve institutionalization. We illustrate the importance of high-quality relationships, marked by respect, mutuality, and appreciation, as the foundation upon which hope can be built and the creativity needed for institutionalization to flourish. National ownership and sustainability of innovations are enhanced when implementation and institutionalization approaches are attuned to the logics inherent in national identity.
In this article, we highlight the importance of institutional and interpersonal dynamics in the institutionalization of social innovation in health systems.
世界各国政府越来越有兴趣扩大有效的公共卫生创新，但将公共卫生系统之外产生的创新作为国家服务的一部分进行制度化并不总是容易的。关于国家政府如何切实做到这一点的证据有限。本文描述了“通过电话设立健康中心”（CCPF）这一社会创新在马拉维公共卫生体系中的制度化过程，并确定了当地行为者为实现这一目标所采用的积极的制度化做法。
采用了以积极为导向的跨学科多方法定性案例研究设计。在18个月的时间里，通过关键 informant访谈、观察和文件收集数据。一个由制度理论和积极组织学术研究提供信息的综合社会创新框架指导了主题内容分析。
四类积极的制度化做法有助于创新的制度化：建立高质量的关系；创造体验互动的机会；培养希望；以及逻辑协调和意识。我们描述了这四种做法如何作为一个“日常创造力”的过程共同运作以实现制度化。我们说明了以尊重、相互性和欣赏为特征的高质量关系的重要性，它是建立希望以及使制度化蓬勃发展所需创造力的基础。当实施和制度化方法与国家身份所固有的逻辑相协调时，创新的国家自主权和可持续性会得到增强。
在本文中，我们强调了制度和人际动态在卫生系统社会创新制度化中的重要性。
