

Partnerships between public and private healthcare providers are often seen as an important way to improve health care in resource-constrained settings. Despite the reconfirmed policy support for including private providers into public tuberculosis control in India, the public-private mix (PPM) activities continue to face apprehension at local implementation sites. This article investigates the causes for those difficulties by examining PPM initiatives as cases of organisational innovation. It examines findings from semi-structured interviews, observations and document analyses in India around three different PPM models and the attempts of innovating and scaling up. The results reveal that in PPM initiatives underlying problem definitions and different control practices, including supervision, standardisation and culture, continue to clash and ultimately hinder the scaling up of PPM. Successful PPM initiatives require organisational control practices which are rooted in different professions to be bridged. This entails difficult balancing acts between innovation and control. The innovators handle those differently, based on their own ideas of the problem that PPM should address and their own control practices. We offer new perspectives on why collaboration is so difficult and show a possible way to mitigate the established apprehensions between professions in order to make organisational innovations, such as PPM, sustainable and scalable. © 2013 The Authors Sociology of Health & Illness.
| EMTREE medical terms: | humanIndiainterdisciplinary communicationmass communicationorganizationorganization and managementpublic-private partnershipqualitative researchtheoretical modeltuberculosisutilization |
|---|---|
| MeSH: | Diffusion of InnovationHumansIndiaInterdisciplinary CommunicationModels, TheoreticalOrganizational InnovationPublic-Private Sector PartnershipsQualitative ResearchTuberculosis |
Engel, N.; Department of Health, Ethics and Society/School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, Netherlands;
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