Institutions, organizations and markets for inclusive growth

Abstract

This dissertation views the challenge of delivering new products and services in low-cost contexts as an organization design problem, a thesis explored in three interrelated studies. Study I examines opportunity enactment and inter-organizational design via an in-depth case study on emergency medical response services in India, a context characterised by poor access, resource constraints and institutional voids. The case and context highlight the need for innovation in organization design and governance modes to create a new opportunity that connects state actors, private healthcare providers, and the public at large. It considers the role of open innovation and novel organizational arrangements between public and private actors in creating these service platforms, before discussing their implications for literature on public-private partnerships and institutional entrepreneurship. Study II is a qualitative study on the delivery of prevention of mother-to-child transmission of HIV/AIDS services in three different states in India. Using archival data, fieldwork and interviews with healthcare professionals and front-line workers in the National AIDS Control Organization of India (NACO), it examines how work is coordinated in stigmatized client settings. It proposes a model for organization design and work integration in contexts where stigma is an antecedent to disenfranchisement. In addition, my findings highlight the interplay of formal design choices and informal coordinating practices in restoring the integrative conditions necessary for collective work. Study III is a comparative case study of two hybrid organizations. Combining stakeholder theory with organization design perspectives, it explores the prioritization of stakeholder preferences within two social enterprises. Specifically, how the demands of their most salient stakeholders influence internal governance and organization design arrangements. It demonstrates how salient preferences create complex trade-offs between coordination and agency costs associated with alternate governance choices. Their impact on the depth and breadth of social value creation are also discussed.