Drivers and Barriers of Innovation Dynamics in Healthcare - Towards a framework for analyzing innovation in Tuberculosis control in India
Nora Engel
#2008-077
Tuberculosis remains the biggest infectious killer in India and
worldwide, and it has recently regained substantial international
attention with its come-back in drug resistant forms. The environment,
the disease and the societal response to it are changing and with it
challenges and opportunities to control the disease. Innovation in a
variety of areas such as improved diagnostic tests, drugs, delivery
mechanisms, service processes, institutions and treatment regimes is
needed in order to be able to respond to the changing public health
challenge. This paper reviews theoretical approaches to innovation of
direct relevance to the case and examines what theoretical framework is
useful to look at the problem of innovation in public health in India.
Such an analysis can reveal drivers and barriers of change within the
context of the Indian health system in a comprehensive, problem-oriented
way and is thus able to add to existing research done on TB. However,
given that TB control is a public health challenge, concerned with
problems of delivery and implementation, the concept of innovation has
to go beyond technological innovation and the private sector. Therefore
it is argued that the case can simultaneously contribute to innovation
theory in order to better understand what change processes and
innovation for concrete public health challenges in a country such as
India mean. After a short description of recent changes in TB control
based on fieldwork in India the paper proceeds with an examination of
existing frameworks on healthcare innovation upon their usefulness for
such a case. The paper concludes with a proposal for a theoretical
framework and areas for further empirical fieldwork.
Keywords: Innovation in healthcare, Tuberculosis control, India
JEL: I18, O31, O38
UNU-MERIT Working Papers
ISSN 1871-9872