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This paper examines the Multistakeholder initiative (MSI) "German Initiative on Sustainable Cocoa (GISCO)". MSIs represent arenas in which heterogeneous actors from governments, businesses and civil society come together to achieve sustainability goals that they cannot achieve otherwise. The self-defined goals of GISCO are first, to improve the living conditions of cocoa farmers and their families; second, to conserve and protect natural resources and biodiversity; and third, to increase the share of sustainably produced cocoa. Although all stakeholder groups share these goals, they have different agendas and conflicting interests. Despite numerous case studies, no theoretical basis has been established on the functioning and success of negotiations in MSIs. Therefore, the question arises as to how the governance of an MSI can be captured empirically to explain (un)achieved outcomes of the collaboration. The contribution of this paper is the development of a theoretical framework and its application to the case study. Minutes of 84 meetings and 18 qualitative expert interviews were analyzed by social network analysis and qualitative content analysis using MaxQDA to identify (a) influential actors, (b) collaboration structures and (c) processes as well as (d) topics discussed to explain (not) achieved outcomes regarding the self-defined goals. The results provide detailed insight into the governance of an MSI. The MSI helps members to extend their individual networks and to learn from each other, but quickly reaches its limits in achieving the self-imposed common goals. One reason for this is the lack of representation of actors from the Global South, despite addressing environmental and living conditions there in two out of the three GISCO goals. Furthermore, it is shown that the structures and processes of decision-making within the MSI are designed in such a way that a lack of hierarchical directives, sanctions and other decision-making mechanisms makes negotiation-based compromises difficult. Consequently, the power of each stakeholder group to use their veto right to delay or prevent the changes required to achieve common goals cannot be overcome.

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Background: This article offers a new perspective of the Association of Southeast Asian Nations (ASEAN) as network governance (NG) using the policy network theory (PNT) for the analysis. Methods: Two case studies were selected from the ASEAN Community to examine the applicability and effectiveness of NG in promoting ASEAN cooperation. These case studies were chosen due to their prominence and the prevalence of critical comments about their effectiveness in promoting cooperation. The content analysis utilised primary data from ASEAN reports, documents, research articles and processes, and studies on NG and policy networks. A literature review was conducted using online academic databases and ASEAN-related websites. The search covered the period from June 2019 to March 2021, with further searches conducted between January and July 2023. These data collection efforts provided a robust analysis of the case studies within the NG and ASEAN integration contexts. Results: The findings show ASEAN as a hybrid structure which has supported its survival and relevance. This approach provides legitimacy for ASEAN globally by purposefully adopting structures similar to the EU without the supranational elements. It also showcases ASEAN's motivation for asserting its centrality. Adopting a hybrid structure has led to ASEAN's soft institutionalisation, driven by its norms and characterised by a less empowered secretariat, where the member states are the decision-makers and implementors of policies. It opens a pathway to recognising ASEAN states' autonomy, where the actors' will and interests affect decision-making and define performance. Conclusions: This article demonstrates NG's viability in promoting ASEAN's centrality in regional cooperation and institutional arrangements and allows for a nuanced assessment of its performance considering the context of the issue and ASEAN's history and emphasising the member states' primacy in policymaking. The NG framework contributes to ASEAN's legitimacy, regional cooperation and performance despite its inherent limitations.

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Increasingly, health and social care providers are adopting technology-mediated processes to optimise the delivery of care and to influence policy- and decision-makers. However, fragmentation persists in and between health and social care, impeding the provision of rounded person-centred care. Health and care delivery for an ageing population involves many diverse stakeholders with a range of motivations and agendas. The creation of a functional and sustainable network may promote the achievement of a well-functioning and integrated health and care sector. This work-in-progress paper outlines the evolution of an optimal governance model for the SHAPES network.

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BACKGROUND: Structured exercise programs provide considerable health benefits for cancer patients. Therefore, various OnkoAktiv (OA) networks were established in Germany with the aim to connect cancer patients with certified exercise programs. However, knowledge about the integration of exercise networks into cancer care systems and conditions of interorganisational collaboration is lacking. The aim of this work was to analyse the OA networks to guide further network development and implementation work. METHODS: We used methods of social network analysis within a cross-sectional study design. Network characteristics were analysed such as node and tie attributes, cohesion and centrality. We classified all networks into their level of organisational form in integrated care. RESULTS: We analysed 11 OA networks with 26 actors and 216 ties on average. The smallest network counted 12 actors/56 ties, the largest 52/530. 76% of all actors operated within the medical/exercise sector, serving 19 different medical professions. In smaller "linkage" networks, several individual professionals were linked "from service to service", whereas the more integrated networks revealed a core-periphery-structure. DISCUSSION: Collaborative networks enable the involvement of professional actors from different operational fields. This study provides an in-depth understanding of underlying organisational structures that provides information for further development of exercise oncology provision. TRIAL REGISTRATION: Not applicable, as no health care intervention was performed.

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Collaborative governance ebbs and flows. Partnerships become dormant or extinct, only to resurface with new members, and names, forms, or boundaries. This paper uses a systematic qualitative analysis of data from 4 watershed governance efforts in the United States--Delaware Inland Bays, Narragansett Bay, Tampa Bay, and Tillamook Bay. The study's objective is to develop theory grounded in these data by examining the developmental trajectories associated with collaborative partnerships. The paper begins by summarizing a four-stage life-cycle model. Each stage identifies a cluster of developmental challenges related to sustaining the health and useful life of a collaborative partnership. The paper identifies 31 partnerships across the four watersheds that were self- or externally-initiated. They experienced many different developmental trajectories. Some remained relatively healthy for a considerable period while others declined quite rapidly. Some partnerships had reorientations involving minor and rapid changes to the partnership structure. Some involved recreations with more profound shifts in core values and purposes. Some partnerships lasted for a considerable period while others ended when their work was done. Healthy partnerships also ended prematurely while unhealthy partnerships endured for a considerable period after their useful life ended. The paper concludes with a discussion of the implications for theory and practice.

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We focus on the relationship between the network structure of Chilean rural drinking water associations (APRs) and effective governance outcomes regarding the provision of infrastructure and drinking water to peripheral rural communities in the Valparaiso region. Based on a comparative regional multi-method case study, we assess the coherence of differences in the governance network structure with the corresponding governance outcomes. Using qualitative interviews, participant observation, and a network survey of collaboration and legitimacy relationships among leaders of local APRs, we find that when isolated APRs establish collective organizations, they can generate better governance outcomes even without support from the state. We demonstrate that higher levels of collaboration as well as a more integrative distribution of legitimacy relations in the network are coherent with more effective governance outcomes. The findings suggest to strengthen social and organizational capacity at the local level of water governance in order to overcome the challenges of megadroughts and of a lack of public infrastructure in peripheral rural areas.

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Networked forms of organizing in health care are increasingly viewed as an effective means of addressing "wicked", multifaceted health and societal challenges. This is because networks attempt to address these challenges via collaborative approaches in which diverse stakeholders together define the problem(s) and implement solutions. Consequently, there has been a sharp increase in the number and types of networks used in health care. Despite this growth, our understanding of how these networks are governed has not kept pace. The purpose of this chapter is to chart a research agenda for scholars who are interested in studying health care network governance (i.e., the systems of rules and decision-making within networks), which is of particular importance in deliberate networks between organizations. We do so based on our knowledge of the literature and interviews with subject matter experts, both of which are used to identify core network governance concepts that represent gaps in our current knowledge. Our analysis identified various conceptualizations of networks and of their governance, as well as four primary knowledge gaps: "bread and butter" studies of network governance in health care, the role of single organizations in managing health care networks, governance through the life-cycle stages of health care networks, and governing across the multiple levels of health care networks. We first seek to provide some conceptual clarity around networks and network governance. Subsequently, we describe some of the challenges that researchers may confront while addressing the associated knowledge gaps and potential ways to overcome these challenges.

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The Fédération Internationale de Football Association (FIFA) has faced constant accusations of human rights violations associated with World Cup Qatar 2022, with prominent media coverage and international football team demonstrations. This study aims to analyze and discuss the approach taken by the tripartite policy network of actors, namely FIFA, Qatar's Supreme Council (SC), and the Local Organizing Committee (Q22) for the creation of the the FIFA World Cup Qatar 2022 Sustainability Strategy (hereafter WCSS22) published in January 2020. The WCSS22 represents the first time FIFA has clearly articulated its responsibility in connection with impacts that are linked to the construction and operation of World Cup stadia and facilities, in line with the United Nations Guiding Principles on Business and Human Rights (UNGPs). The strategy was also the first to be planned and delivered jointly by FIFA, the SC, and the Q22. Qualitative Content Analysis (QCA) of documents associated with the WCSS22 was performed to answer the following research questions: a) What are the recurrent features of the policy formulation and design process and what role do the UNGPs play? b) How do FIFA and the other policy actors contribute and position themselves in relation to human rights? c) What form did governance (interdependence, interactions, regulated rules, and steering) take in the policymaking process? The study establishes that there are four recurrent features of policy formulation and design: 1) a collective, systematic, and diverse policymaking approach, 2) emphasis on leveraging internal resources and external input, 3) the building foundation of best practice principles, guidelines, strategies, and existing initiatives, and 4) inconsistency on decision-making and accountability measures. FIFA contributes to policymaking primarily through their existing statutes, human rights policy, and commitments to mitigate negative human rights impacts. Furthermore, specified actions, and mechanisms for construction workers' living and working conditions and recruitment processes are articulated by the SC, who take a more prominent role in worker initiatives. Q22, although involved in collective action, and participating in workers welfare, takes a more peripheral role in the policymaking process. In conclusion, it was found that the tripartite policy network of actors represents a participant-based governance approach with cohesive policy formulation, varied resources at their disposal, inconsistencies in accountability measures and with the lead network role dependent on specific actor initiatives and commitments.

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This paper empirically explores the contribution and collaborative networks of public and private actors to cybersecurity provision in Spain. The article draws on data from three sources: policy and legal documents, a Delphi study with cybersecurity experts, and 34 interviews. Rooted in the theoretical underpinnings of nodal governance and anchored pluralism, the paper argues that the position of actors and public-private collaboration dynamics involved in cybersecurity governance can be understood through the analysis of capital exchange. Therefore, the study provides a list of the most relevant nodes for cybersecurity in Spain, assesses the capital they possess and how they exchange it through collaborative networks and explores the characteristics and barriers of these collaborative relationships. Analyses reveal that public organisations hold a preeminent position in cybersecurity governance despite large technology corporations' greater economic and cultural capital. Remarkably, the paper identifies the central position of new public bodies in the network of cybersecurity nodes. Moreover, cultural barriers that are hindering public-private collaboration in Spain are identified. These results indicate that, despite the state's difficulties in providing public solutions to cybersecurity challenges, Spain is an example of how governance can be anchored in public bodies through symbolic and social capital.

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With the COVID-19 pandemic, supply chains are today confronted with more uncertainties than ever before. In the face of unanticipated disruptions, being resilient and sustainable has been rewarding for supply chains in terms of competitive advantage. However, literature is still far from possessing an encompassing sustainable supply chain framework (SSCF). As a contribution to the extant literature, the present study expounds a prominent concept termed negative entropy and explores its role in the SSCF. To accomplish this goal, the effect of negative entropy on supply chain sustainability is tested. Following the open systems theory and drawing from the collaboration and information management aspects of the negative entropy, co-creation, open innovation and network governance concepts which are considered to be relevant in this context are selected to be the antecedents of negative entropy. The empirical research is conducted on prominent logistics service providers and firms from various sectors with approved research and development departments in Turkey. The obtained data were subjected to covariance-based structural equation modeling analysis via Lisrel program. According to results, negative entropy is found to be a robust element in explaining supply chain sustainability. Furthermore, whereas co-creation and network governance reflected significant effects on negative entropy, surprisingly, open innovation demonstrated no substantial impact. This paper opens up a new front in sustainable supply chain management studies with a notable empirical study introducing negative entropy in the context of open systems theory.

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The countries worldwide have adapted diverse governance approaches to the pandemic to suit their contexts. While the diversity of the country-specific governance responses has been widely discussed, the hybrids nature of those governance practices has been explored less. This study analyses the responses toward COVID-19 in South Korea as responsive dialogues of different modes of governance, i.e., consensus-based hierarchy, state-sponsored market, and principle-based network. This study aims to remind us that pandemic governance needs to enable organic and responsive processes for all actors in society. This conceptual discussion of the governance modes illustrates that the pandemic allowed the emergence of the hybrids of governance modes to cope better with the complex realities of the diverse sectors and actors in South Korea. The characteristic of the responses diverges from the conventional governance classification of or market-based. It is a responsive and evolving dialogue of different modes of governance. It would be productive to think beyond the oversimplified understandings of governance modes and embrace flexible and different hybrids of governance modes to be more responsive, effective, efficient, and equitable.

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BACKGROUND: Despite increasing interest in joint research priority-setting, few studies engage end-user groups in setting research priorities at the intersection of the healthcare and management disciplines. With health systems increasingly establishing performance management programmes to account for and incentivize performance, it is important to conduct research that is actionable by the end-users involved with or impacted by these programmes. The aim of this study was to co-design a research agenda on healthcare performance management with and for end-users in a specific jurisdictional and policy context. METHODS: We undertook a rapid review of the literature on healthcare performance management (n = 115) and conducted end-user interviews (n = 156) that included a quantitative ranking exercise to prioritize five directions for future research. The quantitative rankings were analysed using four methods: mean, median, frequency ranked first or second, and frequency ranked fifth. The interview transcripts were coded inductively and analysed thematically to identify common patterns across participant responses. RESULTS: Seventy-three individual and group interviews were conducted with 156 end-users representing diverse end-user groups, including administrators, clinicians and patients, among others. End-user groups prioritized different research directions based on their experiences and information needs. Despite this variation, the research direction on motivating performance improvement had the highest overall mean ranking and was most often ranked first or second and least often ranked fifth. The research direction was modified based on end-user feedback to include an explicit behaviour change lens and stronger consideration for the influence of context. CONCLUSIONS: Joint research priority-setting resulted in a practice-driven research agenda capable of generating results to inform policy and management practice in healthcare as well as contribute to the literature. The results suggest that end-users are keen to open the "black box" of performance management to explore more nuanced questions beyond "does performance management work?" End-users want to know how, when and why performance management contributes to behaviour change (or fails to) among front-line care providers.

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This paper explores the potential for collaborative governance approaches to support Cumulative Effects Assessment (CEA) in the Cree territory of Eeyou Istchee, located in Northern Quebec, Canada, where a long history of large-scale hydroelectricity development, mining and forestry activities have negatively affected wildlife populations, imposing burdens on the traditional food systems and livelihoods of local Indigenous communities. Drawing on key informant interviews with policy actors from government, non-government and private sector organizations working on Impact Assessment in Eeyou Istchee, the potential for more decentralized and networked approaches to regional wildlife monitoring and baseline data collection in support of CEA is considered. Results suggest a shared willingness to collaborate towards improving the overall regional environmental conditions and to generate long-term data on wildlife population and distribution. Challenges include the absence of essential supporting programs (land-use plans, regional environmental frameworks, lead monitoring agencies, designated funding), and high levels of distrust between proponents and NGOs which combine to suppress the initiation of collaborative governance processes as well as the potential utility of any regional monitoring program that might be established. The need for leadership to facilitate reciprocal knowledge flows among actors, build trust and enable long-term cooperative structures based on a shared vision and goal congruency is identified.

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Background: Cooperation among university units is considered a cornerstone for the promotion of students' health. The underlying mechanisms of health-promoting networks at universities have rarely been examined so far. Shedding light on partnerships is generally limited to the naming of allied actors in a network. Objectives and Methods: In this study, we used network analysis intending to visualize and describe the positions and characteristics of the network actors, and examine organizational relationships to determine the characteristics of the complete network. Results: The network analysis at hand provides in-depth insights into university structures promoting students' health comprising 33 organizational units and hundreds of ties. Both cooperation and communication network show a flat, non-hierarchical structure, which is reflected by its low centralization indices (39-43%) and short average distances (1.43-1.47) with low standard deviations (0.499-0.507), small diameter (3), and the non-existence of subgroups. Density lies between 0.53 and 0.57. According to the respondents, the University Sports Center is considered the most important actor in the context of students' health. Presidium and Institute of Sport and Sports Science play an integral role in terms of network functionality. Conclusion: In the health-promoting network, numerous opportunities for further integration and interaction of actors exist. Indications for transferring results to other universities are discussed. Network analysis enables universities to profoundly analyze their health-promoting structures, which is the basis for sustained network governance and development.

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BACKGROUND: The share of out-of-pocket payments in Iranian families has the greatest burden on the poor and lead to an impoverishment caused by catastrophic health expenditures. In order to improve access of the poor to public resources, it is necessary to create a better governance system and effective policy-making. The purpose of this study is to improve network effectiveness of the Iranian health system and to design a financial protection network for the poor, based on the network governance theory. METHODS: We are using a quantitative method framework in conjunction with a Social network analysis (SNA) strategy. To draw an optimal network, we conducted interviews with experts by focusing on the arrangement and relationship among different institutions. The research sample was purposefully selected. We used UCINET software for data analysis and NetDraw software to draw networks. RESULTS: In this article, an optimal network was proposed with the following characteristics: First, the problem of the density of relationships among several central institutions and the isolation of the other institutions have been solved. Second, in our model, the relationships have been distributed in a balanced manner among all institutions in the network. Third, the number of participants has been reduced and consensus on poor people support policies has been achieved in this optimal network. Forth, executive organizations keep their central positions and upper institutions are not at the central position, so that the power is distributed in favor of more balanced governance. However, in order to increase efficiency and to have coherent decision-making, it is necessary to establish a "core" for this optimal network. The "core" has to include the organizations with the most relationship with others. CONCLUSION: The result revealed that the usefulness of network analysis as a tool for proposing the effectiveness of governance. By strengthening the relationship among the main actors, an organized system of network management can be achieved. The network has to include all actors from different levels, from policy-making to implementation. The network also has to clarify the tasks from identifying the poor to covering costs. From an academic perspective, this study showed the adequacy of network analysis as a tool for policy sciences. Governance in our optimal health financial protection model follows the shared-governance pattern due to its high density, low centralization and low distance. The model of network governance can be the source of changes in the health governance system. It is a necessary structural condition to provide access to universal health coverage.

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BACKGROUND: Health workforce governance has been proposed as key to improving health services delivery, yet few studies have examined the conceptualisation of health workforce governance in detail and exploration in literature remains limited. METHODS: A literature review using PubMed, Google Scholar and grey literature search was conducted to map out the current conceptualisation of health workforce governance. We identified all published literature relating to governance in health workforce since 2000 and analysed them on two fronts: the broad definition of governance, and the operationalisation of broad definition into key dimensions of governance. RESULTS: Existing literature adopts governance concepts established in health literature and does not adapt understanding to the health workforce context. Definitions are largely quoted from health literature whilst dimensions are focused around the sub-functions of governance which emphasise operationalising governance practices over further conceptualisation. Two sub-functions are identified as essential to the governance process: stakeholder participation and strategic direction. CONCLUSIONS: Although governance in health systems has gained increasing attention, governance in health workforce remains poorly conceptualised in literature. We propose an improved conceptualisation in the form of a stakeholder-driven network governance model with the national government as a strong steward against vested stakeholder interests. Further research is needed to explore and develop on the conceptual thinking behind health workforce governance.

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Continuums of Care (CoCs) are the primary coordinating bodies for homeless services in the United States. However, the complexities involved in delivering homeless services across interagency networks challenges coordination and system improvement. CoC governance, planning, and service provision have received little attention in academic literature, and thus, Continuums attempt to manage complex systems with little guidance. This evaluation applied community-based system dynamics with homeless consumers and service providers to (1) identify capability traps that impede services delivery and to (2) engage stakeholders in a structured system improvement process. Results revealed organizational structures for governance and planning that inhibit system outcomes. Insights led to policy and practice recommendations for the homeless system.

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BACKGROUND: People living with and beyond cancer (PLC) receive various forms of specialty care at different locations and many interventions concurrently or over time. They are affected by the operation of professional and organizational silos. This results in undue delays in access, unmet needs, sub-optimal care experiences and clinical outcomes, and human and financial costs for PLCs and healthcare systems. National cancer control programs advocate organizing in a network to coordinate actions, solve fragmentation problems, and thus improve clinical outcomes and care experiences for every dollar invested. The variable outcomes of such networks and factors explaining them have been documented. Governance is the "missing link" for understanding outcomes. Governance refers to the coordination of collective action by a body in a position of authority in pursuit of a common goal. The Quebec Cancer Network (QCN) offers the opportunity to study in a natural environment how, why, by whom, for whom, and under what conditions collaborative governance contributes to practices that produce value-added outcomes for PLCs, healthcare providers, and the healthcare system. METHODS/DESIGN: The study design consists of a longitudinal case study, with multiple nested cases (4 local networks nested in the QCN), mobilizing qualitative and quantitative data and mixed data from various sources and collected using different methods, using the realist evaluation approach. Qualitative data will be used for a thematic analysis of collaborative governance. Quantitative data from validated questionnaires will be analyzed to measure relational coordination and teamwork, care experience, clinical outcomes, and health-related health-related quality of life, as well as a cost analysis of service utilization. Associations between context, governance mechanisms, and outcomes will be sought. Robust data will be produced to support decision-makers to guide network governance towards optimized clinical outcomes and the reduction of the economic toxicity of cancer for PLCs and health systems.

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The establishment of strategic coordination bodies with members from different agencies and that are governed by various laws and regulations can be understood as an answer to the demand for improved coordinated care for citizens with complex needs, such as frail older people. However, this demand raises fundamental questions of democratic control and accountability in the modern welfare state. Although these issues are addressed in current literature on network governance, they have not been investigated empirically very much. The aim of this paper is to investigate coordination bodies as important actors in integrated care, and especially to investigate how the members of these governance networks perceive their own influence and how they are held accountable by their principals. This study is conceptually built on theories of network governance and accountability. The empirical investigation is based on a survey with 545 respondents from 73 different coordination bodies in Sweden. The analysis shows that there seems to be an imbalance between perceived influence and perceived demands from different stakeholders to account for the services. This imbalance provides an opening for a discussion of how to improve the current situation for vulnerable groups and about new perspectives on accountability and power in the modern welfare state.

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The Health in All Policies (HiAP) approach requires formal and sustained governance structures and mechanisms to ensure that the policies of various non-health sectors maximize positive and minimize negative impacts on population health. In this paper, we demonstrate the usefulness of a network perspective in understanding and contributing to the effectiveness of HiAP. We undertook an exploratory, qualitative case study of a HiAP structure in Iran, the Kerman province Council of Health and Food Security (CHFS) with diverse members from health and non-health sectors. We analyzed relevant policy texts and interviewed 32 policy actors involved in the CHFS. Data were analyzed using within-case analysis and constant comparative methodology. Our findings suggest that CHFS governance from a network perspective drew in practice on elements of two competing network governance modes: the network administrative organization (NAO) and the lead organization mode. Our results also show that a shift from a hierarchical and market-based mode of interaction to a network logic within CHFS has not yet taken place. In addition, CHFS suffers from large membership and an inability to address complex 'wicked problems', as well as low trust, legitimacy and goal consensus among its members. Drawing on other HiAP studies and commentaries, insights from organization network theory, and in-depth findings from our case study, we conclude that a NAO may be the most effective mode of governance for tackling complex social problems in HiAP structures. Since similar studies are limited, and our single case study may not be transferable across all contexts, we suggest that further research be undertaken to explore HiAP structures from a network perspective in different institutional and cultural settings. With increasing emphasis given to HiAP approaches in national and international health policy discourse, it is important that comparative knowledge about the effectiveness of HiAP governance arrangements be developed.

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