Multi-stakeholder Initiatives Research Articles

The Shared Principles of Primary Care: A Multistakeholder Initiative to Find a Common Voice.

As America's health care system continues to transform, the foundational importance of primary care becomes more clear. The Joint Principles of the Patient Centered Medical Home are now more than a decade old. As delivery reform continues, the importance of seven essential shared principles have emerged from a dynamic, collaborative, and iterative process of consensus building across multiple stakeholders. These seven principles will help the public, policy makers, payers, physicians, and other clinical providers speak with a unified voice about these core principles that define the enduring essence and value of primary care. The seven shared principles of primary care consist of: (1) person and family centered, (2) continuous, (3) comprehensive and equitable, (4) team based and collaborative, (5) coordinated and integrated, (6) accessible, and (7) high value. When used together, these shared principles provide a solid platform on which to build all further health care reform.

Can Multi-Stakeholder Initiatives Improve Global Supply Chains? Improving Deliberative Capacity with a Stakeholder Orientation

ABSTRACT:Global multi-stakeholder initiatives (MSIs) are important instruments that have the potential to improve the social and environmental sustainability of global supply chains. However, they often fail to comprehensively address the needs and interests of various supply-chain participants. While voluntary in nature, MSIs have most often been implemented through coercive approaches, resulting in friction among their participants and in systemic problems with decoupling. Additionally, in those cases in which deliberation was constrained between and amongst participants, collaborative approaches have often failed to materialize. Our framework focuses on two key aspects of these breakdowns: assumptions about the orientation of MSI participants, and the deliberation processes that participants use to engage with each other to create these initiatives and sustain them over time. Drawing from stakeholder and deliberation theories, we revisit the concept of MSIs and show how their deliberative capacity may be enhanced in order to encourage participants to collaborate voluntarily.

Progressive and Conservative Firms in Multistakeholder Initiatives: Tracing the Construction of Political CSR Identities Within theAccord on Fire and Building Safety in Bangladesh

The proliferation of multistakeholder initiatives (MSIs) over the past years has sparked an intense debate on the political role of corporations in the governance of global business conduct. To gain a better understanding of corporate political behavior in multistakeholder governance, this article investigates how firms construct a political identity when participating in MSIs. Based on an in-depth case study of the Accord on Fire and Building Safety in Bangladesh—an MSI established after the collapse of the Rana Plaza garment factory complex in 2013 to improve working conditions in the Bangladeshi garment industry—we introduce the construct of a political CSR (corporate social responsibility) identity (PCSRI) and explore how firms construct their PCSRIs in MSIs. Employing a qualitative, inductive theory-building method, we analyze interviews and archival data to develop a framework that elucidates how companies construct their PCSRIs within a continuum ranging from conservative to progressive. We show that constructing a PCSRI involves enacting specific, yet interrelated, political strategies that are themselves shaped by several forces over time. This article contributes to the literature by providing a political perspective on organizational identity construction that extends the emerging integrative perspective in political corporate social responsibility (PCSR) research. We suggest that MSIs should be conceptualized as inherently political governance mechanisms that are driven by multidirectional and dynamic political processes of identity construction. Our study shows that corporate political engagement in MSIs is a more nuanced and complex phenomenon than presently theorized.

Can multinational companies foster institutional change and sustainable development in emerging countries? A case study

AbstractEmerging countries present institutional necessities that hinder their sustainable development. In the face of this challenge, companies, and in particular multinational companies (MNCs), can foster sustainable development through their corporate social responsibility (CSR) initiatives. This study focuses on the role of institutional change in transforming CSR into sustainable development in emerging countries. To this end, we propose a view of CSR focused on its institutional determinants and outcomes from a social and developmental perspective. By using quantitative and qualitative data, we analyse the case of three MNCs from different industries based in Europe and operating in Mexico. The case study shows how firms can stimulate institutional change in developing economies and contribute to their sustainable development as measured by the sustainable development goals. Various mechanisms about how this process is made are devised: institutional entrepreneurship, multistakeholder initiatives, interconnection of different institutional dimensions, and subsidiary entrepreneurship. The case study highlights the interaction among MNCs, developing countries, and institutions and how firms' sustainable actions scale up to the macro level.

The power of third sector organizations in public education

PurposeThe purpose of this paper is to address school–NGO interactions by analyzing the power of foundations – a specific type of third sector organization or NGO in education.Design/methodology/approachData are collected through a quantitative survey, qualitative interviews, official documents, reports and websites. Social network analysis and grounded theory are used to analyze the data with the aim to develop a theoretical approach.FindingsThe study identifies three dimensions, i.e. relational, structural and discursive dimensions of power. Based on the analysis of an illustrative multi-stakeholder initiative, the paper highlights the role of foundations in framing educational settings, concepts and structures of the education system as such.Practical implicationsThe three-dimensional power perspective offered in this paper is particularly useful for scholars investigating school–NGO interactions or multi-stakeholder partnerships in education. Furthermore, it is of crucial importance for practitioners, school principals and education administrators dealing with school–NGO interactions given that foundations seem to be increasingly able to draw on new sources of power in these interactions.Originality/valueWhile the number and power of the third sector in education continues to rise worldwide, there is wide consensus that NGO power in education has, to date, hardly been researched. This paper contributes to this dearth of research by uncovering foundations’ different sources of power and by developing a theoretical approach for analyzing the power of third-sector organizations in education.

Multi-Stakeholder Initiatives on Sustainability: A Cross-Disciplinary Review and Research Agenda for Business Ethics

Although the literature on multi-stakeholder initiatives (MSIs) for sustainability has grown in recent years, it is scattered across several academic fields, making it hard to ascertain how individual disciplines such as business ethics can further contribute to the debate. Based on an extensive review of the literature on certification and principle-based MSIs for sustainability (n=293 articles), we show that the scholarly debate rests on three broad themes (“the 3Is”): the input into creating and governing MSIs; the institutionalization of MSIs; and the impact that relevant initiatives create. While our discussion reveals the theoretical underpinnings of the 3Is, it also shows that a number of research challenges related to business ethics remain unaddressed. We unpack these challenges and suggest how scholars can utilize theoretical insights in business ethics to push the boundaries of the field. Finally, we also discuss what business ethics research can gain from theory development in the MSI field.

Co-creation of patient engagement quality guidance for medicines development: an international multistakeholder initiative

IntroductionMeaningful patient engagement (PE) can enhance medicines’ development. However, the current PE landscape is fragmentary and lacking comprehensive guidance.MethodsWe systematically searched for PE initiatives (SYNaPsE database/publications). Multistakeholder groups integrated these...

Corporate social responsibility against workers?

Purpose This paper aims to investigate to what extent and for which reasons the codes of conduct and social audits of multinational corporations (MNCs) have failed to change practices within Chinese factories. A special attention is given to the social compliance initiatives (SCIs) and multi-stakeholder initiatives (MSIs) which did not overcome the main obstacles of the compliance approach. Design/methodology/approach This research is based on a fieldwork in China, including 36 semi-constructed interviews with practitioners involved in corporate social responsibility (CSR), participant observation in the CSR programme of the International Labour Organisation office in Beijing and several visits of factories involved in CSR programmes. Secondary sources are used to estimate the distribution of value added along global value chains (GVCs). Findings The codes of conduct and social audits tend to reproduce the domination of MNCs within GVCs. This paper highlights some obstacles – and opportunities – for CSR appropriate to the Chinese context. Research limitations/implications Only a few MNCs agreed to meet the author and speak openly. No one allowed the author to visit their suppliers’ factories. Practical implications The findings of this study suggest that the most widespread approach to CSR by MNCs is flawed. More attention should be given to specific institutional contexts and to workers’ participation. Originality/value CSR discourse and practices in China are put in the context of GVCs and in the transformation of Chinese industry and labour relations. This method allows going beyond a case study approach. Instrumentations of several SCIs and MSIs are also analysed in detail.

Assembled but unrehearsed: corporate food power and the ‘dance’ of supply chain sustainability

ABSTRACTIn recent years, many of the companies collectively known as ‘Big Food’ have undertaken efforts to assess and improve agricultural sustainability, both within their own supply chains and as members of multi-stakeholder initiatives (MSIs). Taking up Friedmann’s call for closer attention to corporate sustainability practices, this paper finds that companies are doing more than they advertise, but making slower progress than originally hoped. Up to a point, political economy perspectives on corporate power and governance help to explain both why these MSIs have taken shape, and why their corporate members’ immense market power might not guarantee quick results. Yet these perspectives do not fully capture how corporations’ sustainability efforts contend with not only other actors’ challenges to their legitimacy and authority, but also their own lack of knowledge and access to information. This paper therefore also draws on global assemblage and science and technology studies (STS) frameworks in order to analyze corporate power – and its limits – inside a set of ongoing sustainability initiatives.

Compliance Codes and Women Workers’ (Mis)representation and (Non)recognition in the Apparel Industry of Bangladesh

This paper explores how women workers in Bangladeshi garment factories are misrecognised and not represented in the apparel industry through focussing on two enacted collective compliance measure agreements adopted by global brands to improve safety and working conditions. Our paper draws on Amartya Sen’s rights-based approach to capabilities as a means of explaining the narratives of women trade union leaders and the experiences of women factory workers’ status in their workplace and in the industry. Specifically, we examine how a strategy of misrepresentation and nonrecognition of the women factory workers is being played out in the multi-stakeholder initiatives of compliance codes which leads to a lack of consideration for the basic human rights of the women workers. Our paper contributes to the discussion regarding how the politics of ethical procurement becomes visible through an exclusionary approach in managing the apparel global production network (GPN) despite the favourable consensus regarding the compliance codes.

Trade Unions in Multi-Stakeholder Initiatives: What Shapes Their Participation?

There is a growing concern about the extent to which multi-stakeholder initiatives (MSIs), designed to improve social and environmental sustainability in global supply chains, give a meaningful voice to less powerful stakeholders. Trade unions are one particular civil society group whose participation in MSIs has received little scholarly attention so far. The objective of this paper is to examine the determinants that enable and constrain trade union participation in MSIs. Based on interviews, focus groups, observations and document analysis we determine local trade union participation in three MSIs, operating at company, national and transnational level respectively, in the Costa Rican pineapple industry. To explain the limited encountered trade union participation, an analytical framework is developed combining structural and agency dimensions, namely the MSI design and trade union’s power resources. The findings show shortcomings in the representativeness, procedural fairness and consensual orientation in the design and implementation of the MSIs. These are, however, not sufficient to explain weak trade union participation as trade union power resources also have an influence. Strong network embeddedness and improved infrastructural resources had a positive effect, whereas the lack of internal solidarity and unfavourable narrative resources constrained the unions’ participation.

Framing sustainability: Alternative standards schemes for sustainable palm oil and South-South trade

Agri-food sustainability standards developed through multi-stakeholder initiatives (MSIs) are an increasingly prominent form of governance that seeks to enhance participation by a broader range of stakeholders in defining and implementing sustainable agricultural practices. However, they have been characterised by social scientists as largely depoliticising and marginalising in their effects, leading to responses from stakeholder groups such as contestation, compromises and attempts to ‘ratchet-up’ existing standards. In this paper, we consider a response to MSI-developed sustainability standards that has been given limited attention in the literature to date – the development of alternative standards schemes and the framing of sustainability in the context of South-South trade relationships. Through a focus on the Indonesian and Malaysian Sustainable Palm Oil schemes (ISPO and MSPO), we apply Callon's writing on ‘framing’ to highlight how these schemes provide a response to the perceived stringent framing of sustainable palm oil in the Roundtable for Sustainable Palm Oil standards. Our analysis shows that the ISPO and MSPO are important in the creation of alternative frames for including smallholders who may not have the capacities or resources to participate in the RSPO. More significantly, the ISPO and MSPO provide a way of reframing sustainable palm oil that enables the palm oil sector in Indonesia and Malaysia to bypass the perceived challenges of RSPO certification and to balance existing price-based demands from their main export markets of India and China with future prospective sustainability demands in those markets. The paper concludes by arguing that sustainability schemes geared towards markets in the Global South need to be given greater scrutiny in terms of how they: (a) address the exclusion generated by MSI-developed certification schemes, and (b) reframe sustainability in ways that meet the current and emerging market requirements in South-South trade.

Leaping Together Toward Sustainable, Patient-Centered Innovation: The Value of a Multistakeholder Safe Haven for Accelerating System Change.

Leaping Together Toward Sustainable, Patient-Centered Innovation: The Value of a Multistakeholder Safe Haven for Accelerating System Change.

Evolution of a multi-stakeholder initiative of health promotion in 20 suburban Roman districts

Evolution of a multi-stakeholder initiative of health promotion in 20 suburban Roman districts

1888P - Improving value for cancer patients: A European study of outcomes in practice

Background: ICHOM (International Consortium for Health Outcomes measurement) and All.Can– an international multi-stakeholder initiative – are in partnership to identify and support a community of European hospitals to assess how they can optimize the efficiency of cancer care in breast and lung cancer patients. Methods: A community of 10 hospital sites for lung cancer and 10 for breast cancer will be supported to implement and measure the ICHOM standard sets of outcomes. This community will measure clinical and patient reported outcomes and will use Time Driven Activity Based Costing to measure the cost to deliver cancer care. Guidance will also be provided to the community to support the utility of outcomes and cost data. The All.Can Patient Survey will also be deployed at the sites to obtain patient insights on sources of potential inefficiency in their care. Additional aspects of care, including intervention type and delivery of care, will also be measured based on results of an international literature review on determinants of value in the two indications. Outcome domains for collection for lung cancer patients include survival, complications, other outcomes such as treatment delays and quality of measures at the end of life. For breast cancer, the outcomes domains include survival and cancer control, disutility of care such as the impact of acute complications and degree of health. All data will be collected over a six-month period. Outcomes data will be collected on all patients with a first diagnosis of lung or breast cancer, followed up over a 6-month period, with three data collection points: (1) immediately after diagnosis, prior to treatment initiation; 3 months and 6 months after treatment initiation. Results: Risk adjusted outcomes and costing data for the lung and breast pathways will be compared to one another to identify variation and its potential drivers. Qualitative interviews and insights from the All.Can Patient Survey will be used to identify barriers and enablers to value measurement and innovative value improvement strategies. Conclusions: Findings will guide All.Can policy recommendations to improve the efficiency of cancer care. Legal entity responsible for the study: International Consortium for Health Outcomes Measurement (ICHOM). Funding: Bristol-Myers Squibb (main sponsor), Amgen, MSD and Johnson & Johnson (sponsors). Disclosure: All authors have declared no conflicts of interest.

Lessons for Effective Governance: An Examination of the Better Work Program

Recent decades have seen a proliferation of global multistakeholder initiatives that address “problems without passports,” but the effectiveness of these initiatives is debatable. This article discusses Better Work, an initiative that improves labor standards in the garment industry. It provides an overview of the program and discusses five lessons from Better Work that can be applied to other initiatives. These are: cooperation can be more effective than coercion; training complements the application of incentives; local ownership is critical for global initiatives; international organizations can anchor initiatives to prevent capture by powerful stakeholders; and multinational corporations can be responsible partners, but should not play a leading role.

Stakeholder Perceptions of the Environmental Effectiveness of Multi-stakeholder Initiatives: Evidence from the Palm Oil, Soy, Cotton, and Timber Programs

The roundtable on sustainable palm oil (RSPO), the round table on responsible soy (RTRS), the better cotton initiative (BCI), and the forest stewardship council (FSC) are examples of multi-stakeholder initiatives (MSIs), established to foster sustainable commodity production. While these programs are promoted as collaborative schemes for natural resource management, the significant gap in understanding of MSIs’ effectiveness presents a major concern over the credibility and legitimacy of such programs. We explore stakeholders’ perceptions of the environmental effectiveness of four MSIs in relation to their impacts in reducing agrochemical use and conserving habitats. We found that stakeholders feel positive about the role of the schemes in advocating environmental sustainability in the commodity sectors, and establishing norms of good practice. However, numerous issues, including the inadequate monitoring and evaluation contribute to perceptions of ineffectiveness and a lack of confidence in the schemes’ ability to drive fundamental transformation in environmental performance.

The Dynamics of Legitimacy in Multi-stakeholder Initiatives: Insights from the RSPO case

Multi-stakeholder Initiatives (MSIs) fill an important role in governing Corporate Social responsibility (CSR) issues but need to be legitimate if they are to be effective in influencing business practices. To address this relevant issue Mena and Palazzo (Bus Ethics Quarterly, 22(3): 527-56, (2012)) conceptualized MSI legitimacy identifying its dimensions (input and output), related criteria and how these can be operationalized. Based on an in-depth study of the Roundtable on Sustainable Palm Oil (RSPO) this research provides a refinement to Mena and Palazzo’s (2012) framework. We propose two new criteria of MSI legitimacy; participation and adoption. We also refine two existing criteria by identifying that transparency consists of inward and outward transparency and that for efficacy, ideological and practical objectives are necessary. Moreover the paper adds a dynamic dimension to the framework, illustrating interdependences between and across input and output legitimacy criteria. Results highlight that to maintain legitimacy, MSIs should set both practical and ideological objectives, manage inward and outward communication and ensure both member participation in decision-making and substantial adoption of standards and rules. We also highlight the interdependencies between legitimacy criteria noting that a weakness in one criterion is likely to impact other facets of MSI legitimacy.

Why do Firms Support Transnational Industrial Relations Arrangements? A Processual Lens

Looking at the emergence of transnational industrial relations (TIRA) systems in the global garment industry, this paper explores firms’ decisions to join TIRAs. Taking a multi-level processual lens, we examine the case of the Action Collaboration Transformation initiative (ACT), a new multi-firm TIRA aiming to implement living wages in the global garment industry. Our data shows that ACT membership cannot be fully explained by the drivers emphasized in the existing literature, such as firms’ reputational sensitivity, firm size, market segment or firm type. Rather, our inductive approach shows that the creation of ACT occurred through the interaction of multi- level processes connecting micro and macro level dynamics. Our analysis makes two contributions to extant literature. First, we show how labor governance and CSR institutions – such as CSR departments within firms and multi-stakeholder initiatives – can foster particular kinds of agency and stimulate further institutional development across issue domains within the same industry. Second, we highlight the importance of interpersonal relationships and human agency in the development of TIRAs as a new, union-inclusive form of labor governance.

Which Firms Leave MSIs? A Resource Dependence Perspective on the UN Global Compact

Abstract: This study analyzes which firms leave multi-stakeholder initiatives (MSIs) for corporate social responsibility (CSR). Based on an analysis of all active and delisted participants from the...