Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 13 1 2024 12 01 Identifying Positive Practices to Institutionalize Social Innovation in the Malawian Health System 1 11 4675 10.34172/ijhpm.8141 EN Lindi Van Niekerk Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Chembe Collaborative, Los Angeles, CA, USA Lenore Manderson School of Public Health, University of the Witwatersrand, Johannesburg, South Africa School of Social Sciences, Monash University, Melbourne, VIC, Australia Nedson G. Fosiko The Malawi Ministry of Health, Lilongwe, Malawi Andrew Likaka The Malawi Ministry of Health, Lilongwe, Malawi Carla P. Blauvelt VillageReach, Lilongwe, Malawi Barwani Msiska Malaria Alert Centre, Kamuzu University of Health Sciences, Blantyre, Malawi Susan Rifkin Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2023 05 31 Background Governments worldwide are increasingly interested in scaling up effective public health innovations, but it is not always easy to institutionalize innovations, arising outside the public health system, as a part of national delivery. Evidence on how country governments can practically achieve this is limited. This article describes the institutionalization of the Chipatala Cha Pa Foni (CCPF, Health Center by Phone) social innovation into the Malawian public health, and identifies positive institutional practices that local actors drew on to achieve this. Methods A positive-oriented interdisciplinary multi-method qualitative case study design was adopted. Data were collected from key informant interviews, observations, and documents over 18 months. A composite social innovation framework, informed by institutional theory and positive organizational scholarship, guided the thematic content analysis. Results Four clusters of positive institutional practices aided the institutionalization of the innovation: building highquality relationships; creating opportunities for experiential interaction; cultivating hope; and logic attunement and awareness. We describe how these four practices operated together as a process of “everyday creativity” to achieve institutionalization. We illustrate the importance of high-quality relationships, marked by respect, mutuality, and appreciation, as the foundation upon which hope can be built and the creativity needed for institutionalization to flourish. National ownership and sustainability of innovations are enhanced when implementation and institutionalization approaches are attuned to the logics inherent in national identity. Conclusion In this article, we highlight the importance of institutional and interpersonal dynamics in the institutionalization of social innovation in health systems.

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