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Table 4 Enablers and barriers

From: The application of social innovation in healthcare: a scoping review

Enablers Barriers
Stage 1: Idea development & implementation
A facilitator overseeing the process—guidance, bricolage, linkages with the system [73] External support—A social innovation process facilitated by professionals would be costly at scale [73]
A protective niche/environment—a safe setting for ideas to be developed and granting participants permission  
Open information sharing between participants and stakeholders across different sectors and disciplines, including involving community or frontline voices [61, 71, 73]  
Timing/Leveraging windows of opportunity—when resources and support is available. [70]  
Context—history of innovation and enterprise in a specific people group, alignment with cultural values, existing organizations, active civic participation [80, 86] Political context—a changing policy landscape and mandates [88]
Characteristics of the innovator—an insider (from local community, embedded and lived experience), access to different forms of capital (cultural, intellectual, political, social, financial) [65, 80] Characteristics of implementers—lacking motivation and drive [88]
Community ownership—self-governance structures to place the community (beneficiaries) in charge of the innovation [64, 65]  
Stage 2: Transfer/diffusion/scale
Alignment with existing regime and structures [74, 77] Political culture—A lack of willingness of the existing system or government to make allowance for the integration of the innovation or for new actors to play a role [69, 70]
Partnerships with stakeholders & especially policy makers [65, 74] Resource constraints—limitations in funding [65]
Digital formats e.g. applications, mobile phones, online networks [64, 66, 79] Limited evidence on social innovation effectiveness and unintended consequences [83, 85]
Stage 3: Institutionalisation
Political context—encouraging civic engagement and participatory democracy through discussion and deliberation between civil society and state; history of community organizing and social movements; political capacity of government to bring about changes in healthcare [86]  
Communication and advocacy—movement building by engaging a range of organizations to engage in the discussion/spread the message [77, 86]
Leveraging available infrastructure and competencies ( in contrast to creating new ones)—health facilities, health providers including traditional providers [77, 82, 86]
Political work—engaging existing institutions e.g., professional associations and forming new ones [77]
Educating work—developing training for new actors to become involved (medical professionals or volunteers) [77, 86]
Policing work—through certification of certain actors, quality is enforced and monitored [77]