Political Economy of Reforms: A Case Study of Telemedicine Project in Sheikhupura, Punjab
Keywords:health, informal institution, Sub-National Governance (SNG), New Institutional Sociology (NIS), local development
The paper explores the applicability of New Institutional Sociology (NIS) as systemic pathways and inadequacies of New Public Management (NPM) towards the institutionalization of the Telemedicine Project in Punjab, Pakistan. While advancing qualitative evidence, the study observes the technical, procedural and operational inadequacies in the design, implementation and institutionalization of the Telemedicine Project. Evidence collected through primary data collection techniques and supported by secondary data obtained from the district government Sheikhupura, Punjab has been used to understand the lack of institutionalization of the Telemedicine Project. The two primary aspects of the research are: (i) a diagnostic of the design, implementation and institutionalization of the intervention within service delivery frameworks of the Government and, (ii) the application of the NIS as a theoretical framework to understand the dynamics constraining the desired institutionalization of the Telemedicine Project. The paper finds that adoption of ‘one size fits all’ approach, lack of understanding of local development context and the role of informal institutions such as culture, norms and traditions, play a critical role in the success or failure of public sector reforms.