Formal and informal institutions in governance networks: managing diabetes in Australia and India

Abstract

Networks are increasingly being used a models to capture elements of governing neglected by the bureaucracy and market models in public administration and management. However, extant literature on networks uses the concept in a narrow manner, and tends to mostly focus on formal networks. Informal networks have not received adequate attention. In this paper I argue that it is equally important to focus on informal networks, in addition to the formal networks, in public administration and management. Based on a comparative case study of diabetes care in Australia and India, this paper develops a typology of diabetes network in these two countries with the type of network (that is, formal and informal networks) on one side of the matrix and the type of health professional (that is, professional and non-professional) on the other side. Mapping the prevailing diabetes care of the two countries onto the matrix reveals that diabetes care in Australia relies mostly in the formal network quadrants, that is, health professionals and voluntary and community groups. And diabetes care in India relies on the informal network quadrants, that is, non-health professionals and personal communities. While the paper discusses some of the reasons why each of these countries rely on a particular type of network for diabetes care, the main finding of the paper is that infusing aspects of the formal and informal networks results in improved health outcomes for people with diabetes as well as reducing the increasing costs of diabetes care. The field of public administration and management can certainly draw on the experiences of diabetes care by using both formal and informal networks to improve outcomes as well as to minimize expenses. T H