The Evolution of an Interorganisational Network in Higher Education: the Case of a Provincial Health Authority and Health Sciences Faculties in South Africa

  • Therese Fish

Student thesis: Doctoral ThesisPhD


This study investigated the evolution of an interorganisational network between a Provincial Health Department and the four universities located in a province in South Africa. The five actors within this network negotiated and signed a multiparty agreement in 2012, which following a history of decades of negotiations, was intended to establish governance structures to regulate their relationship and to formulate fundamental principles that would form the basis of the four revised dyadic agreements between each of the universities and the health authority. There has been slow progress towards the operationalisation of the network and the finalisation of the dyadic agreements.
This research study was conceptualised within the context of academic health complexes. These complex organisations have a tripartite mission of delivering high quality research, health professions education and clinical care. In different national and international settings, various organisational entities have been established to govern the interdependence between the health and higher education entities. This research conceptualised such an organisational entity as an interorganisational network.
A conceptual framework drawn from the process framework for interorganisational relationship development, the theory of networks and governance network theory was used to frame the study. An interpretative case study using a qualitative methodology was used to explore the evolution of the network. This approach enabled a socially rich, in-depth understanding of a complex interorganisational phenomenon with the exploration of both context and process. In keeping with the characteristics of case study research, data were collected in different ways and used documentary review and semi-structured interviews.
Thematic analysis was done to examine the text data to identify patterns and key concepts within the data. The tool used to organise this was thematic networks. Thematic networks are web-like illustrations which facilitate a three-level staging process constituting of six steps to systematise and present the qualitative analysis.
Analysis revealed four thematic networks. The four Global Themes represented by the networks were concerned with the following areas: Network Evolution, Network Development, Network Management and Organisational Capabilities. Each Global Theme contained lower order Organisational Themes and these in turn were comprised of Basic Themes. The four Global Themes were synthesised around an overarching theme of ‘networks as processes in flux’.
The findings show that the evolution of an interorganisational network between a health authority and regional universities is a complex and dynamic process. The network is influenced by exogenous and internal factors. These complexities included the legislative and policy disjuncture, a painful historical context and power asymmetry. The interdependence of the member organisations required a formalised structure to govern the relationships. A facilitative intervention developed twelve foundational principles which formed the basis for a transformative journey of collaboration. A number of shifts occurred which reflected the transformational interactions within the network. These were underpinned by the commitment of the actors to a journey of trust, strengthening of partnerships and the embedding of values within the network. Three key processes were critical in the evolution – the need for a change management and interorganisational learning process at a network level, a skilled team to drive the negotiations and careful consideration of the context specifically the historical context.
The conceptual framework used to frame the research was adapted to incorporate the components of context (specifically historical context), negotiations and change management. The revised framework could guide other networks on their journeys.
Date of Award8 Sept 2021
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorChristos Vasilakis (Supervisor) & Dan Davies (Supervisor)


  • Interorganisational networks
  • South Africa
  • Evolution interorganisational networks
  • academic health complexes

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