Collaboration and Conflict at Chief Minister’s Initiative on Primary Healthcare (CMIPHC)

This case study is about the organization Chief Ministers Initiative on Primary Health Care (CMIPHC). The organization was created as a collaboration between the Government of Punjab province in Pakistan and a local nonprofit organization named Punjab Rural Support Program (PRSP). CMIPHC was given control of Basic Health Units (BHU) in 12 out of 36 districts of Punjab. However, the provincial health department retained the infrastructure in other aspects of public health. Despite signs of success, CMIPHC had come under criticism from the provincial health department officials and the local government administration throughout its operation. In 2014, the conflict had reached a point where the provincial government had started considering the closure of CMIPHC and returning BHUs to the provincial health department. The final decision was to be taken after a third-party evaluation. While the CMIPHC leadership was confident that a third-party evaluation would favour the collaboration, they were still concerned about the financial and functional stability of their organization. This was because the leadership felt that some officials from the local health department were resentful of the fact that PRSP was treading on their turf. This instruction manual uses a resource dependency framework to analyse the facts presented by the case and aims to help the students better understand the opportunities and threats posed by collaborative approaches to public service delivery.