We propose an analytical approach that links the theoretical literature discussing institutional origins to path dependency and institutional theory relating to proto institutions in order to illustrate the differences in coalition formation processes that shape governance within four multilateral agencies involved in global health.
Addressing this literature and comparing it with SCA's proposed path dependency and institutional change theories helps to justify why path dependency and institutional change theory was chosen and why these two schools of thought appear to be more advantageous in accounting for similar institutional challenges and change processes within multilateral health agencies.
While earlier in this article I underscored these theories' advantages when compared to other similar institutional theories, this is not to say that my proposed path dependency and institutional change theoretical frameworks can and should explain all types of path dependent and institutional change processes within multilateral health agencies.
Due to political decision making, path dependency, and institutional inertia, domain-specific policies differ from one another.
Although existing studies highlight the explanatory power of institutionalist theories for integration policies (see Boswell, 2008; Favell, 2001; Hansen, 2000, 2002; Koenig, 2007), the focus of the literature is predominantly on explaining path dependency and institutional change of these policies, and rarely focuses on the integration process as such.
Through this approach, investigators may use institutional theory, such as path dependency and institutional change theory, to select agencies for comparative analysis.
But it is also important to note that there are several limitations to the path dependency and institutional change theories used to conduct the SCA comparative method.
The application of path dependency and institutional change theory also leads to a sequential analytical approach to understanding the transformative capacity of multilateral health agencies.
This study has argued that we can provide insight into these questions by using social science institutional theories, such as path dependency and institutional change theory, to conduct a Sequential Comparative Analysis (SCA) of multilateral health agencies.
The path dependency and institutional change theories used in this article were provided as an example of the potential utility of using institutional theories to guide the selection and comparison of multilateral health agencies.
