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Innovation is crucial for improving health outcomes in low and middle-income settings (LMIS) in the U.S. and abroad. There has been extensive research on how organizations implement individual innovations separately. There has been less research on how organizations implement sets of innovations, how they are combined, and the drivers for these innovation sets. Furthermore, a lack of supporting infrastructure and challenges that arise from organizational structure and environmental uncertainty in LMIS require a better understanding of a combined approach to innovation. This study introduces the concept of innovation solution sets. We explore the relationship between innovation solution sets, combination approaches as influenced by organizational structure, and innovation drivers through a multi-case study using qualitative and archival information from five healthcare organizations in Repiblik Ayiti (Haiti). We find that organizations tend to combine product/service, business model, and social innovations simultaneously in private organizations and sequentially in public-private partnerships. Drivers of simultaneous combination include limited external support, determined autonomy through external opposition, and financial need identification and the requisite knowledge and will to meet the need. Drivers of sequential combination include social need identification, community connections, and flexibility.
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