Co-creating innovation ecosystems in contexts of absolute uncertainty: The case of low-cost heart valves in India

The development of innovations aimed at tackling grand challenges requires the support of an appropriate innovation ecosystem. However, there is a limited understanding of how such innovation ecosystems emerge in contexts of absolute uncertainty. We addressed this gap by examining the boundary work carried out by key actors in the creation of the biomedical innovation ecosystem in India that supported the development of a successful low-cost heart valve over the 1976–1995 period. We developed a process model demonstrating how the ecosystem leader co-created the innovation ecosystem that led to the development of a low-cost heart valve by engaging in three types of configuration boundary work: establishing ecosystem configuration, modeling ecosystem configuration, and expanding ecosystem configuration. Our study contributes to the literature on innovations for grand challenges, innovation ecosystems, and boundary work.