Paths to innovation ecosystem robustness: An fsQCA of structural and relational conditions in Dutch healthcare innovation ecosystems

Innovation ecosystems must be robust to withstand internal disruptions. Ecosystem orchestrators can shape robustness through structural and relational governance mechanisms, yet little is known about how they interact. This study explores governance configurations conducive to internal robustness in Dutch healthcare innovation ecosystems. Drawing on 27 orchestrator interviews and a fuzzy-set Qualitative Comparative Analysis (fsQCA), we identify three archetypal pathways: Structured Collaboration, Coordinated Trust, and Directed Autonomy. Across all pathways, value capture emerged as a necessary condition for sustaining engagement. The findings extend emerging literature on ecosystem robustness by demonstrating equifinality and substitution logics: robustness can be achieved through multiple, context-dependent governance designs. We contribute a typology of governance archetypes, linking maturity stages, trust dynamics, and governance mechanisms, offering both theoretical insights and practical guidance for orchestrators.