Abstract
Social purpose initiatives rarely take place in only one sector or policy domain. They are likely to cross sector, community, local, and national interests and, in so doing, require alternative governance arrangements that are responsive and sustainable. This article focuses on the process of forging such governance processes drawing on a case study characterized by complex cross-sector demands. The subject of the case study is a paradigm-breaking primary health and well-being initiative for a region of New Zealand with longstanding healthcare challenges, but contemporary possibilities. We were invited by the creators of this initiative to record and reflect on the challenges and successes and, from this, to identify what might be possible for future innovations. In doing so, we draw on the adaptive governance literature to frame the governance challenges and offer five paradoxes requiring collective navigation. We conclude with a series of recommendations on how such paradoxes are navigated for those needing to build governance practice in innovative social purpose initiatives and recognize the importance of engaging with indigenous scholarship in future analyses.