Enabling adaptation

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One of the most important insights to come out of the accountability and complexity research fields over the past decade or so, is that as important as local feedback is to getting stuff done (whether this stuff is about improving services or reducing inequalities or enhancing democracy), those on the receiving end of feedback have to actually have the capacity to make improvements.  Capacity can mean lots of things:  power, skills, knowledge, resources, incentives and so on.

One of the problems with this is that in the aid sector, most funding does not really allow for adaptation.  At the excellent LSHTM Centre for Evaluation symposium on Timely Evaluation that I went to last week, a number of presenters and participants pointed out that even where evaluation procedures allowed for rapid, short feedback loops, the “project cycle” – with its predetermined 3-5 year plan for processes and outcomes – hampered any real prospect of change.  At best, we heard that reactive adaptations are possible but only to the extent that they don’t rock the boat. Just so long as they fit in the logframe, in other words.  And one of the few examples given of where rapid feedback did lead to immediate adaptation came from routine monitoring of a routine service (the application of statistical process control to routine healthcare services). I.e. not a project.

I noticed in Duncan Green’s latest “vlog” (from Myanmar where he is visiting adaptive management projects) that he said there was lots of good stuff happening but because it is so fluid and non-linear it is “hard to report on”.  But often the main reason we even need to report on projects is because they are… projects.

Pointing out the limitations of the logframe and the project cycle, and “planning”, is of course not new; and in any case the cycle has been pretty resistant to these critiques.  But the discussions have got me thinking about a couple of things that might be worth looking into.

Firstly, I’ve not seen a lot of work on identifying the determinants of adaptation.  In other words, do we know what it is that leads a service provider or a project manager to improve what they are doing? I made a few suggestions above but it would be good to see some rigorous work on identifying these determinants and on how best to flip the switches. How can we make it easier for providers and managers to do the right thing?

Secondly (and related), in the aid sector there has been a great deal of research on the impact of unconditional cash transfers to individuals and households, and on the impact of performance based funding for service providers.  But I’m not aware of  much knowledge on the use of unconditional cash transfers directly to service providers.  Could providing flexible or contingency resources directly to frontline service providers increase their capacity to gather and act on feedback and make improvements to how they deliver services?  Institutional or facility-level cash transfers?

The third thing that interests me right now – still in the development sector – is the idea of bringing real-time evaluation methods and skills into routine services.  Most of the aid sector’s evaluation efforts are directed to evaluating aid funded projects, and many are also tied into research publication requirements.  So they suffer from the same “project cycle” problems.  But in lower income countries, many public services are actually provided without aid funding – or with minimal aid funding.  They are not timebound projects although they are vulnerable to ebbs and flows in funding.  I’d like to see more aid resources going to support evaluation and improvement capacity in those services rather than focusing on measuring aid impact.

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Ownership

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Aid donor 1: So I thought we should meet to talk about how better to coordinate our [thing] distribution programme.

Aid donor 2: yes, thanks for the initiative, we’ve heard from the government that they would like us to rationalise our efforts – it’s a huge country but the way we’re working right now, most of the [things] are concentrated in 2 or 3 districts, and…

Aid donor 1: True, but those are also the districts where the highest number of people needing [things] live, and we’ve decided that they should be our [thing] focus districts for our programme going forward. At least for the next year.

Government: Can I…

Aid donor 2: OK, so we’re fine with that, we can just move out of your [thing] focus districts and go to other districts.

Aid donor 2’s number 2: Kind of, but our [thing] distributors are going to struggle with that because they’ve built up all their [thing] distribution networks in those districts, they’ve influenced [thing] consumption norms, they no they can hit their targets because there are high levels of [thing] demand there, they’ve…

Aid donor 1: OK so let’s have a transition plan so that you can hand over those districts…

Aid donor 1’s number 2: I’m not sure we want them to hand them over entirely

Aid donor 1: Really?

Aid donor 1’s number 2: The thing is, in some of those districts we are promoting the [things], changing attitudes to [things], and building the capacity of [thing] distributors, but we aren’t actually funding the [things]. Aid donor 2 is paying for the [things].

Government: There’s also some work there by Aid donors 3 and 4, and in a couple of districts we are using government money to…

Aid donor 2: So will you take over the funding of the [things] in your districts, Aid donor 1?

Aid donor 1: Yes of course! Mostly. I mean, some of them – but we’re talking a LOT of [things]. We might need you to keep on paying for some of them. Quite a lot of them, even.

Government: What we would like is for each Aid donor to fund its own [things] in its own districts (they’re actually not really *your* districts because it’s not your country, but whatever…).

Aid donor 1: Yes, Government, absolutely, that’s what we want and what we will do.  But it’s also important to be flexible.

Aid donor 2: So Aid donor 1, you are going to take over some of our [thing] consumers?  Then you get all the people already consuming [things] and we have to build up our [thing] consumer numbers from scratch again.

Aid donor 1: Well actually they are our [thing] consumers already.

Aid donor 1’s number 2: Our definition of a [thing] consumer includes anyone who got a [thing] in our districts even if we didn’t actually pay for the [thing].

Government: If you add all of your [thing] consumers together, that’s well over a hundred thousand [thing] consumers – great impact!

Aid donor 2’s number 2: But you can’t add those numbers together. In some cases they’re the same [things]. They’re the same [thing] consumers. That would be double counting.

Aid donor 1: That’s our definition and that’s what we have to report. We want to know who our [thing] consumers are. They are ours. OURS.

Doing aid differently

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If you don’t have time to read ODI’s 50 odd page report on Adapting development (part of the “doing development differently” movement) then I can recommend at least looking at Duncan Green’s good summary here. It is full of good examples and will probably have most aid people nodding (once they get over cringing at the concept that development is something that international donors and NGOs “do”).

I also find it slightly frustrating because although these insights have been gaining currency for a few years now I’m not optimistic that aid agencies are really taking them on board (something which I keep going on about: blah; blah; blah).

My pessimism stems largely from knowing what most aid agencies are like but I also feel like the recommendations in the report don’t exactly rock the boat:

• Being adaptive and entrepreneurial.

• Supporting change that reflects local realities and is locally led.

• Aiding development that is politically smart and locally led.

And for monitoring the extent to which programmes adopt these approaches:

• Measures of the extent to which issues have local salience or relevance, and whether processes give priority to local leadership and capacity.

• Evidence of adaptation to context.

• Evidence of learning in action.

• Measures of innovation and entrepreneurial action.

These are fine but they just look a bit too much like things that most aid agencies claim they are doing anyway – you’d be hard pushed to find an agency that does not believe it is living these values already.  And as for the monitoring recommendations I’m envisioning swathes of new toolkits and indicators that “promising local change agents” are going to have to spend even more time reporting on and telling donors about (and consequently having far less time to promisingly agent local change). And given how much we love a shortcut, it’s not a stretch to imagine that “asking simple questions about the extent to which users and local networks and organisations are involved in issue selection, design and implementation” could very easily turn into mandating the precise structure and composition of the multi-sectoral local coordination committee. E.g.

In short, while I think a lot of the thinking in this report is going in the right direction, it feels to me like it is a version of progress and development that is all about aid donors and (smart) international aid people.  And while I do think we can contribute a lot, I don’t think it should be left up to us.

Counting

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Here’s a screen shot of the marketing email that academic health publisher LWW sent to me yesterday.  And where they state that three healthcare workers worldwide have been infected by Ebola.

I think they’re only counting the ones in rich countries.

LWW Ebola

Taking responsibility

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A quick post after a long hiatus.

Aid donors have, for a long time, asked recipient governments (or agencies) to come up with counterpart funding, or in layperson’s terms, to pay a share of the cost of a programme.  It is a slightly complex issue, given that money is fungible – for instance, if the UK’s DFID were to offer a country £9 million for an HIV treatment programme on the condition that the country would stump up a further £1 million, that £1 million has to come from somewhere. We’d like to imagine it is going to be taken off the defence budget but the chances are it will come from somewhere else in the health budget.  Either way, it means the donor is using their financial clout to influence how the recipient government’s spending decisions.

There’s another conundrum.  Often a donor will pay out on a co-funded programme on the basis that the recipient government has given a guarantee or commitment that it will pay its share.  But what if that share never comes – either due to bad will, or because there were other, more pressing claims on that pot of money?  Should donors “trust” commitments from recipient governments?  If they’ve got reason to believe that the co-payment might not be forthcoming, should they decide to spend the money in another country, where the government is going to co-pay?  Do they take the risk and fund the programme with an unreliable co-funding commitment?  Or do they decide to scrap the co-payment condition and give the funds anyway, so as to avoid the embarrassment and reputational risk of the co-funding never coming through?

The last scenario seems to defeat the whole purpose of co-payment policies, but it probably means more lives will be saved (which is, after all the purpose of aid).  But what is worrying about it, is that it means the donor is taking responsibility for the possible/probable default of the country. Whose responsibility is it?