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How does adaptive implementation work in practice? Drawing on extensive interviews and observations, this paper contrasts the ways in which an adaptive component of a major health care project was implemented in three program and three matched comparison states in Nigeria. The paper examines the bases on which claims and counterclaims about the effectiveness of these approaches were made by different actors, concluding that resolution requires any such claims to be grounded in a...
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How and to what degree is the World Bank putting its new institutional citizen engagement (CE) commitments into practice? This question guides an independent assessment that the Accountability Research Center (ARC) at American University has undertaken as part of the Institute of Development Studies-led Action for Empowerment and Accountability (A4EA) research programme’s investigation into how external actors can best support local processes of and conditions for empowerment and...
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This paper examines adaptive approaches to aid programming in Nigeria. Through field research and desk reviews, we have investigated some of the assertions around the ‘adaptive management and programming’ approach, which has arisen in recent years as a response to critiques of overly rigid, pre-designed, blueprint and linear project plans. This is the second of three case studies in a series which explore if and how adaptive approaches, including rapid learning and planning responses, are...
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Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in conditions in different jurisdictions present very substantial challenges to reformers, and militate against adopting one-size-fits-all policy solutions. As a consequence, approaches to change management in China have frequently emphasised the importance of sub-national experimentation,...
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There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing...
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The National Monitoring and Evaluation System of Costa Rica and its corresponding laws were established during the 1990s. Since then, the country has endeavored to implement monitoring and evaluation (M&E) activities as part of its public policy framework. Nevertheless, hardly any systematic evaluations had been conducted, and monitoring activities had been reduced mainly to the institutional self-reporting of implementation compliance. Persisting regional disparities and growing levels of...
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LASER synthesis papers aim to help donors and other stakeholders better understand why and how to approach investment climate reform programming differently. The papers reflect emerging best practice and lessons learnt on what works and what does not work in doing development differently. The papers have been peer-reviewed by experts in the field including senior advisers at DFID, World Bank, IFC and the Donor Committee for Enterprise Development (amongst others).
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This case study describes how LASER has gone about enabling systemic change and sustainable uptake of reforms that address complex institutional problems in Kenya, Rwanda, Sierra Leone, Somaliland and Uganda. In each of these countries LASER has designed-in a sustainable approach from the start based on: (i) local ownership and leadership of reforms based on developing country (rather than donor) priorities; (ii) use of country (rather than donor programme) systems; and (iii) an...
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