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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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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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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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