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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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This paper examines adaptive approaches in aid programming in a fragile, conflict and violence-affected setting (FCVAS), namely Myanmar. A combination of desk review and field research has been used to examine some of the assertions around the ‘adaptive management’ approach, which has arisen in recent years as a response to critiques of overly rigid, pre-designed, blue-print and linear project plans. This paper explores if and how adaptive approaches, including rapid learning and planning...
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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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Despite a swathe of critiques of logframes and other blueprint approaches to development over the last 30 years, most aid infrastructure continues to concentrate on the design and subsequent implementation of closed models. This article does not propose an alternative to blueprints, but challenges the inflexibility of their implementation, which is inadequate given the complex nature of social change. It proposes a supplementary management and learning approach which enables implementers to...
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More examples are needed of aid programming that works by being responsive to country realities: politically smart, problem-driven and locally led DFID’s SAVI programme has revealed a hitherto untapped potential for change leading to better development results at state level in Nigeria SAVI provides low-profile support to state-level organisations and partnerships, building their capacity to engage constructively with government It avoid the pitfalls of a donor-driven approach by...
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In this sequel to "Rural Development: Putting the last first" Robert Chambers argues that central issues in development have been overlooked, and that many past errors have flowed from domination by those with power.Development professionals now need new approaches and methods forinteracting, learning and knowing. Through analyzing experience - of past mistakes and myths, and of the continuing methodological revolution of PRA (participatory rural appraisal) - the author points towards...
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