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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,...

Doing development differently rests on deliberate efforts to reflect and learn, not just about what programmes are doing and achieving, but about how they are working. This is particularly important for an action research programme like Child Labour: Action- Research-Innovation in South and South-Eastern Asia (CLARISSA), which is implemented by a consortium of organisations from across the research and development spectrum, during a rapidly changing global pandemic. Harnessing the potential...

This learning paper highlights how elements of outcome mapping were used by Save the Children Sweden in a project (2018-2020) that supports adolescents, affected by the Syria crisis, to become more resilient. The paper first outlines how the spheres of influence framework has been applied to develop an actor focused theory of change. It then describes how progress markers, as an alternative to SMART indicators, were formulated to monitor the programme’s results. The paper also outlines how...

In order to support the digital transformation of government operations Digital Learning Modules for Civil Servants are available, an off-the-shelf package of capacity development in form of replicable training modules to empower public servants at both the local and central government level to be leaders of digital transformation for delivering better public services. The modules cover a multitude of fundamental areas: comprehending digital government and services, human-centered design...

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...

Calls for more ‘adaptive programming’ have been prominent in international development practice for over a decade. Learning-by-doing is a crucial element of this, but programmes have often found it challenging to become more learning oriented. Establishing some form of reflective practice, against countervailing incentives, is difficult. Incorporating data collection processes that generate useful, timely and practical information to inform these reflections is even more so.This paper...

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...

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...

What Passages has Learned about Adaptive Management: • Be reflective about information that is collected and create a culture of learning. • Be systematic about establishing monitoring and learning systems. • Be strategic about data sources and analysis, prioritizing areas for learning and addressing issues raised. • Be inclusive about information collection: who is collecting what, how, and how is it being used.

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...

DT Global is proud to introduce our new Guidance Note: Practical Introduction to Adaptive Management There is a growing consensus around adaptive management as an effective (even necessary) approach when programs are tackling complex development problems. While there is no standard definition of adaptive management, there is general agreement that such programs need to routinely engage with and respond to program context; constantly test what works in that context; and adjust approaches,...

This thesis applies ideational and institutional theories to analyse how two specific ideas, results and adaptation, have changed the theory and practice of development cooperation. The thesis addresses the question of why the results and adaptation ideas are often treated as binaries and how this debate has evolved historically. In a first theoretical paper, the evolution of results and adaptation is conceptualised as a combination of institutional layering and diffusion within development...

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...

Executive Summary When Christian Aid (CA) Ireland devised its multi-country and multi-year Irish Aid funded Programme Grant II (2017-2022), they opted to move away from a linear programme management approach and to explore an adaptive one. Across seven countries: Angola, Colombia, El Salvador, Guatemala, Israel and the occupied Palestinian territory, Sierra Leone, and Zimbabwe, CA and partner organisations support marginalised communities to realise their rights, reduce violence and address...

This report addresses the well-recognized evidence gap1 on the longer-term impacts created by marketdriven programming; specifically, programming influenced by market systems development (MSD) principles. It does so by presenting the findings of an ex-post study conducted three and a half years after the close of USAID’s Feed the Future Senegal Naatal Mbay Activity (hereafter Naatal Mbay) in 2019. It examines the scale and sustainability of changes resulting from Naatal Mbay’s introduction...