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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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Transdisciplinarity is not a new science per se, but a new methodology for doing science with society. A particular challenge in doing science with society is the engagement with non-academic actors to enable joint problem formulation, analysis and transformation. How this is achieved differs between contexts. The premise of this paper is that transdisciplinary research (TDR) methodologies designed for developed world contexts cannot merely be replicated and transferred to developing world...
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Abstract Motivation On December 15, 2012 Sombath Somphone was abducted at a police checkpoint in his home city of Vientiane, the capital of Laos; his whereabouts remain unknown. This article considers his work and disappearance through the lens of Thinking and Working Politically (TWP) approaches to development. The article is supportive of TWP, but emphasizes the significant risks of politicized programming in authoritarian contexts. Purpose By examining the case of Sombath Somphone, the...
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Diverse approaches to promoting disability inclusive employment aim to transform workplaces into truly inclusive environments, usually with intervention strategies targeting two main groups: employers and jobseekers with disabilities. However, they do not always consider other relevant stakeholders or address the relationships and interactions between diverse actors in the wider social ecosystem. These approaches often neglect deeper ‘vexing’ difficulties which block progress towards...
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This chapter examines good practices in implementing effective Monitoring, Evaluation, and Learning (MEL) systems within complex international development Democracy, Human Rights, and Governance (DRG) programs, which are characterized by challenges of non-linearity, limited evidence of theories of change, and contextual and politically contingent nature of outcomes. The chapter presents three cases of MEL systems in complex projects implemented by Pact across distinct and diverse operating...
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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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Motivation This paper explores adaptive approaches to development programmes that aim at improving service provision in underperforming sectors in fragile and conflict affected states (FCAS). It does this through a case study of the Integrated Maji Infrastructure and Governance Initiative for eastern Democratic Republic of the Congo's (IMAGINE) public-private partnership model for water provision. Purpose The processes and decisions that culminated in IMAGINE's model emphasize the need...
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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 theme of learning from experience as a means of improving the effectiveness of rural development projects and programmers has been common in recent years. Considerable effort has been put into refining, monitoring and evaluation systems to enhance organizational learning processes. However, an emphasis on normative approaches to evaluation and learning from experience has led to the neglect of research into the actual processes by which rural development agencies utilize experience. The...
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How have local governments in China been able to break through central policy restrictions in a unitary and authoritarian political system? Why is China's official discourse in the reform era often so conservative and unfavorable to reform? The author argues the two issues are components of a signaling game between China's central government and local officials, in which local officials know that the center may be reformist, but the reformist center imitates the rhetoric of a conservative...
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Motivation In the last decade, a movement formed around making aid delivery more adaptive, relying on principles such as context sensitivity, flexibility, and ownership. The approaches seem promising for civil society organizations (CSOs) to fulfil their mission of fostering social transformation. While several donor agencies have started engaging with such approaches, the authors hardly see their political implications in practice. Purpose The article aims to provide evidence on an adaptive...
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Meeting the United Nations Sustainable Development Goals (SDGs) will require adapting or redirecting a variety of very complex global and local human systems. It is essential that development scholars and practitioners have tools to understand the dynamics of these systems and the key drivers of their behavior, such as barriers to progress and leverage points for driving sustainable change. System dynamics tools are well suited to address this challenge, but they must first be adapted for...
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The positive deviance approach in international development scales practices and strategies of positively-deviant individuals and groups: those who are able to achieve significantly better development outcomes than their peers despite having similar resources and challenges. This approach relies mainly on traditional data sources (e.g. surveys and interviews) for identifying those positive deviants and for discovering their successful solutions. The growing availability of non-traditional...
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