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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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The practice of using rigorous scientific evaluations to study solutions to global poverty is relatively young. Although researchers continue to advance our knowledge of the mechanisms at work, confusion about their role and value persists. Having evidence from specific studies is fine and good, but for policy makers, the point is not simply to understand poverty, but to eliminate it. Do decisions always need to be informed by evidence from the local context? What potential and limits do...
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Development actors facing pressure to provide more rigorous assessments of their impact on policy and practice need new methods to deliver them. There is now a broad consensus that the traditional counterfactual analysis leading to the assessment of the net effect of an intervention is incapable of capturing the complexity of factors at play in any particular policy change. We suggest that evaluations focus instead on establishing whether a clearly-defined process of change has taken place,...
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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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Over the past 10 years or so the “Field” of “Mixed Methods Research” (MMR) has increasingly been exerting itself as something separate, novel, and significant, with some advocates claiming paradigmatic status. Triangulation is an important component of mixed methods designs. Triangulation has its origins in attempts to validate research findings by generating and comparing different sorts of data, and different respondents’ perspectives, on the topic under investigation. Respondent...
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