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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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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...
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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...
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Reflection on how DFID was created.
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The United Kingdom’s (UK) Department for International Development (DFID) is an ambitious government department that is committed to reducing poverty and conflict overseas. Many of the issues on which DFID works are complex; whether focused on climate change, gender equality, health or other priorities, simple solutions rarely exist. And to tackle these complex challenges, DFID staff must interact with unpredictable systems of political, organisational and individual behaviours and...
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Development donors invest significantly in governance reform, including in contexts characterised by conflict and fragility. However, there is relatively little comparative study of their change strategies, and little understanding of what works and why. This paper explores the strategies of six recent DFID-funded programmes in Mozambique, Myanmar, and Pakistan with empowerment and accountability aims. Document review and field interviews are used to analyse the application of multi-scalar...
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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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The world changes too much for anyone who is invested in social change work to imagine that this work is linear and predictable. Opportunities come and go, whether caused by a pandemic or political shifts. This much most social movement leaders and activists intuitively understand. But what can be done with this realization? How might movement groups better prepare for moments of opportunity? We want to explore how we can create the changes we want to see by responding to the changes that are outside our control.
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The world faces converging crises of health, climate, gender and racial injustice and extreme economic inequality. The calls are mounting to ‘build back better’ to create more inclusive, caring and environmentally sustainable futures. But what evidence exists that this is possible? The Inspiring Better Futures case study series investigates whether radical change at scale is possible and how it was achieved. This paper synthesises 18 cases which show that people are already successfully...
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Achieving broad-based socio-economic development requires interventions that bridge disciplines, strategies, and stakeholders. Effective sustained progress requires more than simply an accumulation of sector projects, and poverty reduction, individual wellbeing, community development, and societal advancement do not fall neatly into sectoral categories. However, researchers and practitioners recognize key operational challenges to achieving effective integration that stem from the structures...
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The objective of this report, Integrating Local Knowledge in Development Programming is to share knowledge of how development donors and implementing organizations leverage local knowledge to inform programming. In a recent speech at Georgetown University, United States Agency for International Development (USAID) Administrator Samantha Power said, “As Americans with a fraught history living up to our own values, we’ve got to approach this work with intention and humility. But the...
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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...
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In September of 2014, USAID’s Office of Learning, Evaluation & Research (LER) awarded the Learning and Knowledge Management (LEARN) contract to Dexis Consulting Group and subcontractor RTI International.1 This document—the End of Contract Report—captures five and half years of results and reflections for our stakeholders. Our intention is to share the good and the bad, and while this report would not be considered a “tell all,” we think we have a story worth sharing, particularly to USAID...
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This report is the second in a program of evaluations that the Independent Evaluation Group (IEG) is conducting on the learning that takes place through World Bank projects. Learning and knowledge are treated as parts of a whole and are presumed to be mutually reinforcing.
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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...
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Adaptive management approaches potentially offer us opportunities to deliver high quality results in circumstances where change is complex, including in fragile, unstable or conflict affected places. However, building adaptive programming continues to be a challenge for the sector. For CARE, our Department for International Development -UK Aid funded Girls’ Education Challenge (GEC) programming has provided useful learning on how to operationalise adaptive approaches. In this paper we expand...
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